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Clinical Neurology and Neurosurgery

Hipólito Nzwalo, Jerina Nogueira, Patrícia Guilherme, Pedro Abreu, Catarina Félix, Fátima Ferreira, Sara Ramalhete, Ana Marreiros, Turgut Tatlisumak, Lars Thomassen, Nicola Logallo
OBJECTIVES: Spontaneous intracerebral hemorrhage (SICH) survivors are at risk of hospital readmissions. Data on readmissions after SICH is scarce. We aimed to study the frequency and predictors of readmissions after SICH in Algarve, Portugal. PATIENTS AND METHODS: Retrospective study of a community representative cohort of SICH survivors (2009-2015). The first unplanned readmission in the first year after discharge was the outcome. Cox regression analysis was performed to identify predictors of 1-year readmission...
April 12, 2018: Clinical Neurology and Neurosurgery
Victor M Lu, Kevin Phan, Richard A Rovin
Surgical resection of eloquent glioma can be achieved under general anesthesia (GA) or awake anesthesia (AA). The appeal of AA is that it facilitates intraoperative identification and avoidance of eloquent areas, which has the potential to minimize functional compromise. The aim of this meta-analysis was to compare the operative outcomes of eloquent glioma resection performed under GA compared to AA to assist in optimizing the decision algorithm between the two approaches. Searches of seven electronic databases from inception to December 2017 were conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines...
April 9, 2018: Clinical Neurology and Neurosurgery
Nidan Qiao
It is unclear whether the endoscopic technique has any advantages over transcranial approach in the aspect of endocrine outcomes in patients with craniopharyngiomas, thus, we conducted a systematic review and meta-analysis. We conducted a comprehensive search of PubMed to identify relevant studies. Pituitary, hypothalamus functions and recurrence were used as outcome measures. A total of 39 cohort studies involving 3079 adult patients were included in the comparison. Among these studies, 752 patients across 17 studies underwent endoscopic transsphenoidal resection, and 2327 patients across 23 studies underwent transcranial resection...
April 7, 2018: Clinical Neurology and Neurosurgery
Kok Ann Colin Teo, Tseng Tsai Yeo, Vijay K Sharma
OBJECTIVES: We report the long-term outcome and rates of recurrent cerebral ischemic events in our cohort of carefully selected patients after STA-MCA bypass for severe steno-occlusive disease of intracranial ICA or MCA with exhausted cerebral vasodilatory reserve. PATIENTS AND METHODS: In this retrospective study, we reviewed the hospital records for all patients who underwent direct superficial temporal artery-middle cerebral artery bypass surgery at our institution from January 2010 to August 2017...
April 3, 2018: Clinical Neurology and Neurosurgery
Kazuyoshi Kobayashi, Kei Ando, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Naoki Ishiguro, Shiro Imagama
OBJECTIVES: Adherence to scheduled times in surgery is important in hospital management. However, sudden surgical changes or unexpected intraoperative problems may lead to prolongation of operative times. The purpose of this study was to investigate operative times in spinal surgery and to identify causes of delays during surgery. PATIENTS AND METHODS: A retrospective review of 488 cases of spinal surgery was performed to investigate operations prolonged for >2 h and to identify factors associated with prolongation...
April 3, 2018: Clinical Neurology and Neurosurgery
Thorsten Jentzsch, Rudolf M Moos, Valentin Neuhaus, Kariem Hussein, Jan Farei-Campagna, Burkhardt Seifert, Hans-Peter Simmen, Clément M L Werner, Georg Osterhoff
OBJECTIVES: The use of new anticoagulants potentially carries the risk of increased intracranial bleeding, but there is a lack of evidence. The aim of this study was to investigate whether the morbidity and mortality differs in head trauma patients depending on the type of anticoagulation. PATIENTS AND METHODS: A retrospective cohort study was conducted in 2009-2014. Based on sex, age, and Glasgow-Coma Scale (GCS), patients that received rivaroxaban were matched to two control groups, one that received no anticoagulant and another one that received phenprocoumon...
April 3, 2018: Clinical Neurology and Neurosurgery
Hong-Xiang Wang, Rong Qin, Jian Mao, Qi-Lin Huang, Fan Hong, Feng Li, Zhen-Yu Gong, Tao Xu, Yong Yan, Shao-Hui Chao, Shi-Kun Zhang, Ju-Xiang Chen
OBJECTIVE: Cytoplasmic polyadenylation element binding protein 4 (CPEB4) is a regulator of gene expression at transcriptional level and has been reported to be associated with biological malignancy in cancers. However, little was known about the correlation between CPEB4 and glioblastoma cell proliferation and the prognostic significance in patients. Our aim was to investigate the functional role and prognostic value of CPEB4 in glioblastoma. PATIENTS AND METHODS: We determined the expression of CPEB4 protein using immunohistochemistry in tissue microarrays containing 278 glioma patients (including 98 primary glioblastomas) and evaluated its association with pathological grades and clinical outcome by univariate and multivariate analyses...
