World Neurosurg
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Patients with hematologic disorders who present with subdural hematomas (SDH) present a surgical decision-making challenge. Because of intrinsic coagulopathy, platelet dysfunction, and immunosuppression, surgical intervention poses a unique set of risks. ⋯ Low platelet and hemoglobin levels are consistent markers of poor prognosis and surgical intervention, either as a proxy of or as a cause for clinical deterioration, is associated with increased mortality risk.
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Case Reports
Surgical rescue technique for incomplete burr hole using a small bone piece and the craniotome.
Incomplete penetration of a burr hole sometimes occurs when performing a craniotomy in elderly patients due to osteoporosis. Completion of the burr hole takes more time and may sometimes cause tearing of the dura mater. We have introduced a small bone piece method that can easily and reliably recover an incomplete burr hole safely. ⋯ Application of the unlocked craniotome on the small bone piece can easily complete the burr hole. Less bone deficit is caused compared with making a new burr hole. In addition, time is saved without changing the attachment, and the burr hole is completed safely. This small bone piece method is effective to recover an incomplete burr hole.
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Case Reports
Solitary Extra-axial Intracranial Primary Meningeal Pleomorphic Xanthoastrocytoma: An Extremely Rare Case.
Pleomorphic xanthoastrocytomas (PXAs) are a rare type of astrocytoma, which, similar to other gliomas, can rarely arise from glial nests in the meninges, manifesting as an extra-axial mass. We describe a solitary extra-axial intracranial primary meningeal PXA in the pediatric age group, which was masquerading as a tentorial meningioma. ⋯ Solitary extra-axial intracranial primary meningeal PXA is an extremely rare entity with only 3 reported cases in the literature including the present case. This is the first report of such a tumor in a pediatric patient. This report also highlights that primary meningeal PXA can manifest as an extra-axial mass lesion and may warrant inclusion in the differential diagnosis of extra-axial mass lesions.