World Neurosurg
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Surgical resection is most often performed for superficially located brain metastasis. We evaluate the use of gamma knife radiosurgery (GKS) for resectable non-small cell lung cancer (NSCLC) brain metastases located <3 cm away from the outer cortical surface. ⋯ GKS for NSCLC brain metastases is effective in patients with 3 or fewer resectable tumors. The need for a craniotomy in this subgroup of patients after GKS is very low.
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Acute hydrocephalus (ventricular enlargement within 72 hours) is a common complication in patients with aneurysmal subarachnoid hemorrhage (SAH). Cerebrospinal fluid (CSF) secretion may be increased in the early phases of SAH, but it has not been proved definitively. We studied the histologic features of choroid plexus (CP) in the early and late phases of SAH. ⋯ In SAH with aneurysm rupture, increased CSF secretion seems to be triggered by hemorrhage in the early phase, but it is not possible in the late phase because of CP degeneration. In the early phase of hemorrhage, CSF secretion may be stimulated by the irritant receptor glossopharyngeal and vagal nerve endings, which innervate the healthy CP epithelium and arteries. Our findings may be accepted as being causative. It is likewise possible that CSF blockage per se leads to hydrocephalus, and the morphologic changes are sequelae that occur later in the course of disease. This is the first study to show the water vesicles of CP as a causative factor in the development of acute hydrocephalus after SAH.