April 3, 2018: Clinical Neurology and Neurosurgery
Zhuo-Jie Liu, Bang-Ping Qian, Yong Qiu, Sai-Hu Mao, Jun Jiang, Bin Wang
OBJECTIVE: To investigate if pelvic incidence (PI) and lumbar lordosis (LL) mismatching affects surgical outcomes for ankylosing spondylitis (AS) related kyphosis following 1-level lumbar pedicle subtraction osteotomy (PSO). PATIENTS AND METHODS: AS patients with thoracolumbar kyphosis, who underwent 1-level lumbar PSO from March 2006 and February 2014 in our institution, were retrospectively reviewed. The radiographic measurements and health-related quality of life (HRQoL) scores, including Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) for pain, were recorded at baseline and the last follow-up...
April 3, 2018: Clinical Neurology and Neurosurgery
Jiyong Gu, Weiwei Lei, Zong Xin, Yi Wu, Lin Peng, Zhibin Li, Zize Feng, Minchan Zhao, Songtao Qi, Yuntao Lu
OBJECTIVE: Fixation with the axis vertebra (C2) using pedicle screws is commonly used to treat an unstable occipitocervical junction; however, it is accompanied by a risk of vertebral artery injury. The occiput-C2 (OC2) crossing translaminar screw fixation technique may avoid this risk, but rod implantation is difficult. Offset connectors can help facilitate this construct. This study aimed to evaluate the stability of a technique for OC2 crossing translaminar screw fixation using offset connectors (C2LAM + OF) in comparison with other methods...
April 3, 2018: Clinical Neurology and Neurosurgery
Chunyan Ge, Wangmiao Zhao, Hong Guo, Zhaosheng Sun, Wanzeng Zhang, Xiaowei Li, Xuehui Yang, Jinrong Zhang, Dongxin Wang, Yi Xiang, Jianhui Mao, Wenchao Zhang, Hao Guo, Yazhao Zhang, Jianchao Chen
OBJECTIVES: Surgical treatment is widely used for haematoma removal in spontaneous intracerebral haemorrhage (ICH) patients, but there is controversy about the selection of surgical methods. The CT angiography (CTA) spot sign has been proven to be a promising factor predicting haematoma expansion and is recommended as an entry criterion for haemostatic therapy in patients with ICH. This trial was designed to evaluate the clinical efficacy of two surgical methods (haematoma removal by craniotomy and craniopuncture combined with urokinase infusion) for patients in the early stage (≤6h from symptom onset) of spontaneous ICH with a moderate haematoma volume (30 ml - 60 ml)...
April 3, 2018: Clinical Neurology and Neurosurgery
Nayan Lamba, Chunming Liu, Hasan Zaidi, M L D Broekman, Thomas Simjian, Chen Shi, Joanne Doucette, Steven Ren, Timothy R Smith, Rania A Mekary, Adomas Bunevicius
BACKGROUND: Low triiodothyronine (T3) syndrome could be a powerful prognostic factor for acute stroke; yet, a prognostic role for low T3 has not been given enough importance in stroke management. This meta-analysis aimed to evaluate whether low T3 among acute stroke patients could be used as a prognostic biomarker for stroke severity, functional outcome, and mortality. METHODS: Studies that investigated low T3 prognostic roles in acute stroke patients were sought from PubMed/Medline, Embase, and Cochrane databases through 11/23/2016...
March 31, 2018: Clinical Neurology and Neurosurgery
Oscar H Del Brutto, Robertino M Mera, Danielle Gladstone, María Sarmiento-Bobadilla, Kristen Cagino, Mauricio Zambrano, Aldo F Costa, Mark J Sedler
OBJECTIVE: The Evans Index (EI) is used for recognition of individuals with normal pressure hydrocephalus. However, recent studies suggest that the EI is not a reliable marker of this condition. Rather, the EI may be inversely correlated with cognitive performance, but information on this correlation is lacking. We aimed to assess the relationship between the EI and cognitive performance in community-dwelling older adults. PATIENTS AND METHODS: The study included 314 non-disabled, stroke-free, individuals aged ≥60 years enrolled in the Atahualpa Project undergoing brain MRI and MoCA testing...
March 30, 2018: Clinical Neurology and Neurosurgery
T Schirinzi, S Scalise, G Di Lazzaro, R Cerroni, A Chiaravalloti, P Lavorenti Figueras, M Pierantozzi, A Pisani, A Stefani
No abstract text is available yet for this article.
