World Neurosurg
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Clinical Trial
Posterior fossa reconstruction using titanium plate for the treatment of cerebellar ptosis after decompression for Chiari malformation.
We describe our use of a perforated titanium plate to perform a partial posterior fossa cranioplasty in the treatment of cerebellar ptosis and dural ectasia after posterior fossa decompression (PFD). ⋯ Placement of a titanium plate appears to be an effective method of treatment of cerebellar ptosis and dural ectasia after PFD for Chiari malformation.
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Review
Riluzole for acute traumatic spinal cord injury: a promising neuroprotective treatment strategy.
Over the years, understanding of the specific secondary injury mechanisms that follow traumatic spinal cord injury (SCI) has improved. These pathologic mechanisms collectively serve to increase the extent of neural tissue injury, reducing prospects for neurologic recovery. An enhanced understanding of the pathobiology of SCI has permitted investigation of therapies targeting specific elements of this pathologic cascade. It is now known that the continuous posttraumatic activation of neuronal voltage-gated sodium ion channels leads to increased rates of cell death through the development of cellular swelling, acidosis, and glutaminergic excitotoxicity. The objective herein is to provide an update regarding the current status of the potential neuroprotective drug riluzole in the treatment of traumatic SCI. ⋯ This article reviews the biologic rationale, existing preclinical evidence, and emerging clinical data for riluzole in the treatment of traumatic SCI.
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Anticoagulated patients with intracranial hemorrhage represent a major management challenge. Our goal is to determine how patient characteristics and management decisions influence outcome. ⋯ Our results provide prognostic information that may assist management of these patients. Our results also suggest that it may be unwise to withhold anticoagulation indefinitely after an index hemorrhage. As thromboembolic or hemorrhagic complications may be associated with worse outcome, efforts to avoid them may be wise. The studies that comprise our dataset have important limitations and a prospective study will be required to confirm these results.
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Review Case Reports
Intracranial salivary gland choristoma within optic nerve dural sheath: case report and review of the literature.
Salivary gland choristomas or their neoplastic derivatives may appear throughout the intracranial space, most frequently in the middle ear or sella. Here, we present the case of a salivary gland choristoma embedded within the optic nerve dural sheath and review the literature of intracranial salivary gland masses. ⋯ Intracranial salivary tissue has been previously described but never before in the suprasellar space. Although rare, knowledge of their natural history and pathologic features may inform surgical management if they are encountered in the operating room.
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Review Case Reports
Multiple spinal hemangioblastomas complicated with postoperative remote cerebellar hemorrhage: review of the literature of two rare entities.
Multiple spinal hemangioblastomas constitute a rare pathology; most patients have von Hippel-Lindau disease. In the literature, spinal surgery has been complicated with remote intracranial hemorrhage in a very few cases. ⋯ This case report includes 2 rare entities, of which every spinal surgeon should be aware.