World Neurosurg
-
Case Reports
Primary Central Nervous System Lymphoma Presenting as Growing Intracerebral Hemorrhage.
Hemorrhage at presentation in primary central nervous system (CNS) lymphoma is rare. We encountered a case of primary CNS lymphoma presenting as a growing intracerebral hemorrhage. ⋯ Although exceedingly rare, primary central nervous system lymphoma can present as growing intracerebral hemorrhage due to repeated intratumoral hemorrhages. High expression of vascular endothelial growth factor and the mass effects of hemorrhage could be associated with the onset and growth of intracerebral hemorrhage. Early evaluation and meticulous observation are important to avoid progressive, life-threatening situations in such cases.
-
Transoral robotic surgery has been used successfully to assist many surgical procedures. Here, we report its first use as pure robotic surgery, applied to excise an odontoid metastatic mass. ⋯ This article presents the first pure robotic surgery for odontoid. The increasing number of robot-assisted cases will demonstrate the necessity of this evolution in neurosurgery and should accelerate the process.
-
Antiplatelet therapy is common and complicates operative management of acute intracranial hemorrhage. Few data exist to guide antiplatelet reversal strategies. ⋯ When patients on antiplatelet medication present with operative intracranial hemorrhage, the majority of neurosurgeons do not perform qualitative platelet testing. Antiplatelet reversal strategies are significantly influenced by the antiplatelet therapy with more aggressive reversal strategies employed in the presence of ADP antagonists.
-
Tumors extending into the optic canal can cause progressive visual impairment because of optic nerve compression. Prompt surgical resection is often necessary. When the tumor is located medially in the optic canal, endoscopic transnasal surgery provides a safer, less invasive alternative to a transcranial approach. ⋯ Endoscopic transnasal surgery is a valuable option for aggressive lesions in the optic canal. Although the efficacy of radiotherapy for solitary fibrous tumor remains controversial, it should be considered when the tumor shows progressive features.
-
Optimal drainage after débridement for treating postoperative surgical site infection (SSI) is controversial. We compared single-tube drainage with double-tube drainage. ⋯ There were no significant differences between the 1 drain and 2 drains groups in surgery-related and patient-related risk factors, pathogenic bacteria and antibiotic therapy, laboratory tests results, or drainage efficiency and time. However, patients in the 1 drain group exhibited better clinical outcome and shorter hospital stay.