World Neurosurg
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In the early days of modern neurologic surgery, the inconveniences and potential dangers of general anesthesia by chloroform and ether using the so-called "open-drop technique" led to the quest for alternative methods of anesthesia. This became all the more necessary, since patient positioning and the surgical arrangements often hindered the use of a drop bottle. One approach to solve this problem was intrarectal ether application. The present article aims to shed light on this original, less well-known anesthesia technique in the neurosurgical field.
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The treatment of brain arteriovenous malformations (BAVMs) supplied by the anterior choroidal artery (AChA), or aBAVMs, remains challenging. The aim of this study was to determine the surgical outcomes and risk factors for worsened muscle strength (MS) after surgery in patients with aBAVMs. ⋯ Surgical treatment of aBAVMs can cause a high incidence of MS deficits. Niduses supplied by cisternal segment of AChA and shorter LCD were crucial risk factors for postoperative MS worsening. Motor-evoked potential monitoring was an effective intraoperative technique to predict postoperative MS deficits.
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We report a case in which common radiologic images masked a rare case of supratentorial hemangioblastoma (HBL). Other peculiarities of this case are the clinical presentation with status epilepticus and the occurrence of a supratentorial HBL unrelated to von Hippel-Lindau syndrome. Based on clinical and radiologic findings, including massive cerebral edema and hemorrhagic presentation, our preoperative diagnosis was a cerebral metastasis. In this scenario, physicians must take into account the words of the Roman fabulist Phaedrus: "Non semper ea sunt, quae videntur, decipit frons prima multos" (things are not always what they seem; the first appearance deceives many).
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Comparative Study
The Protective effect of Omeprazole Against Traumatic Brain Injury: An Experimental Study.
The development of secondary brain injury via oxidative stress after traumatic brain injury (TBI) is a well-known entity. Consequently, the aim of the present study was to evaluate the role of omeprazole (OM) on rat model of TBI. ⋯ The results of the present study showed that OM was as effective as MP in protecting brain from oxidative stress, and apoptosis in the early phase of TBI.
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To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. The authors also evaluated the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs. ⋯ Several factors were identified as significant markers of associated injuries, including female sex, MVA, and presenting symptoms. Neck and chest pain were significantly associated with vascular injuries. Clinicians should maintain high indices of suspicion for associated injuries in patients with ITPFs, especially after high-velocity mechanisms.