Hemorrhagic PitNets Are Associated with Previous Vascular Events and Result in Worse Endocrine Outcome.

Background: Pituitary apoplexy is a potentially life-threatening condition that most often results from hemorrhage into a preexisting pituitary neuroendocrine tumor (PitNet) presenting with acute headache, visual impairment and endocrine dysfunction. Here, we aimed to identify factors associated with hemorrhage and present the pituitary hormonal status before and after transnasal-transsphenoidal tumor removal in a comparative study design.

Methods: A series of 100 patients with PitNet were analyzed.

Early clinical experience with the new generation Pipeline Vantage flow diverter in the treatment of unruptured saccular aneurysms using short-term dual antiplatelet therapy.

Purpose: The Pipeline Vantage flow diverter with Shield technology (PV) used in this study is a 4th-generation flow diverter (FD) designed to reduce thrombogenicity, promote endothelialization of the implant and increase efficiency in achieving aneurysm closure. In this study, we report the aneurysm occlusion rate, complication rate and clinical outcome with short-term dual antiplatelet therapy (DAPT) in the treatment of unruptured intracranial saccular aneurysms using the PV.

Methods: We retrospectively identified patients treated between September 2021 and January 2023 with the PV and subsequently underwent short-term DAPT for 3 months.

Effect of a bundle approach on external ventricular drain-related infection.

Background: Emergency placement of an external ventricular drain (EVD) is one of the most frequently performed neurosurgical procedures. EVD-related infection continues to be a major challenge causing significant morbidity and costs. Bundle approaches have been shown to reduce infection rates; however, they are still not widely used, and observation periods often were rather short.

Intracranial emergencies during pregnancy requiring urgent neurosurgical treatment.

Objective: Despite contemporary diagnostic and therapeutic techniques intracranial emergencies in the obstetric setting pose still a major challenge for the clinicians. There are limited guidelines and differing ethical views. Multidisciplinary teams are needed to support the pregnant woman in a way that she can deliver a viable and healthy child.

De Novo Arteriovenous Malformation Growth Secondary to Implantation of Genetically Modified Allogeneic Mesenchymal Stem Cells in the Brain.

Background And Importance: Local biological drug delivery in the brain is an innovative field of medicine that developed rapidly in recent years. Our report illustrates a unique case of de novo development of a cerebral arteriovenous malformation (AVM) after implantation of genetically modified allogeneic mesenchymal stem cells in the brain.

Clinical Presentation: A 50-year-old man was included in a prospective clinical study (study ID number CM GLP-1/01, 2007-004516-31) investigating a novel neuroprotective approach in stroke patients to prevent perihematomal neuronal damage.

CLIPPERS Syndrome: An Entity to be Faced in Neurosurgery.

Background: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder of the central nervous system; it has only recently been defined and to date has received only limited attention. Its cause is as yet unknown. The pathologic characteristics are infiltration of T lymphocytes into the perivascular spaces of the pons, responsiveness to immunotherapy, and gadolinium-enhancing punctiform lesions in the brainstem seen on magnetic resonance imaging (MRI).

An unusual cause of ventriculoperitoneal shunt infection.

Infection associated with ventriculoperitoneal (VP) shunt implantation can be a significant problem. VP shunt infection with Serratia marcescens, a gram-negative anaerobic rod, usually is related to underlying abdominal disease. This article describes treatment of two patients suffering from a VP shunt infection with S.

Normobaric hyperoxia for treatment of pneumocephalus after posterior fossa surgery in the semisitting position: a prospective randomized controlled trial.

Background: Supratentorial pneumocephalus after posterior fossa surgery in the semisitting position may lead to decreased alertness and other symptoms. We here aimed to prove the efficacy of normobaric hyperoxia on the absorption of postoperative pneumocephalus according to a standardized treatment protocol.

Methods And Findings: We enrolled 44 patients with postoperative supratentorial pneumocephalus (> 30 ml) after posterior fossa surgery in a semisitting position.

Surgical treatment of distal anterior cerebral artery aneurysms aided by electromagnetic navigation CT angiography.

The surgical treatment of distal anterior cerebral artery (DACA) aneurysms still presents a challenge for neurosurgeons because of their small size and their location in the depth of the narrow frontal interhemispheric fissure. This study aimed to investigate feasibility, safety, accuracy, and usefulness of electromagnetic (EM) navigation to aid clipping of DACA aneurysms. Eight patients (age between 2 and 68 years, mean age 49.

Neurosurgical intensive care unit--essential for good outcomes in neurosurgery?

Introduction: Neurosurgical intensive care units were increasingly agglomerated in large centralized interdisciplinary intensive care units in the last two decades. In the majority, these centralized interdisciplinary intensive care units were directed and managed by intensivists coming from anaesthesiology. We sought to review the evidence supporting neurosurgical intensive care as a highly specialized discipline resulting in benefits for the treated patients.

The effect of physical activity and physical fitness on plasma adiponectin in adults with predisposition to metabolic syndrome.

The purpose of this study was to measure changes in plasma adiponectin (ApN) over 24 months of exercise intervention in middle age adults with a predisposition to metabolic syndrome and to determine if changes in ApN were more affected by physical activity or physical fitness. Thirty-six subjects completed a 24 months home-based exercise program (cycling>or=three times per week, >or=45 min/session at 50-65% of VO2peak). Body composition, blood samples, and physical fitness were studied at baseline and after 12 and 24 months of participation in the study.

Functional impairment, disability, and quality of life outcome after decompressive hemicraniectomy in malignant middle cerebral artery infarction.

Object: Whether decompressive hemicraniectomy is an appropriate treatment for space-occupying middle cerebral artery (MCA) infarction is still a controversial issue. Previous studies are in agreement on a reduction of the mortality rate, but the reported functional outcome was highly variable. The authors sought to determine functional impairment, disability, and health-related quality of life (QOL) outcome in long-term survivors who had undergone this procedure, and tried to identify factors related to functional outcome.

S-100B protein as a serum marker of secondary neurological complications in neurocritical care patients.

There is growing evidence that S-100B protein measured by a simple blood test can be used as a novel biochemical marker of brain cell damage. The objective of our study was to investigate the potential of S-100B measurements to diagnose an acute neurological complication in the analgo-sedated and intubated intensive care patient and the impact on patient management. Serum S-100B levels were serially investigated in 246 neurocritical care patients.

Serum S-100B protein as a molecular marker in severe traumatic brain injury.

Purpose: There is growing evidence that S-100B protein may be used as a novel biochemical marker of brain cell damage, measured by a simple blood test. In this paper, we summarize the current knowledge about S-100B serum measurements in severe head injury and address actual controversies.

Methods: The material of the present analysis consists of a MEDLINE literature search for S-100 and severe head injury from 1966 to 2003.

Effect of the novel endothelin(A) receptor antagonist LU 208075 on contraction and relaxation of isolated rat basilar artery.

Increased levels of endothelin (ET)-1 and bigET-1 may be responsible for enhanced cerebroarterial resistance under pathologic conditions. Therefore, the effect of LU 208075, a novel ET(A)-selective receptor antagonist was determined. The aim of the study was to investigate in vitro the inhibitory effect of LU 208075 on ET-1 and bigET-1 induced contraction and relaxation in rat basilar artery segments.

Primary meningeal osteosarcoma: case report and review of the literature.

Objective And Importance: Primary meningeal osteosarcomas are extremely rare lesions; before this case report, only five cases had been reported in the literature. We encountered a patient with a meningeal osteosarcoma but no evidence of additional tumor at another remote site.

Clinical Presentation: A 56-year-old man presented with progressive weakness of the right leg and the right arm.