World Neurosurg
-
Contrary to expectations, some patients with poor-grade subarachnoid hemorrhage (SAH) show favorable outcomes. However, the factors predictive of good prognosis are unclear. The purposes of this study were to identify factors related to poor-grade SAH and to analyze preoperative prognostic factors. ⋯ Poor outcomes correlated with older age, brain-destructive hemorrhage, and EI ≥0.3. The EI reflects both hydrocephalus and the patient's frailty. Radiographic signs of poor-grade SAH were not correlated with poor outcome, suggesting that early decompressive surgery may improve outcome.
-
Cerebral amyloidoma is the rarest presentation of amyloid-related diseases of the central nervous system. We present the case of a patient with visual difficulty and an infiltrating lesion in the temporal lobe, shown by magnetic resonance imaging. In as much as a benign clinical course is expected, a knowledge of this entity, along with state-of-the-art imaging and close follow-up, could avoid invasive procedures such as biopsy.
-
Antiplatelet therapy is common and complicates the operative management of subdural hematomas (SDH). The risk of reoperation inferred by antiplatelet medication and the ability of platelet transfusion to reduce hemorrhagic complications in patients presenting with antiplatelet associated SDHs are poorly defined. ⋯ Antiplatelet medication was not a significant predictor of reoperation following evacuation of an acute or mixed-density SDH. In patients on antiplatelet medication, preoperative platelet transfusion did not reduce reoperation rates.
-
We aimed to expound feasibility of serum cell-free microRNA-214 (miR-214) as a noninvasive biomarker for glioma in this study. ⋯ Serum cell-free miR-214 could serve as a promising noninvasive biomarker of glioma in tumor stratification, early diagnosis, and prognostic evaluation.
-
The term anterior communicating (ACom) aneurysm is often broadly used to classify any aneurysm formed on the A1-A2 junction, A1, A2, or ACom arteries. Aneurysm location has been associated with rupture risk, so whether an aneurysm is truly formed on the ACom artery can critically affect treatment decisions. The aim of this study was to reclassify broadly termed ACom aneurysms into 4 subgroups (A1, A2, true ACom, and A1-A2 junction) based on their location. ⋯ We found only 13% of the aneurysms initially referred to as ACom to be true ACom aneurysms. A more nuanced approach to ACom aneurysm classification may better guide management strategies.