World Neurosurg
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Split cord malformation (SCM) is a rare anomaly characterized by a split along the midline of the cord, which divides it into 2 symmetric or nonsymmetric entities. SCM surgical indications and outcomes are still debatable, the signs and symptoms are generally nonspecific and are commonly associated with other anomalies and deficits. ⋯ Most patients with SCM present during childhood. Postoperative complications after SCM corrective surgery are generally minimal, and the overall outcomes, mainly including partial or complete symptomatic improvement and/or symptom stability and hydronephrosis resolution, were favorable.
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Case Reports
Deep brain stimulation for the treatment of dopa-responsive dystonia: A case report and literature review.
The aim of this study was to observe the improvement in patients with dopa-responsive dystonia (DRD) after deep brain stimulation (DBS) of the globus pallidus internus (GPi). ⋯ After 6 months of GPi DBS treatment, the total BFMDRS score of the patient was 5, a 94.28% improvement over the preoperative baseline score. In addition, the MMSE, MOCA, HAMA, and HAMD scores of the patient were 30, 30, 1, and 2, respectively. Intelligence and cognitive levels of the patient did not change significantly compared with the preoperative baseline level, whereas anxiety and depression status of the patient improved compared with the preoperative status. GPi DBS treatment can significantly improve the symptoms of systemic dystonia in patients with DRD, and to a certain extent improve the anxiety and depression status of these patients. Therefore, we conclude that GPi DBS is an alternative safe and effective treatment for patients with DRD.
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Observational Study
Reduced Admission Serum Fibrinogen Predict 6-month Mortality of Poor-Grade Aneurysmal Subarachnoid Hemorrhage.
To retrospectively analyze the relationship between fibrinogen levels and outcomes in poor-grade aneurysmal subarachnoid hemorrhage (aSAH). ⋯ Patients with poor-grade aSAH with reduced admission fibrinogen level have a higher risk of delayed cerebral ischemia and 6-month mortality compared with those without. The admission serum fibrinogen level might be useful as a predictor and treatment target in patients with poor-grade sSAH who have undergone surgical treatment.
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Case Reports
Laser interstitial thermotherapy for treatment of symptomatic peritumoral edema after radiosurgery for meningioma.
Symptomatic peritumoral edema (PTE) is a known complication after radiosurgical treatment of meningiomas. Although the edema in most patients can be successfully managed conservatively with corticosteroid therapy or bevacizumab, some medically refractory cases may require surgical resection of the underlying lesion when feasible. Laser interstitial thermotherapy (LITT) continues to gain traction as an effective therapeutic modality for the treatment of radiation necrosis where its biggest impact is through the control of peritumoral edema. ⋯ This case demonstrates that LITT may be a viable alternative treatment for patients with meningioma with symptomatic PTE who have failed medical therapy and require surgical intervention.
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Randomized Controlled Trial
Clinical and Radiological Outcome of Intra-Cranial Aneurysm Clipping aided by Transit Time Flowmetry.
Since the International Subarachnoid Aneurysm Trial, coiling has been favored over clipping for intracranial aneurysms, resulting in selection of increasingly complex aneurysm configurations for clipping. We present the outcomes of clipping of aneurysms not suitable for coiling, with transit time flowmetry technology to aid monitoring of intraoperative flow. ⋯ In this study of clinical and radiological outcomes of surgically treated cerebral aneurysms not suitable for unassisted coiling, we showed positive results for these challenging aneurysms, aided by transit time flowmetry as a valuable tool, providingquantitative measurements of arterial blood flow to help achieve optimal clip placement and minimizing aneurysm residuals that may be sites of rebleeding. Adequate flow, defined as ≥50% of baseline, greatly reduces the risk of unfavorable outcome.