World Neurosurg
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Distal catheterization in the ophthalmic artery beyond the origin of the central retinal artery has been attempted to avoid visual complications in cases of transarterial embolization (TAE). Although avoiding visual complications is important, extraocular complications have been rarely reported and discussed. Here, we report a case of an intraorbital arteriovenous fistula (AVF) presenting with impaired extraocular movement after a provocation test and discuss the potential risks associated with TAE at the third segment of the ophthalmic artery. ⋯ In intraorbital hypervascular lesions, occlusion of the third segment of the ophthalmic artery is associated with a potential risk of extraocular complications.
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Review Case Reports
An extradural dumbbell-shaped tuberculoma masquerading as a nerve sheath tumor: Case report and review of the literature.
Spinal tuberculosis has been listed as a rare cause of neuroforaminal widening with only 2 previous reports in the literature. Here, we report the third case of an extradural tuberculoma extending through and expanding the neural foramen closely masquerading as a nerve sheath tumor including, to the best of our knowledge, the first description of magnetic resonance imaging, operative, and histopathology findings. ⋯ This case illustrates that a tuberculoma can have many of the features of a benign neoplasm, such as encapsulation, appearance of a slow rate of growth, and development of necrosis or even cystic degeneration. With the specific findings of entrapped nerve fascicles, we postulate that the lesion represents a nerve sheath tuberculoma rather than spinal tuberculosis of the pedicle or posterior elements. Furthermore, only a lesion of the nerve sheath would have the characteristic dumbbell appearance as it extends through the foramen.
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In the present study, we sought to evaluate the timing and outcomes in patients with hemorrhagic stroke who received tracheostomy. ⋯ In our cohort, early tracheostomy in patients with hemorrhagic stroke may help reduce hospital stays and hospital costs, but not in-hospital mortality. Future prospective multicenter studies are warranted to validate these findings.
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Traumatic brain injury (TBI) refers to any insult to the brain resulting in primary (direct) and secondary (indirect) damage to the brain parenchyma. Secondary damage is often linked to the molecular mechanisms that occur post TBI and result in excitotoxicity, neuroinflammation and cytokine damage, oxidative damage, and eventual cell death as prominent mechanisms of cell damage. ⋯ We also mention the long-term sequelae and their pathophysiology in relation to TBI focusing on Parkinson disease, Alzheimer disease, epilepsy, and chronic traumatic encephalopathy. Understanding of the molecular mechanisms is important in order to realize the secondary and long-term sequelae that follow primary TBI and to devise targeted therapy for quick recovery accordingly.
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Review Case Reports
Spontaneous regression in intracranial germinoma: case report and literature review.
Spontaneous regression in intracranial germ cell tumors (GCTs) is an extremely rare phenomenon with only 9 cases reported. The mechanism and natural history of this phenomenon are still equivocal. ⋯ Tumor regression in intracranial GCTs could be a iatrogenic transient phenomenon, caused by complex immune reactions triggered by interventions.