Neurosurgery
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Review Historical Article
Three steps forward and 2 steps back: the Echternach procession toward optimal hydrocephalus treatment.
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Clinical Trial
The impact of sedation on brain mapping: a prospective, interdisciplinary, clinical trial.
During awake craniotomies, patients may either be awake for the entire duration of the surgical intervention (awake-awake-awake craniotomy, AAA) or initially sedated (asleep-awake-asleep craniotomy, SAS). ⋯ Cognitive and motor performance were significantly influenced by prior sedation in the TIVA and RAS groups, but not in the AAA group. Therefore, prior sedation may be assumed to cause a change in the baselines, which may compromise brain mapping and thus endanger a patient's neurological outcome in the case of an SAS.
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Angioleiomyoma (ALM) is a rare, benign smooth muscle tumor that can occur anywhere in the body. Diagnosis is usually delayed due to the unfamiliar location and presentation of the lesion. This tumor is not frequently discussed in neurosurgical publications as part of the differential diagnosis of painful subcutaneous lesions. To our knowledge, this is the first report of a neurosurgical presentation of ALM within an extremity. ⋯ Neurosurgeons should keep ALM in the differential diagnosis of painful extremity lesions. Localization using a fiducial marker directly overlying the area of suspicion is useful for the neurosurgeon and also for the radiologist so that the lesion may not be overlooked. Unnecessary interventions for the patient may be avoided with appropriate diagnosis, and surgical resection provides complete cure of the symptoms.