Intraventricular cavernomas (IVCs) are extremely infrequent and only occur in 2.8 to 10% of patients with cerebral cavernomas. We describe three IVC cases and briefly review previously documented IVC cases in PubMed. Among 136 IVC cases, the mean age of the patients was 36.5 years; the male-to-female ratio was 0.8. The most frequent location was the lateral ventricle (52.6%), and most of the clinical symptoms (74%) were related to mass effects on adjacent brain tissues. Intraventricular hemorrhage occurred in 22.9% of cases. Most of the articles concluded that complete surgical resection is the treatment of choice.The microsurgical approach is currently considered the gold standard for IVC resection. Using the neuroendoscope and neuronavigational guidance and based on the biological characteristics of the IVC, proper lesion size, and dilated ventricles, we totally resected the lesion in all three cases. Neuroendoscopy can be considered as an alternative to microsurgery of IVCs. However, we believe a larger series of cases is necessary to demonstrate when microsurgery and when neuroendoscopy should be performed for IVC resection.
Background The rate of traumatic brain injuries (TBIs) due to the accidents is high around the world. Patients with mild TBIs may suffer from some psychological disorders, including aggression, and mental fatigue, and thus their quality of life decreased. Among different treatments for TBI, two treatments, namely transcranial direct current stimulation (tDCS), and mindfulness-based stress reduction (MBSR) have shown to be effective. Therefore, this study aimed to compare the effects of these two treatments on mental fatigue, aggression and quality of life in mTBI patients. Materials and methods This randomized controlled trial study was conducted on 48 TBI patients referred to emergency and neurosurgery departments of Shahid Beheshti Hospital, Kashan, Iran. They were selected using the convenience sampling method. Data were collected using the mental fatigue scale, the World Health Organization Quality of Life-BREF (short version), and the Buss–Perry Aggression Questionnaires. Then, the data were analyzed using a Mixed Repeated Measures ANOVAs, and the Levene and Kolmogorov–Smirnov tests by SPSS-23 software. Results The mean age of patients in the three groups of MBSR, tDCS and control were 69.38 + 6.11 (25% male), 25.40 + 12.11 (25% male) and 69.37 + 0.2 (18.8% male), respectively. There was no significant difference between the three groups in terms of mental fatigue, quality of life and aggression (P < 0.05). In addition, the results showed that there was a significant difference between the main effect of time and the interaction between time and group (P < 0.001). Conclusions Both MBSR and tDCS methods are effective in reducing the mental fatigue and aggression and increasing quality of life of mTBI patients; MBSR treatment, as indicated in the present study, can be more effective than tDCS in patients with mTBI. Trial registration : Thailand Registry of Clinical Trials, TCTR20180827003 Registered on August 24, 2018.
Background & Aim: We described the presentation, management and subsequent treatment outcomes of children and adolescents diagnosed with a pituitary adenoma in a joint neuroendocrine setting followed up by a single service as well as assessing long-term outcomes in terms of endocrine status and neurology symptoms. Methods & Materials/Patients: A total of 21 participants with histologically verified pituitary adenoma between January 2011 and June 2014 were studied. Patients' data from clinical, radiological and pathological records were analyzed using SPSS (Version 16). Results: All these children and adolescents with pituitary adenomas were managed with microscopic transsphenoidal surgery. The most common symptom was Cushing (47.6%, n=10). The functional type (76.2%, n=16) was more than the non-functional. The post-operative control MRI of most of them was clear (90.5%, n=19). The lab control of most of them was normal (76.2%, n=16). Apoplexy was seen in 5 patients (33.8%). Gross-total resection (GTR; 100% tumor removal as judged by early post-operative imaging) was achieved in 19 cases. Only one of these patients showed evidence of radiologic recurrence. Conclusion: In our study, all patients underwent microscopic transsphenoidal surgery due to limitation of endoscopic approach in pediatric and avoided wide anatomical deficit. Doing a comparative study between these two approaches will bring about promising results.
Background: The rate of traumatic brain injuries (TBIs) due to the accidents is high around the world. Patients with mild TBIs may suffer from some psychological disorders, including aggression, and mental fatigue, and thus their quality of life decreased. Among different treatments for TBI, two treatments, namely transcranial direct current stimulation (tDCS), and mindfulness-based stress reduction (MBSR) have shown to be effective. So, this study aimed to compare the effects of these two treatments on mental fatigue, aggression and quality of life in mTBI patients.Materials and methods: This randomized controlled trial was conducted on 2000 TBI patients referred to emergency and neurosurgery departments of Shahid Beheshti Hospital, Kashan, Iran, in 2017. They were selected using the convenience sampling method. Data were collected using the mental fatigue scale, the World Health Organization Quality of Life- BREF (short version), and the Buss-Perry Aggression Questionnaires. Then, the data were analyzed using a Mixed Repeated Measures ANOVAs, and the Levene and Kolmogorov-Smirnov tests by SPSS-23 software.Results: Data were collected from 48 patients with mTBI. The mean age of patients in the three groups of MBSR, tDCS and control were 69.38 + 6.11 (25% male), 25.40 + 12.11 (25% male) and 69.37 + 0.2 (18.8% male), respectively. There was no significant difference between the three groups in terms of mental fatigue, quality of life and aggression (P <0.05). Also, the results showed that there was a significant difference between the main effect of time and the interaction between time and group (P <0.001).Conclusions: Both MBSR and tDCS methods are effective in reducing the mental fatigue and aggression and increasing quality of life of mTBI patients; MBSR treatment, as indicated in the present study, can be more effective than tDCS in patients with mTBI.Trial registration: Thailand Registry of Clinical Trials, TCTR20180827003 Registered on August 24, 2018.
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