Neurol Neurochir Pol
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Neurol Neurochir Pol · May 2008
Review Case ReportsNeuroendoscopic third ventriculostomy in the management of noncommunicating hydrocephalus secondary to giant basilar artery bifurcation aneurysm - case report and review of literature.
Recently neuroendoscopic third ventriculostomy has become a well-established procedure for the treatment of noncommunicating hydrocephalus. However, morphological changes of the third ventricular floor can make endoscopic fenestration technically difficult, and increase the risk of injury to the basilar artery and perforators. The risk is especially high in patients with basilar artery bifurcation aneurysms, in whom aneurysm exclusion should precede treatment of hydrocephalus. ⋯ We report upon a case of obstructive hydrocephalus produced by a non-ruptured partially thrombosed giant basilar artery bifurcation aneurysm, in which definitive treatment was considered impossible, successfully treated with neuroendoscopic third ventriculostomy. To the authors' knowledge this is the first reported case of its kind. The authors conclude that in similar cases neuroendoscopic ventriculostomy is worth trying if anatomical landmarks are identifiable.
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Neurol Neurochir Pol · May 2008
Effects of palliative treatment with temozolomide in patients with high-grade gliomas.
The aim of the study was to assess the results of treatment with temozolomide in patients with high-grade gliomas who no longer benefit from surgical treatment and radiotherapy. ⋯ Objective benefit from the temozolomide treatment (stabilization or objective remission) was observed in 49% of patients irrespective of histological diagnosis. Tolerability of treatment with temozolomide in patients with high-grade gliomas is good.
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The presence of tumefactive lesions on magnetic resonance imaging (MRI) in multiple sclerosis (MS) patients can cause diagnostic difficulties. It requires differential diagnosis between tumefactive demyelinating lesion (TDL) and the coexistence of neoplasm; it also implies further management. ⋯ We present three cases of MS presenting with tumour-like lesions of the brain. Based on serial MRI studies, stereotactic biopsy and the response to treatment with corticosteroids, the diagnosis of TDL was established in every case.
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Neurol Neurochir Pol · Nov 2007
Case Reports[Compression neuropathy of cranial nerves in the course of Takayasu arteritis].
Takayasu arteritis is a rare vasculitis of the aorta and its branches. Neurological manifestation usually results from central nervous system ischaemia. We report a case presenting with unilateral paresis of the cranial nerves (V, IX and XII nerve) caused by a vascular conflict due to Takayasu arteritis. ⋯ Magnetic resonance angiography showed internal carotid artery dissection and prominent thickening of walls of both vertebral arteries as well as the left renal artery with narrowing of lumen. Compression of glossopharyngeal and hypoglossal nerves and the trigeminal ganglion was a result of a markedly dilated intracranial segment of the right carotid artery. The clinical and radiological findings were consistent with the diagnosis of Takayasu arteritis.
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Neurol Neurochir Pol · Jul 2007
Malpractice in diagnosis and treatment of craniocerebral injuries in cases reviewed by the Forensic Medicine Department, Medical University of Łódź.
The aim of the study was to determine the most frequent errors in medical treatment of craniocerebral injuries, based on materials reviewed by the Forensic Medicine Department, Medical University of Łódź, Poland. ⋯ Analyzed material comprised 17 errors during the decision-making process, including 4 diagnostic errors, as well as 1 therapeutic, 1 executive, and 1 organisational error. The most common error was disqualification from hospitalization of patients who should be observed in hospital. It was followed (in order of frequency) by errors related to transportation to the sobering chamber or to another hospital, and failure to perform or misinterpretation of imaging studies. The fewest errors referred to treatment. The main cause of craniocerebral injury was fall of a drunk person, and the alcohol intoxication made diagnosis difficult and delayed.