World Neurosurg
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Neurocysticercosis (NCC) is the most common parasitic infection in the central nervous system and the most common cause of acquired neurological symptoms in young adults living in developing countries. Many "asymptomatic" patients begin experiencing neurological symptoms after the use of antiparasitic drugs for gastrointestinal treatment. Patients who are previously diagnosed with NCC require special care during cysticidal treatment because of the inflammatory effects caused by the interaction between the drug, the parasite, and the host. ⋯ Anthelminthic drug treatment requires tailor-based prescription considering risk-benefit ratio with the drug-parasite-host interaction in mind. Treatment is not harmless so patients have to be closely watched. In select cases, medical treatment cannot replace surgical procedures, which can be the primary approach with drug treatment as a complement.
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To analyze the impact of intraoperative ultra-low-field magnetic resonance imaging (MRI) on the extent of tumor resection in nonfunctioning pituitary adenomas (NFPAs). ⋯ This study shows that the outcome of surgical treatment of NFPAs was improved by the use of intraoperative MRI owing to more radical resection. The remission rate seems to depend on tumor characteristics. Recurrent disease might be reduced by the use of intraoperative MRI leading to more complete surgical resection of NFPAs.
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The stereotactic biopsy is widely integrated into clinical practice as an efficient and safe procedure for histologic diagnoses. However, the surgical risk increases when the lesions are close to the eloquence of the adjacent brain. The present report describes two patients with deep-seated brain tumors who underwent a stereotactic biopsy with electrical monitoring and demonstrates the importance of this technique. ⋯ This report describes two patients with deep-seated brain tumors who underwent stereotactic biopsies with electrical recording and stimulation. The electrical monitoring appears to be a useful technique to complement the ordinary image-guided biopsy.
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Delirium among critically ill patients is common. Presence of delirium imparts a poorer prognosis to patients, including longer ICU and hospital length of stay, increased risk of institutionalization, higher health related costs, and elevated mortality. ⋯ The importance of early recognition through validated tools and appropriate management of this life-threatening condition cannot be over emphasized. This article provides an overview of delirium pathophysiology, diagnosis, and management with a focus on critically ill patients.