World Neurosurg
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Review
Treatment Strategies to Attenuate Perihematomal Edema in Patients with Intracerebral Hemorrhage.
Spontaneous intracerebral hemorrhage (SICH) continues to be a significant cause of neurologic morbidity and mortality throughout the world. Although recent advances in the treatment of SICH have significantly decreased mortality rates, functional recovery has not been dramatically improved by any intervention to date. There are 2 predominant mechanisms of brain injury from intracerebral hemorrhage: mechanical injury from the primary hematoma (including growth of that hematoma), and secondary injury from perihematomal inflammation. ⋯ PHE therefore lends itself to being a potential therapeutic target. In this article, we will review 1) the pathogenesis and time course of the development of PHE, and 2) the clinical series and trials exploring various methods, with a focus on minimally invasive surgical techniques, to reduce PHE and minimize secondary brain injury. Promising areas of continued research also will be discussed.
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Review Case Reports
Ossified Intracranial Meningiomas: Description of the First Series of Cases and Review of the Literature.
Metaplastic meningiomas are characterized by mesenchymal differentiation with formation of bone, cartilage, fat, or xanthomatous elements. However the presence of extensive areas of ossification is rare in meningiomas. In addition, intracranial location of ossified meningiomas is uncommon. Surgical management represents the optimal treatment for ossified meningiomas, but ossification may interfere with surgery and condition outcome. ⋯ Here we present the largest series, to our knowledge, of surgically treated intracranial ossified meningiomas reported to date. The mechanism of ossification in these meningiomas remains unclear, and various hypotheses have been formulated. Complete lesion removal, or subtotal debulking in those cases characterized by tenacious adherences to vascular structures and/or critical areas, may represent the optimal treatment.
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Review Meta Analysis
Endovascular embolization of intracranial aneurysms: to use stent(s) or not? A systematic review and meta-analysis.
We sought to review the literature concerning stent-assisted coiling (SAC) in comparison with coiling without stents for treating intracranial aneurysms and to evaluate the safety and effectiveness of SAC by conducting a meta-analysis of published studies. ⋯ Compared with coiling without stent, stent-assisted coiling of intracranial aneurysms achieved satisfactory results, with higher long-term angiographic occlusion rate and lower recurrence rate. However, ischemic stroke remains a problem that cannot be ignored.
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Review Meta Analysis
Endovascular embolization of intracranial aneurysms: to use stent(s) or not? A systematic review and meta-analysis.
We sought to review the literature concerning stent-assisted coiling (SAC) in comparison with coiling without stents for treating intracranial aneurysms and to evaluate the safety and effectiveness of SAC by conducting a meta-analysis of published studies. ⋯ Compared with coiling without stent, stent-assisted coiling of intracranial aneurysms achieved satisfactory results, with higher long-term angiographic occlusion rate and lower recurrence rate. However, ischemic stroke remains a problem that cannot be ignored.
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Review Case Reports
Post-traumatic bifrontoparietal extradural hematoma with superior sagittal sinus detachment: a case report and review of the literature.
To present, to our knowledge, the first case of a single bilateral extradural hematoma due to superior sagittal sinus detachment that was treated conservatively with an excellent outcome. ⋯ Bilateral extradural hematomas due to superior sagittal sinus injury almost always require surgical intervention. We present a patient who was treated conservatively with an excellent outcome and we also perform a review of the current literature.