These lesions were consistently hypodense on computed tomographic scans and hyperintense on T1-weighted images with minimal to no enhancement after www.selleckchem.com/products/etomoxir-na-salt.html gadolinium administration. Disseminated fat droplets were present in the subarachnoid space in both cerebral hemispheres in all patients, and five patients had intraventricular rupture with fat-fluid levels in the ventricles. Gross to near-total resection of the primary lesion was achieved in all five surgically treated patients treated at our institution. Four patients had remnant tumor capsules adherent to neurovascular structures that were unresectable.

Repeat resection was performed for one recurrence; there were no further recurrences during a follow-up period of 2 to 134 months (mean, 65.6 mo). Two patients with preoperative hydrocephalus eventually required ventriculoperitoneal

shunting.

CONCLUSION: Ruptured intracranial dermoid cysts represent 0.18% of all central nervous system tumors surgically treated in our institution during a 12-year period. The presence of disseminated fat droplets in the subarachnoid space or ventricles on neuro-imaging is diagnostic for a ruptured dermoid cyst. Gross total removal is achievable; however, residual tumor capsules adherent to neurovascular structures should be left behind to minimize complications.”
“OBJECTIVE: Carotid artery stenting click here (CAS) and carotid endarterectomy (CEA) are currently being compared in ongoing randomized,

controlled trials using postprocedural 30-day stroke rate, myocardial infarction, and mortality as primary endpoints. Recent data suggest that cognitive function may decline after CEA. Understanding the mechanisms that affect cognitive outcomes after carotid revascularization will be important in the design of future comparative studies of CAS and CEA incorporating cognitive outcome as an endpoint.

SUMMARY OF REVIEW: The effects of carotid revascularization procedures on cognitive outcome are unclear. Several factors contribute to the difficulty in interpreting cognitive data, including patient heterogeneity, variability of surgical techniques, and the differences in neuropsychological testing www.selleck.cn/products/epacadostat-incb024360.html methodology. Mechanisms underlying cognitive effects during CEA have emerged, including the potential detrimental effect of procedural emboli and the beneficial effect of improved cerebral hemodynamics. The emergence of CAS as an alternative to CEA for treating carotid stenosis again raises questions about cognitive outcomes. Despite the use of distal protection devices, CAS is associated with a higher burden of microemboli. CAS does not, however, require the extent of temporary vessel occlusion associated with CEA.