March 28, 2018: Clinical Neurology and Neurosurgery
Pravin Salunke, Madhivanan Karthigeyan, Sushanta K Sahoo, Prashant K Prasad
OBJECTIVE: There is lack of consensus on the preferred approach for unstable Hangman's fracture. The associated soft tissue injuries apart from apparent bony injury add to the complexity of dislocation and needs to be addressed. Here, we evaluated the clinico-radiological characteristics and outcome of patients managed by posterior C2-3 fusion. PATIENTS & METHODS: Nine patients with unstable Hangman's fracture (type II and IIA) were prospectively studied. The displacement of fractured fragments and C2-3 dislocation was studied in multiple planes...
March 27, 2018: Clinical Neurology and Neurosurgery
Yong Liu, Fuqiang Feng, Peigang Ji, Bolin Liu, Shunnan Ge, Chen Yang, Miao Lou, Jinghui Liu, Baofu Li, Guodong Gao, Yan Qu, Liang Wang
OBJECTIVES: Bevacizumab (BEV) plus daily temozolomide (TMZ) as a salvage therapy have been recommended to recurrent glioma. The objective of this retrospective study was to evaluate the effect of the combined regimen on health related quality of life (HRQL) and treatment response in patients with recurrent glioma. PATIENTS AND METHODS: Twenty patients with recurrent glioma were treated with BEV (5-10 mg/kg, i.v. every 2 weeks) plus daily TMZ (daily, 50 mg/m2 )...
March 27, 2018: Clinical Neurology and Neurosurgery
Denise Feierabend, Salah Maksoud, Aaron Lawson McLean, Arend Koch, Rolf Kalff, Jan Walter
OBJECTIVE: Intracranial chondroma is a rare and benign tumor with usual onset in young adulthood. The skull base is the most common site of occurrence although, less often, the tumors can appear at the falx cerebri or at the dural convexity. The differentiation of these lesions from meningiomas through imaging is generally difficult. PATIENT AND METHODS: Clinical case presentation and review of the current literature. RESULTS / CASE PRESENTATION: We report a case of a 25-year-old male patient with a giant convexity chondroma with meningeal attachment in the right frontal lobe that was detected after a first generalized seizure...
March 27, 2018: Clinical Neurology and Neurosurgery
Hongzhou Duan, Jiayong Zhang, Feifan Xu, Zongqiang Zhang, Xiaowen Zhao
BACKGROUND: Intramedullary ectopic choroid plexus is rarely reported, here, we reported a rare case of symptomatic syringomyelia resulted of intramedullary ectopic choroid plexus. CASE DESCRIPTION: The patient was a 30-year-old female who presented with a 2-month history of progressive pain of upper back and bilateral ankle joint and progressive loss of upper-extremity function. MRI examination showed an intramedullary cystic lesion at T2-T4 without enhancement...
March 27, 2018: Clinical Neurology and Neurosurgery
Nguyen Ngoc Cuong, Vu Dang Luu, Tran Anh Tuan, Le Tuan Linh, Kieu Dinh Hung, Vo Truong Nhu Ngoc, Kulbhushan Sharma, Van Huy Pham, Dinh-Toi Chu
OBJECTIVES: Digital subtractional angiography (DSA) is the standard method for diagnosis, assessment and management of arteriovenous malformation in the brain. Conventional DSA (cDSA) is an invasive imaging modality that is often indicated before interventional treatments (embolization, open surgery, gamma knife). Here, we aimed to compare this technique with a non-invasive MR angiography (MRI DSA) for brain arteriovenous malformation (bAVM). PATIENTS AND METHODS: Fourteen patients with ruptured brain AVM underwent embolization treatment pre-operation...
March 27, 2018: Clinical Neurology and Neurosurgery
Xi Zhang, De-Shan Liu, Chun-Yao An, Yu-Zhao Liu, Xiao-Hong Liu, Fang Zhang, Lu-Ning Ning, Chang-Ling Li, Chun-Mei Ma, Rui-Ting Hu
OBJECTIVES: Lower serum uric acid (UA) levels are considered to be related to the risk to develop many neurodegenerative disorders. However, the association between serum UA level and multiple system atrophy (MSA) remains controversial. The aim of this meta-analysis was to evaluate the relationship between serum UA level and MSA. PATIENTS AND METHODS: PubMed, Web of Science, Embase, Cochrane Library and China National Knowledge Infrastructure (CNKI) were searched for eligible studies...
March 27, 2018: Clinical Neurology and Neurosurgery
D P Kidd, D J McCabe, T Wilhelm, M Galloway
OBJECTIVE: To present and review the vascular consequences of arteritis in neurosarcoidosis. PATIENT AND METHODS: neurosarcoidosis is typically an inflammatory disorder of the meninges surrounding the brain and spinal cord. Although inflammation of small and medium sized vessels is seen pathologically and vasculitis is occasionally described, a large intracerebral arteritis has not previously been reported. A few case reports exist, however, which describe the vascular consequences of large vessel compromise in the disorder...
March 22, 2018: Clinical Neurology and Neurosurgery
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