World Neurosurg
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Case Reports
Surgical Management of Giant Intracranial Arteriovenous Malformations: A Single Center Experience over 32 years.
Treatment of giant intracranial arteriovenous malformations (gAVMs) is a formidable challenge for neurosurgeons and carries significant morbidity and mortality rates for patients compared with smaller AVMs. In this study, we reviewed the treatments, angiographic results, and clinical outcomes in 64 patients with gAVMs who were treated at Henry Ford Hospital between 1980 and 2012. ⋯ Treatment of gAVMs carries significant morbidity and mortality; however, good outcomes are attainable with a multimodal treatment approach in carefully selected patients.
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Vestibular schwannomas (VS) are tumors originating from the eighth cranial nerve. The etiology and environmental risk factors for VS remain unclear. The goal of this study was to explore some potential environmental risk factors associated with vestibular schwannoma (VS). ⋯ The profile of patients with VS includes white race, age 50-60 years, either sex, and working in a professional occupation. Better access to health care and diagnostic imaging likely plays a role in the diagnosis of this tumor. Hay fever is strongly associated with VS. Tobacco use demonstrates an inverse relationship with VS, but the possible biologic mechanism for this is poorly understood, and tobacco remains a significant public health problem.
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We report the first case of a recurrent malignant subdural effusion that was treated with whole-brain radiation therapy. A 72-year-old man presented with headaches and de novo left central facial palsy and right upper extremity weakness. His past medical history was remarkable for a prostatic adenocarcinoma diagnosed in 1999 (T4N0M0) with no metastatic disease diagnosed to date. ⋯ Whole-brain radiation therapy was performed from day 10 to 17 after surgery at a palliative dose of 20 Gy in 5 fractions. No treatment-associated complications were reported. Thirty days after radiotherapy, the computed tomography scan of the head showed total resolution of the malignant effusion.
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Comparative Study
Importance of IL-6, MMP-1, IGF-1 and BAX Levels in Lumbar Herniated Discs and Posterior Longitudinal Ligament in Patients with Sciatic Pain.
The aim of this study was to evaluate prognostic importance of interleukin-6 (IL-6), matrix metalloproteinase (MMP)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) levels in biopsy specimens taken from the intervertebral disk specimens and the posterior longitudinal ligaments of patients with sciatic pain. ⋯ Our findings suggest that the cytokines, enzymes, growth factors, and proapoptotic proteins, such as IL-6, MMP-1, IGF-1, and BAX, may be critical factors in the pathophysiology of the degeneration of the intervertebral disks in patients with symptomatic degenerative disk disease.
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To investigate the upper-extremity abduction, and lifting limitations and associated factors after anterior cervical decompression and fusion. ⋯ The rate of upper-extremity abduction and lifting limitation after anterior cervical decompression and fusion is low, indicating a good prognosis after active treatment.