World Neurosurg
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To describe three cases of delayed development of intracranial hypertension (IH) after surgical treatment of intracranial arachnoid cyst, including the pathogenesis of IH and a review of the literature. ⋯ The pathogenesis of delayed development of IH in this clinical setting is not clearly elucidated. When intracranial arachnoid cysts are treated, the possibility of future development of IH should be borne in mind. Delayed presentation with headaches in patients after treatment of intracranial arachnoid cysts should raise the possibility of IH.
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Fluorescence-guided surgery for cranial meningioma has been reported to be useful. There are no reports about spinal cases using this technique. We report on a meningioma of the cervical spine for which fluorescence-guided surgery was used. ⋯ Fluorescence-guided microsurgery is helpful in achieving a total resection of spinal meningiomas, and might therefore reduce the risk of recurrence.
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To examine the influence of cerebral vasospasm on health-related quality of life after subarachnoid hemorrhage. An additional objective was to determine how the timing of nimodipine therapy can influence health-related quality of life. ⋯ Cerebral vasospasm had little influence on health-related quality of life in our patient population. Health-related quality of life cannot be used as the only argument in favor of treating cerebral vasospasm with nimodipine.
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To determine if tubular microdiskectomy is associated with differences in hospital charges compared with open microdiskectomy. ⋯ This analysis revealed significantly lower acute hospital charges associated with tubular microdiskectomy versus open microdiskectomy at an academic tertiary care hospital. These differences appear to the related to decreased use of postoperative resources in the tubular group.
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Case Reports Biography Historical Article
Harvey Cushing's early treatment of meningiomas: the untold story.
In his 1938 monograph, Cushing tabulated 313 meningioma cases treated throughout his career at the Johns Hopkins and the Peter Bent Brigham Hospitals. Of these, 18 patients were treated at the Johns Hopkins Hospital. Cushing provided basic demographic, perioperative, and outcomes data in his tables, but the operative details for many of his early meningioma cases have not been previously described. ⋯ The operative details demonstrate Cushing's early attention to hemostasis, and use of staged resections in patients with large, highly vascular meningiomas. Cushing's first 18 cases of meningiomas, treated while a young attending physician at the Johns Hopkins Hospital, are not the most elegant operations in his lengthy series, but serve as an illustration of his ability to transform clinical challenges into opportunities for improvement.