World Neurosurg
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Spontaneous intracerebral hemorrhage (ICH) can be a devastating event. An increased glucose level in patients with ICH is known to be related to poor outcomes, including acute leukocytosis, which is a well-established response to ICH. The purpose of this study was to evaluate the association between admission laboratory factors and 3-month mortality in patients with spontaneous supratentorial ICH. ⋯ Higher admission white blood cell counts and glucose levels were associated with higher 3-month mortality in patients with spontaneous ICH. These data show that an altered glucose metabolism and inflammatory state after ICH may be related to early deterioration after an ICH.
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Approximately 60 cases of schwannoma unrelated to the cranial nerve have been reported, and only 12 arose from the tentorium. We present a case of tentorial schwannoma extending into the pons and midbrain without cranial nerve involvement, which was almost totally resected with an occipital transtentorial approach. ⋯ The occipital transtentorial approach provides a direct approach to tentorial schwannoma, resulting in total resection even if the tumor extends into the pons and midbrain.
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Patients with small (<5 mm) unruptured intracranial aneurysms (UIAs) are at risk of subarachnoid hemorrhage, but risk assessment of these patients remains controversial in daily clinical practice. We aimed to identify the risk factors of aneurysmal rupture in these patients. ⋯ This study showed that 70.4% of small ruptured intracranial aneurysms (<5 mm) were located at parent artery bifurcations and that bifurcation location was a significant independent factor for the risk of rupture of small UIAs (<5 mm). Prophylactic treatment should be recommended for small UIAs in this location.
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In the very elderly, their general condition and poor compliance with drug regimens can render the treatment of low back pain (LBP) difficult. We report the effectiveness of a less-invasive treatment for intractable LBP from superior cluneal nerve entrapment neuropathy (SCN-EN) and gluteus medius muscle (GMeM) pain. ⋯ Even very old patients with intractable LBP, buttock pain, and leg pain due to SCN-EN or GMeM pain can be treated successfully by peripheral block and less-invasive surgery under local anesthesia.
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Despite ongoing progress in our understanding of long-term outcomes after neuromodulation procedures, acute adverse outcomes shortly after deep brain stimulation (DBS) treatment have remained remarkably limited. ⋯ This study provides individualized estimates of the risks associated with short-term adverse outcomes based on patient demographics and comorbidities. These data can be used as an adjunct for short-term risk stratification of patients with PD being considered for DBS treatment.