World Neurosurg
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Observational Study
Safety and Efficacy of a 600mg Loading dose of Clopidogrel 24 hours before Pipeline Embolization Device treatment.
Clopidogrel/aspirin antiplatelet therapy routinely is administered 7-10 days before pipeline aneurysm treatment. Our study assessed the safety and efficacy of a 600-mg loading dose of clopidogrel 24 hours before Pipeline Embolization Device (PED) treatment. ⋯ In a cohort receiving PED, a 600-mg loading dose of clopidogrel should be safe and efficacious in those off the standard protocol or showing <30% platelet inhibition before treatment.
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Review Historical Article
Henry II of France (1519-1559) and his death from meningoencephalitis following a cranial trauma.
This historical review summarizes the most significant theories regarding the cause of death of King Henry II of France (1519-1559) and the circumstances under which it occurred. Although the historical testimonies are inconclusive and vague, postmortem analysis has shown that the King died of meningoencephalitis, caused by hematoma of a cerebral contusion, with effusion in the cerebral laminae and its surrounding tissue initiated by a periorbital fracture.
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Patients with diffuse low-grade gliomas (DLGGs) typically present with seizures. We sought to review the neurosurgical literature for seizure outcome after resection of these tumors. ⋯ Among articles reporting seizure outcomes after resection of DLGG, the median seizure-free rate was 71% (interquartile range, 64%-82%). Seizure freedom is likely associated with extent of resection.
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Intraoperative neuromonitoring (IONM) has been reported to be sensitive and specific in the detection of neurologic injury during spinal surgery. The purpose of this study was to clarify the incidence of C5 palsy using multimodality IONM and to compare the accuracy of multimodality IONM to predict postoperative C5 palsy with isolated transcranial motor evoked potentials (MEPs). ⋯ Incidence of any neurologic deficit, including C5 palsy, during laminoplasty while using multimodality IONM was relatively low. MEP alerts in the deltoids or biceps had 100% sensitivity and 98.4% specificity for predicting a postoperative deficit. Somatosensory evoked potentials did not appear to be helpful in predicting postoperative deficits.
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To evaluate accuracy of a computed tomography (CT)-guided frameless stereotactic drilling and catheter system. ⋯ Highly accurate catheter placement is achievable using this novel flexible catheter and bone anchor system placed via frameless stereotaxy, with an average deviation between planned and actual target point of 1.60 mm ± 0.98 (1.40 mm, 0.40-4.00 mm).