World Neurosurg
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Choroid plexus papillomas (CPPs) of the cerebellopontine angle (CPA) are extremely rare. We present a series of 21 cases operated on in the last 7 years at our institution. ⋯ CPPs in the CPA region cannot be easily differentiated from other tumors preoperatively. Cysts and calcifications appear on neuroimaging. CPPs in the CPA region usually protrude inferiorly into the foramen magnum region. As much tumor should be removed as possible to avoid recurrence and malignant transition.
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Intracranial extraskeletal mesenchymal chondrosarcomas (MCSs) are rare tumors accounting for <0.16% of intracranial tumors. They are usually described as occurring in the age group of 20-30 years and are commonly found in the frontoparietal region arising from the falx and surrounding dura. We describe 3 cases at varying ages, locations, and outcomes. ⋯ Intracranial MCSs are rare malignant tumors with poor prognosis. Because of their rarity, it may not be considered as a differential diagnosis and it is often misdiagnosed radiologically, but the importance lies in the need of radical excision. The potential effect of postoperative radiotherapy and chemotherapy is controversial. This article sheds some light on variable prognosis of this tumor.
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To evaluate the cerebral and hemodynamic effects of low-dose intramuscular diclofenac sodium (DCFS) administered for fever control in patients with acute brain injury in the intensive care unit. ⋯ Low-dose intramuscular DCFS administration for fever control in patients with acute brain injury is effective but also exposes patients to potentially deleterious hypotensive episodes that must be diagnosed and treated expeditiously to prevent further damage to the injured brain.
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Here, we compare the angiographic characteristics of hemorrhagic and nonhemorrhagic hemispheres within the same adult patient with moyamoya disease (MMD) and identify the possible risk factors for initial and recurrent hemorrhage during the long-term follow-up period. ⋯ Compared with the nonhemorrhagic hemispheres, hemorrhagic hemispheres are more prone to recurrent hemorrhage. Our case-control study showed the dilation of the anterior choroidal artery or posterior communicating artery, as well as the involvement of the posterior cerebral artery, is associated with the initial hemorrhage of MMD, but not for the episode of recurrent hemorrhage. Longer and more detailed clinical and angiographic follow-up are still needed to delineate the specific mechanism underlying the recurrent hemorrhage in hemorrhagic MMD.
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Microendoscopic discectomy (MED) has been widely accepted for its advantage of minimal injury in the treatment of lumbar disc herniation. Recurrence after successful MED has been reported; however, the risk factors responsible for the MED recurrence were still unclear. ⋯ Age (≥50 years old) was the most robust risk factor for MED recurrence. Obesity (BMI ≥25) and modic change were also highly involved in the recurrent herniation after successful MED. Taking these risk factors into consideration before surgery may be instrumental in pursuing a personalized operative method, which may lead to a more satisfactory operative outcome and a relatively lower recurrence rate.