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The effect of temporary CSF diversion modality on shunt-dependency following aneurysmal subarachnoid hemorrhage: A nationwide assessment.
J Clin Neurosci
December 2024
Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) carries a high economic cost and clinical morbidity in the United States. Beyond prolonged admissions and poor post-injury functional status, there is an additional cost of chronic shunt-dependent hydrocephalus for many aSAH patients. Adjuvant lumbar drain (LD) placement has been hypothesized to promote clearance of subarachnoid blood from the cisternal space, with an ultimate effect of decreasing shunt placement rates.
View Article and Find Full Text PDFDiagnostic challenges of diffuse leptomeningeal glioneuronal tumor in an adult female: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background: Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a rare central nervous system tumor, especially in adult females. Typically, it presents with leptomeningeal enhancements in the basal cisterns and spinal cord. However, varied radiological and pathological features can complicate the diagnosis, as the present case illustrates.
View Article and Find Full Text PDFOptimization of antiviral dosing in Herpesviridae encephalitis: a promising approach to improve outcome?
Clin Microbiol Infect
December 2024
Institute of Medical Microbiology and Virology, University Medical Center, Göttingen, Germany.
Background: Despite established antiviral therapy for herpes simplex virus, varicella zoster and cytomegalovirus encephalitis, the outcome remains poor.
Objectives: To assess pharmacokinetic (PK) and pharmacodynamic (PD) data of antiviral drugs in the central nervous system (CNS) to optimize the treatment of Herpesviridae encephalitis.
Sources: PUBMED search 1950 to September 2024, terms (1) "encephalitis" and ("HSV" or "VZV" or "CMV") or (2) cerebrospinal and ("(val)acyclovir" or "(val)ganciclovir" or "foscarnet" or "cidofovir").
Improvement of Isolated Abducens Nerve Palsy with Hydrocephalus after CSF Diversion: A Possible Evaluative Role of Retroclival-pontomedullary Distance.
NMC Case Rep J
November 2024
Department of Neurosurgery, Yokohama City University, School of Medicine, Yokohama, Kanagawa, Japan.
Isolated abducens nerve palsy (IANP), caused by secondary communicating hydrocephalus, has been rarely documented; in addition, its mechanism and appropriate treatment are not understood well. This study presents a case of bilateral IANP with hydrocephalus in a 62-year-old man who was successfully treated with cerebrospinal fluid (CSF) diversion to correct an enlarged retroclival space during the follow-up of recurrent brain tumor in the right parieto-occipital lobe. The patient was treated with three resections, temozolomide, and irradiation before developing IANP.
View Article and Find Full Text PDFArticle Synopsis
- The study is a retrospective analysis investigating the effectiveness of single bolus cisternal urokinase in treating patients with saccular aneurysms and subarachnoid hemorrhages from January 2007 to December 2019.
- It found that administering urokinase during surgical clipping led to better outcomes in terms of reduced vasospasm, lower mortality rates, and fewer permanent CSF diversions compared to endovascular treatment methods, especially in patients with higher Fisher grades.
- Overall, the findings suggest that this treatment is safe and beneficial without significantly increasing complications like hemorrhages or infections.
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