World Neurosurg
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Subarachnoid hemorrhage (SAH) induces widespread inflammation leading to cellular injury, vasospasm, and ischemia. Evidence suggests that progesterone (PROG) can improve functional recovery in acute brain injury owing to its anti-inflammatory and neuroprotective properties, which could also be beneficial in SAH. We hypothesized that PROG treatment attenuates inflammation-mediated cerebral vasospasm and microglial activation, improves synaptic connectivity, and ameliorates functional recovery after SAH. ⋯ PROG treatment ameliorated cerebral vasospasm, reduced microglial activation, restored synaptic GluR1 localization, and improved neurobehavioral performance in a murine model of SAH. These results provide a rationale for further translational testing of PROG therapy in SAH.
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Treatment of intracranial aneurysms (IAs) is largely guided by IA size and growth. Preliminary investigations have found a relationship between clinical factors and growth; yet, the relationship between morphologic and hemodynamic risk prediction models in IA growth is unknown. ⋯ Based on this preliminary study, we conjecture that aneurysms that resemble ruptured IAs may grow faster.
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Only a few cases of intraventricular hydatid cysts have been described. The camalote or water lily sign is described when there is detachment of the endocyst membrane, resulting in a floating appearance like a water lily. ⋯ Here, we describe the camalote sign in an iatrogenically ruptured intraventricular hydatid cyst. Rupture of an intraventricular hydatid cyst poses the threat of widespread dissemination and is described in our case.
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External ventricular drain (EVD) dislodgement is common and leads to significant morbidity and mortality. Many securement techniques to prevent this are described. There are, however, no objective studies comparing them. This study aimed to determine the most secure method of securing an EVD. ⋯ An anchoring suture followed by a coil of the catheter and finally a flange is the most secure method for securing EVDs. This simple technique can withstand up to 8.2 times the force of a single anchoring suture, is easily used, and decreases the likelihood of EVD dislodgement and associated complications.