Very rare meningiomas imaging variants. A case report series and a literature review.

In this respect with this case series study, we try to aim the reporting radiologist or neurosurgeon to have a better view of their wide-range potential manifestation to differentiate these damages from the several lesions that can imitate their appearance and thus, will be helpful in surgical planning. Differential diagnoses should be adapted depending on the tumor sites and imaging findings, but could mostly include hypervascular tumors.THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV

Glioblastoma Multiforme in a Patient with Celiac Disease: Management of Seizures After Gross Total Tumor Resection

Background: A 55-year-old woman with a history of celiac disease presented with focal seizures and a mass lesion located at the left frontal lobe. Management of seizures in these patients is challenging. Case Description: The patient underwent a navigation-assisted tumor resection. A week later, she returned to her regular diet, but 12 days after surgery she started the same pattern seizures. Conclusion: A patient suffering from glioblastoma multiforme who presents with seizures and has a history of celiac disease must be treated more aggressively than usual, with dual or triple anticonvulsant scheme therapy, and provided a strict gluten-free diet after tumor resection. © 2018 Elsevier Inc

The outcome after surgical vs nonsurgical treatment of chronic subdural hematoma with dexamethasone

Background: To determine the patient outcomes of retrospectively collected data between surgical versus nonsurgical treatment of chronic subdural hematoma (CSDH) with Dexamethasone (DX). Methods: This was a retrospective study of 171 patients with chronic subdural hematoma between January 2012 and December 2016 and was derived into three groups: Group A: burr-hole craniostomy (BHC) with DX as an adjunct to surgery; Group B: BHC surgery without DX; and Group C: conservative treatment with DX monotherapy. Results: There were 120 males (70.1%) with mean age 76.4 ± 9.3 years (range 63 years, 33–96). In Group A [n = 24 (14.0%)], there were 20 males (80%) and the mean age was 75.5 ± 8.6 years. In Group B [n = 136 (80.1%)], there were 92 males (67.6%) with mean age 76.9 ± 11.3 years and in Group C [n = 10 (5.8%)], there were 8 males (80%) with mean age 70.0 ± 10.6 years. The incidence of recurrence in Group A was 1 case (4%) compared with Group B 10 cases (7.3%), and Group C 3 cases (30%) and there were a statistical significant difference between groups (P = 0.030). Conclusion: Patients with CSDHs have better outcome when treated with BHC and corticosteroids among other therapeutic options. Between BHC with DX and BHC without use of corticosteroids in surgical management of CSDHs, the combination therapy should be considered a first-choice. © 201

Clipping Versus Coiling in Anterior Circulation Ruptured Intracranial Aneurysms: A Meta-Analysis

Objective To evaluate open surgical versus endovascular repair of anterior circulation ruptured intracranial aneurysms based on operative mortality, permanent neurologic deficit, late mortality, and need for reintervention. Methods This meta-analysis included articles published since December 6, 2016, that compared outcomes of the 2 methods. Extracted data were organized in a standard table format, including first author, country, covered study period, publication year, number of patients and patients at follow-up, operative mortality rate (with 30 days from treatment), permanent neurologic deficit (appearing after surgery), late mortality (after 1 month), and reintervention (surgery or coiling) for both groups of patients. Follow-up was at least 1 year. Results There were 8 articles that matched our study criteria. The study population was 628 patients; 374 were treated with surgical clipping, and 254 were treated with endovascular coiling. Pooled results showed no statistically significant difference between the 2 groups in terms of operative mortality, permanent neurologic deficit, late mortality, and need for reintervention. Conclusions Selection of the appropriate procedure must be made on the basis of the special characteristics of each case. © 2017 Elsevier Inc

Outcomes in meningitis/ventriculitis treated with intravenous or intraventricular plus intravenous colistin

Background: The aim of this work is to evaluate the outcome of patients treated with intrathecal colistin for meningitis/ventriculitis. Methods: This retrospective case series study included patients presenting with nosocomial meningitis/ventriculitis following neurosurgical interventions and having intravenous (IVC group) or intravenous and intrathecal/intraventricular colistin (ITC group) treatment between 2006 and 2014. Results: Thirty-four patients presented nosocomial meningitis/ventriculitis; 11 (32.5 %) were included in the IVC group and 23 (67.6 %) in the ITC group. The most frequent isolated bacteria were Acinetobacter baumannii. The mean dose was 170,000 (±400) IU and the duration of intraventricular treatment was 16.0 (±8.3) days. The duration of intravenous treatment was 16.0 (±8.3) days in the ITC group and 15.3 ± 7.6 days in IVC group. Hospital mortality was significantly lower in the ITC group compared with the IVC group (13 vs. 72.7 %, p = 0.001). Conclusions: The combination of intravenous plus intraventricular (IV-IVT) colistin therapy may improve outcomes in patients attending with meningitis/ventriculitis due to multi-drug resistance infections. © 2016, Springer-Verlag Wien

High-tidal-volume mechanical ventilation and lung inflammation in intensive care patients with normal lungs

Background This study was conducted to investigate whether high-tidal-volume mechanical ventilation is associated with increased lung inflammation compared with low-tidal-volume mechanical ventilation in critically ill patients with no evidence of lung injury. Methods In this prospective, single-blind, randomized (1:1), parallel-group study, 18 critically ill patients with normal lungs were randomly assigned to receive mechanical ventilation with a tidal volume of either 6 mL/kg (low tidal volume) or 12 mL/kg (high tidal volume) during the first 4 days in the intensive care unit. Results At baseline and at 24, 48, and 96 hours, exhaled breath condensate was collected to measure interleukin 1β, interleukin 10, tumor necrosis factor α, and total nitric oxide metabolites. Interleukin 1β levels in exhaled breath condensate were significantly increased at 24 hours compared with baseline in the high-tidal-volume group but not in the low-tidal-volume group. The interleukin 1β increase in the high-tidal-volume group was transient. Exhaled breath condensate levels of interleukin 1β, interleukin 10, tumor necrosis factor α, and total nitric oxide metabolites did not differ significantly between the high-tidal-volume and low-tidal-volume groups at any time point. Conclusion Short-term mechanical ventilation with a tidal volume of 12 mL/kg may trigger inflammatory responses in the lungs of intensive care unit patients without preexisting lung injury. (American Journal of Critical Care. ©2020 American Association of Critical-Care Nurses

Could IGF-I levels play a neuroprotective role in patients with large vestibular schwannomas?

Aim: To evaluate the possible superiority of outcome in patients with elevated IGF-I levels after vestibular schwannoma (VS) resection. Patients & methods: This retrospective study included 65 patients (34 male, 52.3%) with VS operated in between January 2009 and April 2014 (follow-up 3.2 ± 0.7 years). Preoperative or postoperative IGF-I levels were identified for each patient. Results: Patients were divided into two groups: Group A (small size tumor), 56 patients; and Group B (large size tumor), 9 cases. IGF-I levels in Group A (195.8 ± 32.9 ng/ml) were compared with those of Group B (242.2 ± 22.2 ng/ml) and were found to have statistically significant difference (p = 0.001). Conclusion: Increased IGF-I levels could hold a key role in nerve recovery in patients undergoing surgical resection of large VS. Lay abstract The aim of this study was to examine the possible correlation between IGF-I levels in serum in large vestibular schwannomas (VS) and its potential neuroprotective effect on the vestibulocochlear nerve. This retrospective study included 65 patients that underwent surgery, 9 of whom were diagnosed with large VS. Results suggested that elevated IGF-I in serum levels could help identify patients with large VS with better neuroprotective activity. © 2018 2017 George Fotakopoulos