World Neurosurg
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Verapamil, a calcium-channel blocker, has shown promising results on cerebral vasospasm. However, it has not yet been accepted for treatment or prevention purposes because of the associated side effects. Although the effective results of nimodipine and nicardipine's intrathecal administration are well known, intrathecal verapamil has not been considered earlier. We used an experimental subarachnoid hemorrhage-induced vasospasm model for the evaluation of vasodilator and neuroprotective effects of intrathecal verapamil. ⋯ Our findings suggest that intrathecal verapamil can prevent vasospasm, oxidative stress, and apoptosis after experimental subarachnoid hemorrhage.
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A cardiac myxoma (CM) is the most common primary tumor of the heart. This case report highlights that for metastatic CMs, even after a successful total resection, there is a small but real risk of recurrence that can manifest as late as 10 years after initial tumor resection. ⋯ Our case report demonstrates the metastatic nature of CMs to the central nervous system, even after successful gross total resection and no local relapsing mass in subsequent ultrasonographic follow-ups. A comprehensive evaluation on clinical and imagological grounds is mandatory to rule out the presence of myxomatous metastatic disease. Awareness and recognition of the potential neurologic manifestations of a metastatic CM will prevent unnecessary diagnostic workup and treatments.
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A fair number of hospital admissions occur after 30 days; thus, the true readmission rate could have been underestimated. Therefore, we hypothesized that the 90-day readmission rate might better characterize the factors contributing to readmission for pediatric patients undergoing spinal tumor resection. ⋯ The prevalence and charges associated with unplanned hospital readmissions after spinal tumor resection were remarkably high. Younger age, Medicaid insurance, malignant tumors, and complications during the initial admission were significant predictors of 90-day readmission.
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The use of mechanical thrombectomy for the treatment of acute ischemic stroke (AIS) is rapidly increasing. However, there are limited data on the comparative effects of the various devices approved by the U.S. Food and Drug Administration for the treatment of AIS. We aimed to perform a network meta-analysis to assess the relative efficacy and safety of 4 thrombectomy devices. ⋯ We concluded that stent retriever devices were superior to non-stent retriever devices in functional outcomes and recanalization without significant increases in death or symptomatic hemorrhage. We found no evidence for a differential therapy effect by stent type. Further high-quality RCTs assessing efficacy difference between these 2 stent retrievers are justified.
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To investigate the clinical effect and surgical techniques of fourth ventricle astrocytoma resection through the median suboccipital keyhole approach. ⋯ If appropriate microneurosurgical techniques are used via the median suboccipital keyhole approach, the fourth ventricle astrocytoma may be accessed and resected safely with shorter surgery time, reduced hemorrhage during operation, low incidence of postoperative complications, good recovery, and shorter hospitalization time.