World Neurosurg
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Review Case Reports
A case of infratentorial meningioma causing spontaneous downbeat nystagmus. Case report and review of literatures.
Spontaneous downbeat nystagmus is a finding that raises suspicions of a central nervous system disorder. Vermis and lower brainstem lesions are considered to be responsible, but the exact mechanism is still controversial. We observed a rare case of spontaneous downbeat nystagmus caused by an infratentorial meningioma. ⋯ Vertical nystagmus is a finding that raises suspicion of a central nervous system disorder, and requires detailed examination. In addition, in case of vertical nystagmus because of tumor compression of the vermis, removal of the tumor can be an effective treatment.
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Multicenter Study Observational Study
High serum tissue inhibitor of matrix metalloproteinase-1 levels and mortality in patients with spontaneous intracerebral hemorrhage.
Matrix metalloproteinase (MMP)-9, a member of the endoproteinase family, is involved in the neuroinflammation of spontaneous intracerebral hemorrhage (SIH). High circulating MMP-9 levels have been associated with poor functional outcome in patients with SIH. The objectives of this study were to determine whether serum MMP-9 and tissue inhibitor of matrix metalloproteinases (TIMP)-1 levels in SIH patients were higher in nonsurviving than surviving patients, if they were associated with early mortality, and if they could be used as biomarkers of prognosis. ⋯ The novel aspects our study include that serum TIMP-1 and MMP-9 levels in SIH patients were higher in nonsurviving than in surviving patients and that serum TIMP-1 levels were associated with early mortality and could be used as biomarkers for predicting mortality.
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We present a case of 72-year-old man with a history of metastatic melanoma diagnosed in 2015 presenting a stable disease in treatment with dabrafenib. ⋯ The most recent literature lacks studies defining the clinical phenomena of an early recurrence of intracranial melanoma with de novo involvement of dural compartment in patients in treatment with a target immunotherapy. The aim of this present study is to report a case of early recurrence of intracranial melanoma metastases with evidence of fast immunohistochemical and macroscopical mutation of pathologic elements, with an analysis of literature that shows the lack of well-described occurrences.
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Review
Causes, Complications, and Costs Associated with External Ventricular Drainage Catheter Obstruction.
Ventricular catheter obstructions in patients treated with external ventricular drains (EVDs) have the potential to substantially impact the cost of patient care. There is a paucity of literature that directly addresses catheter obstruction over large numbers of patients with EVDs in multiple centers. Contemporary literature was reviewed to characterize causes, complications, and costs of EVD catheter obstruction. ⋯ The estimated diagnostic, procedural, and material cost of EVD replacement is in the range of approximately $1300-$3200 per replacement. The diagnosis and treatment of ventricular catheter obstruction, along with associated complications, creates a substantial cost burden. Further research should focus on strategies to reduce the incidence of ventricular catheter obstruction.
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Review Case Reports
Variant Type of Posterior Reversible Encephalopathy Syndrome Associated with Deep Brain Hemorrhage: A Case Report and Literature Review.
Various radiologic patterns of posterior reversible encephalopathy syndrome (PRES) have been reported. Among them, PRES involving brainstem, thalamus, or deep white matter and lacking parieto-occipital edema is rare. Although PRES in general has a benign course, PRES-related intracranial hemorrhage has been associated with a poor prognosis. We report a case of variant type of PRES associated with deep brain hemorrhage and discuss the characteristics of PRES-related intracranial hemorrhage via a literature review. ⋯ Although hemorrhage in the thalamus, basal ganglia, or brainstem is uncommon in patients with PRES, it may occur in patients with variant type of PRES involving these lesions. It is important to recognize the presence of variant patterns of clinical features and radiologic findings of PRES to allow for early identification and appropriate treatment.