World Neurosurg
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This systematic review and meta-analysis was aimed to evaluate the predictive values of shape irregularity and density heterogeneity of hematoma on noncontrast computed tomography (NCCT) for hematoma expansion (HE). ⋯ Considering the relatively low sensitivity and specificity, the predictive values of shape irregularity and density heterogeneity of hematoma for HE are limited. Further studies are still needed to find optimal NCCT predictors for HE in spontaneous intracerebral hemorrhage patients.
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Review Case Reports
The Long and Winding Road: Thoracic Myelopathy associated with Occipitocervical dAVF.
Spinal dural arteriovenous fistulas (DAVFs) have diverse presentations. Magnetic resonance imaging (MRI) reveals spinal cord swelling in only 45% to 74% of cases. We present an unusual case of a 57-year old man with a craniocervical junction DAVF in which the edema appeared in the thoracolumbar region, skipping the cervical spinal cord. ⋯ This rare presentation highlights the importance of diagnostic persistence when unexplained cord findings are seen on MRI. Repeated angiography and the inclusion of proximal vascular lesions may be considered in the evaluation of isolated thoracic edema.
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Review Case Reports
Marginal en bloc resection of C2-3 chordoma with bilateral vertebral artery preservation and mesh cage reconstruction with review of previously published cases.
Chordomas arise from remnants of the notochord and occur throughout the neuroaxis. En bloc resection of chordomas can prove especially challenging in the upper cervical spine secondary to the unique structural anatomy and intimate relationship to the vertebral arteries and spinal cord. ⋯ Chordomas in the upper cervical spine pose a surgical challenge but are amenable to en bloc resection. With careful planning and intraoperative adaptability, the surgeon can achieve a suitable reconstruction with off-the-shelf products.
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Current prognostic models for traumatic brain injury (TBI) are developed from diverse historical data sets. We aimed to construct a prognostication tool for patients with severe TBI, as this group would benefit most from an accurate model. ⋯ Two accurate prognostic models, NNI Clinical and NNI+, were developed from our cohort of patients with severe TBI. Both models are specific to severe TBI and could be better alternatives to current available models. External validation is required to assess performance of models in a different setting.
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Review Case Reports
Treating CSF Rhinorrhea without Dura Repair - A Case Report of Posterior Fossa Choroid Plexus Papilloma.
Choroid plexus papilloma revealed by nontraumatic cerebrospinal fluid (CSF) rhinorrhea has only been described 5 times, to our knowledge, in the literature. The challenges in this situation are to recognize CSF leak, to rapidly understand the pathophysiology of the leak, and to choose the best treatment strategy in emergency. We report an original case of posterior fossa choroid plexus papilloma revealed by CSF leak. We then discuss the surgical strategy and the pathophysiology of CSF leak, which is explained, in this case, by both hyperproduction of CSF and local skull base erosion. ⋯ Our case shows that 1) causal reasoning is of major importance when dealing with CSF rhinorrhea and that 2) dura repair can be avoided when treating CSF leak secondary to posterior fossa choroid plexus papilloma.