Neurosurgery
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To determine the risks and survival benefit associated with implantation of an absorbable, 1,3-bis(2chloroethyl)-1-nitrosourea-impregnated polymer wafer, we prospectively studied patients with recurrent glioblastoma multiforme and compared them with a demographically matched cohort group. ⋯ 1,3-bis(2-chloroethyl)-1-Nitrosourea wafer implantation for recurrent glioblastoma was associated with a higher risk of postoperative complications, particularly those related to infection and wound healing. No clear survival benefit associated with wafer implantation was identified.
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A computer simulation based on the finite-element method was used to study the biomechanics of acute obstructive hydrocephalus and, in particular, to define why periventricular edema is most prominent in the anterior and posterior horns. ⋯ The distribution of periventricular edema in acute hydrocephalus is a result not only of increased intraventricular pressure but also of ventricular geometry.
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Schwannomas that arise from the trigeminal nerve are rare and are usually managed by surgical resection. The role of radiosurgery in the care of patients with these basal tumors remains to be defined. ⋯ As a minimally invasive alternative to microsurgery, gamma knife radiosurgery proved to be an alternative primary or adjuvant strategy that controlled tumor growth, did not cause new deficits, and often improved presenting symptoms.
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The present study was undertaken to explore the relationship between the characteristic geometry of aneurysms prone to rupture and the blood flow patterns therein, using microsurgically produced aneurysms that simulated human middle cerebral artery aneurysms in scale and shape. ⋯ The localized, extremely low-flow condition that was observed in the dome of aneurysms with aspect ratios of more than 1.6 is a common flow characteristic in the geometry of ruptured aneurysms, so great care should be taken for patients with unruptured intracranial aneurysms with aspect ratios of more than 1.6.
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The purpose of this study was to evaluate three modified, fiberoptic, oxygen saturation catheters as monitors of jugular venous oxygen saturation (SjvO2). ⋯ Catheter 3, which is now being marketed as the Opticath P540-H catheter, represents a significant improvement in performance and may make SjvO2 monitoring in the intensive care unit more practical.