World Neurosurg
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Review
The Introduction of Innovations in Neurovascular Care: Patient Selection and Randomized Allocation.
Most neurovascular innovations have been introduced by using case series followed by observational studies. A better approach would be a pragmatic randomized trial. Two important aspects of trial design, patient selection and randomized allocation, remain poorly understood. We discuss the role trial methodology can play in the protection of patients being offered innovative treatments.
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Bilateral occlusion of the foramen of Monro with aqueductal stenosis is a rare entity. Only 1 previous case has been reported in the literature. ⋯ Bilateral occlusion of foramen of Monro with aqueductal stenosis and tonsillar herniation is rare cause of obstructive hydrocephalus, and can be managed effectively with neuroendoscopic procedure.
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Comparative Study
Transsphenoidal Surgery for Elderly Patients with Acromegaly and Its Outcomes: Comparison with Younger Patients.
Elderly patients with acromegaly who have comorbidities may increasingly encounter perioperative complications; however, little data are available on the risks and outcomes of surgical treatment in these patients. We aimed to analyze and compare the results of transnasal transsphenoidal surgery (TTS) in elderly and younger patients. ⋯ TTS can be considered a safe treatment for both younger and elderly patients with acromegaly. Successful tumor removal provided a significant improvement in comorbidities even in elderly patients with acromegaly.
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Comparative Study Observational Study
Results of Early and Late Surgical Decompression and Stabilization for Acute Traumatic Cervical Spinal Cord Injury in Patients with Concomitant Chest Injuries.
The benefits of early surgical decompression and stabilisation (within 24 hours of injury) for patients with acute traumatic spinal cord injury (SCI) is unclear. The study objective was to investigate the effects of early (<24 hours of injury) versus late (>24 hours of injury) decompressive and stabilisation surgery for traumatic cervical SCI in patients with concomitant chest injuries. ⋯ For patients with acute traumatic cervical SCI and concomitant chest trauma, early surgical decompression and stabilisation was associated with reduced ICU stay and a lower complication rate. Neurological recovery was more likely in younger patients and those with an incomplete SCI.
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Review Case Reports
Granular Cell Tumor of the Neurohypophysis: 3 Cases and a Systematic Literature Review of 98 Cases.
Granular cell tumors (GCTs) of the neurohypophysis are rare neoplastic diseases of the pituitary. Because of the rare nature of the disease, previous descriptions have been limited to single-case studies, small series, or simple reviews. ⋯ These findings lend strong support to the suggestion that tumors probably remain in the transitional cell type. To our knowledge, our systematic review presents the largest number of symptomatic cases ever enumerated, with 98 cases meeting the inclusion criteria.