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Emergency decompressive surgery in patients with transtentorial brain herniation and pupillary abnormalities: the importance of improved pupillary response after osmotherapy and surgery
CONCLUSIONS: With aggressive medical and surgical management, patients with transtentorial brain herniation, including those with bilaterally fixed and dilated pupils, may have considerable rates of survival and functional recovery. Young age, less midline shift, and improved pupillary response following osmotic therapy or decompressive surgery are favorable prognosticators.PMID:37548576 | DOI:10.3171/2023.5.JNS23163
Source: Journal of Neurosurgery - August 7, 2023 Category: Neurosurgery Authors: Daniel W Griepp Aaron Miller Sahar Sorek Komal Naeem Stephanie Moawad David Klein Joseph A DeMattia Ralph Rahme Source Type: research

Management dilemma in a rare case of pituitary apoplexy with akinetic mutism in the setting of ruptured junctional brain aneurysm: A case report and literature review
CONCLUSION: Pituitary apoplexy with ruptured A1-Acom junction aneurysm with nonfunctioning pituitary macroadenoma is rare, and its presentation with akinetic mutism has not been reported. As there is scarce literature suggesting an association between pituitary apoplexy and ruptured aneurysm, it is challenging to comment regarding its pathogenesis. Although akinetic mutism generally has a poor prognosis, it may respond to Levodopa with a better outcome.PMID:36751455 | PMC:PMC9899474 | DOI:10.25259/SNI_942_2022
Source: Surgical Neurology International - February 8, 2023 Category: Neurosurgery Authors: Vikas Chandra Jha Mohammad Shahnawaz Alam Vivek Sharan Sinha Rahul Jain Source Type: research

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery
AbstractSurgery of complex cranial base lesions carries a high risk of damage to main vessels, often resulting in life-changing or even life-threatening injuries. We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery. A linear incision was made behind the ear and standard retrosigmoid craniotomy was performed with preservation of the transverse and sigmoid sinuses. The dura was open...
Source: Neurology and Therapy - November 30, 2019 Category: Neurology Source Type: research

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery
We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery. A linear incision was made behind the ear and standard retrosigmoid craniotomy was performed with preservation of the transverse and sigmoid sinuses. The dura was opened in a Y-shaped fashion and the cerebellum was retracted with cerebrospinal fluid being released. Removing the exposed tumor from the artery resulted in a small arterial bleed....
Source: Neurology and Therapy - July 4, 2019 Category: Neurology Source Type: research

Management of concomitant metabolic encephalopathy and meningioma with vasogenic edema and impending herniation.
Conclusions: Management of concomitant metabolic encephalopathy and meningioma with vasogenic edema and impending herniation can be challenging. Correction of the encephalopathy is crucial to minimize perioperative morbidity and mortality. Awareness of metabolic causes of acute decompensation is critical for perioperative management, so a high index of clinical suspicion can make an important timely diagnosis for treatment initiation. Severely hypothyroid patients are sensitive to anesthetic agents and are at a high risk for perioperative complications. Prompt treatment prior to surgical intervention can help minimize peri...
Source: Surgical Neurology International - March 3, 2018 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

Cn-15 * adverse effects of bevacizumab in brain tumor patients
CONCLUSION: The range of toxicities was similar to other reports. Interestingly, hypertension was the most common adverse effect and was often not treated. The high incidence of lymphocytopenia may have implications for combination with immunotherapies. These findings underscore the need to develop predictive models to identify patients at high risk for serious treatment-related toxicities.
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Pawar, T., Ladha, H., Mandel, J., Gilbert, M., O'Brien, B., Hamza, M., Armstrong, T. Tags: COMPLICATIONS OF THERAPY AND NEUROTOXICITY Source Type: research