Neurosurgery
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Case Reports
Perimesencephalic nonaneurysmal subarachnoid hemorrhage caused by jugular venous occlusion: case report.
The cause of perimesencephalic nonaneurysmal subarachnoid hemorrhage remains unknown. We describe a patient in whom jugular venous occlusion preceded the occurrence of perimesencephalic nonaneurysmal subarachnoid hemorrhage. This finding supports the theory that the source of the hemorrhage is venous in origin. ⋯ The presence of acute jugular venous occlusion as a cause of perimesencephalic nonaneurysmal subarachnoid hemorrhage supports a venous origin of hemorrhage.
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Monitoring of brain tissue oxygen tension is increasingly being used to monitor patients after severe traumatic brain injury and to guide therapies aimed at maintaining brain tissue oxygen tension above threshold levels. The new Licox PMO combined oxygen and temperature catheter (Integra LifeSciences, Plainsboro, NJ) combines measurements of oxygen tension and temperature in a single probe inserted through a bolt mechanism. In this study, we sought to evaluate the accuracy of the new Licox PMO probe under controlled laboratory conditions and to assess the accuracy of oxygen tension and temperature measurements and the new automated card calibration system. We also describe our clinical experience with the Licox PMO probe. ⋯ The new Licox PMO probe is accurate but has a small, consistent tendency to under-read oxygen tension that is more pronounced at higher temperatures. The probe tends to under-read temperature by 0.5 to 0.8 degrees C across temperatures, suggesting that caution should be used when brain temperature is measured with the Licox PMO probe and used to guide temperature-directed treatment strategies. The Licox PMO probe improves upon previous models in allowing consistent and accurate placement in the white matter and obviating the need for placement of 2 separate probes to measure oxygen tension and temperature.
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Tumor control, facial function preservation, and hearing preservation are important criteria for successful management of intracanalicular vestibular schwannomas, whether observation, microsurgery, or radiosurgery is chosen. We collected data prospectively to assess hearing preservation after intracanalicular vestibular schwannoma radiosurgery. ⋯ SRS is a minimally invasive first-line management option for patients with intracanalicular tumors and provides high rates of hearing preservation with minimal morbidity.