World Neurosurg
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Case Reports
Metastatic Basal Cell Adenocarcinoma of Submandibular Gland to the Spine: An Extremely Rare Condition. A Case Report.
Basal cell adenocarcinomas are rare malignant neoplasms of salivary glands, accounting for <1% of salivary gland tumors. Few cases of distant metastases have been reported. ⋯ This case highlighted an extremely rare condition of metastatic basal cell adenocarcinoma of the submandibular gland to the lung and spine, which, to our knowledge, has not been previously reported in the literature.
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Spontaneous intracranial hemorrhage (ICH) is frequently managed in neurosurgery. Patients with durable mechanical circulatory support devices, including total artificial heart (TAH) and left ventricular assist device (LVAD), are often encountered in the setting of ICH. Although durable mechanical circulatory support devices have improved survival and quality of life for patients with advanced heart failure, ICH is one of the most feared complications following LVAD and TAH implantation. Owing to anticoagulation and clinically relevant acquired coagulopathies, ICH should be treated promptly by neurosurgeons and cardiac critical care providers. We provide an analysis of ICH in patients with mechanical circulatory support and propose a treatment algorithm. ⋯ We propose a novel treatment algorithm to manage patients with a LVAD or TAH and ICH, implemented in a multidisciplinary manner to best avoid neurologic and cardiovascular complications.
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In rare instances, extradural internal carotid artery aneurysms can present with massive epistaxis, which is often a fatal event. We present the case of a young female with an aneurysm eroding through the sphenoid sinus and whose timely diagnosis resulted in treatment of the aneurysm with coil embolization and satisfactory outcome.
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Although many studies have evaluated risk factors associated with hydrocephalus after aneurysmal subarachnoid hemorrhage, specific ventricle volume changes after subarachnoid hemorrhage have not been evaluated. We sought to evaluate factors predicting ventricle volume enlargement in patients with aneurysmal subarachnoid hemorrhage by measuring ventricle volume with a validated, semiautomated tool. ⋯ We found that greater body mass index independently predicted suppression of ventricle volume growth, owing to maintenance of subarachnoid trabeculae structures after subarachnoid hemorrhage. Further studies are needed to confirm our findings.
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Glioblastoma is the most frequent primary brain tumor and despite of complete treatment survival is still poor. The aim of this study is to define the utility of reoperation for improving survival in patients with recurrent glioblastoma, and determine other prognostic factors associated with longer survival. ⋯ Reoperation and the extent of resection (EOR) are the only surgical variables that neurosurgeons can modify to improve survival in our patients. Higher EOR and reoperation rates in patients who can be candidates for second surgery, will increase OS and PFS.