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Safety of emergency endoscopic endonasal surgery in COVID-positive patients with hemorrhagic complications of pituitary region tumors: A case report and review of the literature.
Surg Neurol Int
December 2024
Department of Neurosurgery Westchester Medical Center, Valhalla, New York, United States.
Background: Pituitary apoplexy (PA) is a rare, life-threatening clinical syndrome that occurs in response to acute ischemic infarction or hemorrhage of a pituitary adenoma. We report two cases of sudden neurologic and visual decline in patients with pituitary region masses in coronavirus disease (COVID)-positive patients with a focus on potential pathophysiological mechanisms and a safe approach to treatment.
Case Description: Case one is a 58-year-old male presenting with sudden-onset headache and visual disturbance.
Congenital disorders of glycosylation type 1A associated with cerebral hemorrhagic infarction: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Background: Cases of congenital disorders of glycosylation (CDGs) are rare, and the occurrence of hemorrhagic infarction is also rare. The etiology is unclear.
Observations: A 3-year-old Asian boy with CDG type 1A was hospitalized with pneumonia.
Efficacy, safety and dose patterns of tranexamic acid in meningioma surgery: a systematic review and updated meta-analysis of randomized controlled trials.
Neurosurg Rev
January 2025
Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.
Article Synopsis
- The study examined the use and safety of intravenous tranexamic acid (TXA) in patients undergoing surgery for intracranial meningiomas, focusing on how different doses affected outcomes.
- A total of six randomized controlled trials with 881 patients were analyzed, revealing that TXA significantly reduced intraoperative blood loss, blood transfusion rates, surgery duration, and hospital stay lengths, but did not increase postoperative complications.
- The findings suggested that a preoperative dose of 20 mg/kg with an intraoperative maintenance dose was effective in minimizing blood loss, although further research is needed to confirm these observations and optimize dosing strategies.
Coagulopathy at admission in traumatic brain injury and its association with hematoma progression: A systematic review and meta-analysis of 2411 patients.
Clin Neurol Neurosurg
December 2024
Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran. Electronic address:
Progressive hemorrhagic injury (PHI) is a frequent complication of traumatic brain injury (TBI). This study aims to investigate the impact of coagulation factors (platelet [PLT], prothrombin time [PT], activated partial thromboplastin time [aPTT], international normalized ratio , fibrinogen [Fg], D-dimer [Dd], and fibrin [Fib]) at admission and PHI development through a comprehensive systematic review and meta-analysis based on PRISMA 2020 guideline. Databases including PubMed, Scopus, Web of Science, and Embase were searched up to March 2024.
View Article and Find Full Text PDFEconomic Impact of Surveillance of Head Trauma Patients with Coagulopathy and Normal Initial Computed Tomography Scan (ECO-NCT).
Acta Med Port
January 2025
Neurosurgery Department. Unidade Local de Saúde de Santo António. Porto. Portugal.
Article Synopsis
- The Portuguese clinical guidelines recommend 24 hours of hospital monitoring for patients with traumatic brain injuries, even when initial CT scans are normal, despite evidence suggesting this may be unnecessary and potentially harmful.
- A study analyzed the costs and outcomes of this practice, comparing data from 440 patients admitted in 2022, where only 0.5% developed new intracranial lesions during a 24-hour observation period and one patient (0.2%) died from unrelated causes.
- The current monitoring protocol cost €163,157, significantly more than the hypothetical scenario of discharging patients after an initial normal CT scan, which would have cost €29,480, highlighting a difference of €133,677.
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