World Neurosurg
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Case Reports
Muslin granuloma mimicking parenchymal hematoma in a patient with seizures 30 years after aneurysm wrapping.
Muslin foreign body granulomas are a known complication of muslin aneurysm wrapping and have been associated with vision loss from optochiasmatic arachnoiditis. Muslin granulomas have also been confused with abscesses due to surrounding inflammatory changes. In this clinical image, we present a unique case of a muslin granuloma mimicking an intraparenchymal hematoma.
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The exact mechanism, incidence, and risk factors for cerebral vasospasm after traumatic intracranial hemorrhage (ICH) continue to be poorly characterized. The incidence of post-traumatic vasospasm (PTV) varies depending on the detection modality. ⋯ PTV as demonstrated by DCA may be more common than previously reported. Patients who exhibit PTV were more likely to have a Glasgow Coma Scale <9. This subgroup of patients may benefit from more systematic screening for the development of PTV, and earlier monitoring for signs of delayed cerebral ischemia.
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We assessed the contribution of a dynamic surgical guidance (DSG) probe in the accurate placement of thoracic and lumbar pedicle screws (PSs) in patients with spinal deformity. ⋯ Despite having more patients with severe deformities in the DSG group, PS insertion was significantly more accurate with DSG. This technique also reduced the severe unacceptable lateral misplacement rate (>4 mm) and, consequently, the incidence of intraoperative screw revisions even in patients with severe deformities.
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Meningiomas frequently occur in elderly patients, and surgical treatment is hazardous owing to multiple comorbidities. We report a series of elderly patients who were treated with surgical removal of meningiomas and compare them with a group of younger patients with similar tumors. ⋯ Elderly patients with symptomatic skull base meningiomas should be considered for surgical treatment owing to acceptable morbidity and mortality compared with younger patients. Previous comorbidities and involvement of neurovascular structures are important factors in the decision regarding extent of surgical resection.
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Cerebral venous anomaly (CVA) is a rare congenital malformation. Caput medusa and stripe signs were the most common imaging findings in CVA patients. Here, we present the case of a thrombosed CVA with a double annular enhancement in a 62-year-old male with a 2-month history of worsening headaches.