World Neurosurg
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Brain abscess represents a significant medical problem, accounting for 1 in every 10,000 U.S. hospital admissions and imposing a mortality of 17%-32%. Treatment success depends on early diagnosis, allowing for prompt intervention before a potentially catastrophic rupture. However, diagnosis can be difficult because currently no magnetic resonance imaging signal characteristics are pathognomonic. The presence of hemorrhage may further complicate the radiographic detection of an abscess, potentially leading to delayed treatment. ⋯ To our knowledge, this is the first report on recurrent hemorrhages in a cerebellar abscess. Hemorrhagic brain abscess has a complex radiologic appearance, which may delay diagnosis and treatment. A high degree of clinical suspicion is necessary to ensure timely treatment of this potentially lethal lesion.
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Comparative Study Controlled Clinical Trial
Comparison of Primary Spinal Central and Peripheral Primitive Neuroectodermal Tumors in Clinical and Imaging Characteristics and Long-term Outcome.
Primary spinal primitive neuroectodermal tumors are extremely rare entities. The purpose of this study was to analyze the differences in clinical and imaging characteristics and outcomes between primary spinal central PNETs (cPNETs) and peripheral PNETs (pPNETs). ⋯ Patients with spinal cPNETs were younger compared with patients with pPNETs. The prognosis of spinal cPNETs and pPNETs was poor with no significant difference between the entities. The most beneficial treatment modality is GTR combined with adjuvant radiotherapy and chemotherapy.
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Review Case Reports
Complicated Pseudomeningocele Repair after Chiari Decompression: Case Report and Review of the Literature.
Pseudomeningocele is a recognised complication after posterior fossa decompression for Chiari malformation. Its management can be challenging and treatment options vary in literature. ⋯ The reported case ultimately required complete removal of all dural repair materials to eliminate the patient's low-grade infection, a muscular flap, and placement of a ventricular-peritoneal shunt for definitive treatment after a trial of a lumbar drain led to herniation and development of a syrinx.
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Review Case Reports
Acute Paraplegia after Aneurysmal SAH - A rare complication and the review of literature.
Paraplegia after intracranial aneurysmal subarachnoid hemorrhage (SAH) is a rare condition, and its pathogenesis is still unclear. ⋯ To the best of our knowledge, this is the first report to describe the successful treatment of paraplegia after intracranial aneurysmal SAH.
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Decompressive craniectomy (DC) is an established part of the management of patients with increased intracranial pressure due to malignant middle cerebral artery (MCA) infarction or traumatic brain injury (TBI). The aim of this study was to determine prognostic radiologic parameters regarding the functional outcome of patients with increased intracranial pressure (ICP) undergoing DC. Special focus was put on the potential differences between malignant MCA infarction and TBI. ⋯ ΔMLS is an objectifiable parameter, predicting outcome in malignant MCA infarction. In contrast, ΔMLS was of no predictive value in TBI patients. Here postsurgical HDratio serves as a strong predictor of clinical outcome. We recommend applying postsurgical HDratio to TBI patients in order to estimate their clinical outcome and adjust treatment.