World Neurosurg
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Multicenter Study
Emergency trepanation as an initial treatment for acute subdural hemorrhage: a multicenter retrospective cohort study.
Rapid decompression with trepanation and drainage in an emergency room has been proposed as a potentially effective initial intervention for early-stage acute subdural hemorrhage; however, the actual safety and efficacy of the procedure remain unclear. The aim of this study was to evaluate the feasibility of emergency trepanation as an initial treatment for acute subdural hemorrhage. ⋯ Our results indicate that performing trepanation in an emergency room is associated with a decreased survival rate.
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Review Case Reports
Cerebral venous sinus thrombosis secondary to idiopathic hypertrophic cranial pachymeningitis: A case report and review of the literature.
Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare fibrosing inflammatory process involving the dura mater. Currently, there is no consensus on the treatments for IHCP, and the usefulness of immunosuppressive agents as a first-line option remains controversial. Cerebral venous sinus occlusion (CVSO) and cerebral venous sinus thrombosis (CVST) secondary to IHCP, which may cause progressive intracranial hypertension and venous obstructive parenchymal lesions, make the diagnosis and treatment of IHCP more complicated. ⋯ We experienced a patient with CVST secondary to IHCP, who was successfully treated with cyclophosphamide pulse therapy. Because IHCP with secondary venous obstruction has various differential diagnoses, venography is necessary to avoid misdiagnosis. The use of immunosuppressive agents may be promising but needs further verification.
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Review Case Reports
Endoscopic endonasal transsphenoidal approach for the removal of optochiasmatic cavernoma: a case report and literature review.
Cavernoma of the optic chiasm is a rare disease, and the most common clinical presentation is chiasmal apoplexy. Almost all the cases reported in the literature were treated surgically with craniotomy. ⋯ Rapid diagnosis and complete resection of a symptomatic optochiasmatic cavernoma are helpful in improving visual dysfunction. EETA is an alternative, minimally invasive technique for resecting this type of lesion.
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Review Biography Historical Article
Dr. Norman Chater and Chater's point: A Historical Vignette.
Dr. Norman Chater, a University of California San Francisco-trained microvascular neurosurgeon, dedicated his career to the development of surgical bypass techniques. ⋯ He identified Chater's point, an extracranial landmark that marks the posterior extent of the Sylvian fissure, which on craniectomy reliably exposes vessels of the angular gyrus, the vasculature found to be most appropriate for bypass procedures owing to its accessibility and vascular diameter. This surgical landmark continues to be essential for the successful execution of bypass surgeries to this day.
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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.