World Neurosurg
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Prognostic factors of favorable and unfavorable clinical outcome after aneurysmal subarachnoid hemorrhage (SAH) are still not completely known. We retrospectively analyzed the aneurysm location as a factor for patients' outcome after aneurysmal SAH. ⋯ Despite the usual prognostic factors (good admission status, younger age, absence of CVS) for a favorable outcome after SAH, the aneurysm location (carotid bifurcation artery) itself seems to be a prognostic factor. Also, aneurysms of the carotid bifurcation artery showed less occurrence of an early hydrocephalus, which is an indicator for the presence of an early brain injury. According to these results, we question if experimental animal models (especially the endovascular model using the perforation of the carotid bifurcation artery) have to be re-evaluated.
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Case Reports
Epidural spinal cord stimulation: A novel therapy in the treatment of restless legs syndrome.
We report a unique finding of a patient whose restless legs syndrome (RLS) symptoms abated after the placement of a spinal cord stimulator for chronic neuropathic pain. RLS is a common disorder, with many patients unable to find sufficient relief from their symptoms. ⋯ Epidural stimulation may be an additional, alternative, or novel therapy in the treatment of RLS.
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The objective of the current study was to compare the clinical features and outcomes between younger and older patients with skull base chordoma (SBC). ⋯ In younger patients, there were more SBCs located in the occipitocervical regions, and younger patients tended to undergo more aggressive resection. The tumor signal intensity of younger patients with SBC was higher in T2 images but lower in enhanced T1 images. A younger age was a favorable factor for a longer progression-free survival and a good neurologic status at follow-up.
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Case Reports
Gliosarcoma in Cerebellopontine Angle with Rapid Tumor Growth and Intratumoral Hemorrhage: Case Report.
Gliosarcoma is a relatively rare and bimorphous brain tumor, predominantly located in the brain lobe. Here, we report a rare case of gliosarcoma presenting radiologically in the cerebellopontine angle (CPA) region. ⋯ Although rare, gliosarcoma should be considered in the differential diagnosis of CPA tumors, especially if it is associated with rapid tumor growth or intratumoral hemorrhage.
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To assess if modern management of extracranial malignant diseases has prolonged the survival times for patients with more than 2 brain metastases (BM). ⋯ Both the median and 10% survival times have increased in recent years among patients with more than 2 BM treated with GKS. Both linear and exponential regressions accurately expressed the increase in both median and 10% survival times during the years 1990-2010. Findings from other published data support the observation of longer survival times among patients treated more recently, independent of the patients being treated with GKS or with whole-brain radiation therapy with or without radiosurgery. Thus, earlier findings of short survival times for patients with multiple BM are no longer valid, at least not for patients deemed suitable for radiosurgery. Aggressive management is thus warranted for these patients.