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Neurosurgical Forum: Letters to the editor To The Editor Kazuo Tsutsumi , M.D. Saitama Medical Center Saitama, Japan 638 638 I have read with interest the article by Shimoda, et al. (Shimoda M, Oda S, Tsugane R, et al: Intracranial complications of hypervolemic therapy in patients with a delayed ischemic deficit attributed to vasospasm. J Neurosurg 78: 423–429, March, 1993). This paper provides us with good guidelines for hypervolemic therapy in patients with delayed ischemic neurological deficit (DIND) due to

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Pankaj A. Gore, Harvinder Maan, Steve Chang, Alan M. Pitt, Robert F. Spetzler and Peter Nakaji

travel to a higher altitude, it can progress to life-threatening tension pneumocephalus. 1 , 8 , 9 The treatment of substantial postoperative pneumocephalus with supplemental O 2 is a common neurosurgical practice. Yet scant clinical data are available on the efficacy of this therapy and on the rate of pneumocephalus absorption. This study examined the role of supplemental O 2 therapy for the treatment of postoperative pneumocephalus in a prospective, pseudorandomized setting. Clinical Materials and Methods This study was approved by the Institutional Review

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Tord D. Alden, Debra D. Pittman, Elisa J. Beres, Gerald R. Hankins, David F. Kallmes, Benjamin M. Wisotsky, Kelvin M. Kerns and Gregory A. Helm

using gene therapy techniques to introduce the BMP gene into cells at the fusion site to achieve long-term, controllable BMP expression. The most successful technique for the introduction of therapeutic genes into cells in vivo is cellular transduction using viral vectors. 1, 8, 10–12, 20, 23 Although retroviruses, adenoassociated viruses, lentiviruses, and herpes viruses are all actively being investigated, adenoviruses are advantageous because of their high transduction rates and high production titers. However, adenoviruses can induce a strong immune

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Giuseppe Lanzino

The increased use of stent-assisted coiling, and more recently, flow diverters and the need for dual antiplatelet therapy have introduced an additional layer of complexity to the management of intracranial aneurysms. Because of the pitfalls of dual antiplatelet therapy in patients with freshly ruptured aneurysms, acute subarachnoid hemorrhage (SAH) was long considered a relative contraindication to the use of these devices. In the setting of acute SAH, dual antiplatelet therapy exposes the patient to higher risks of hemorrhagic complications, especially if

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Matthew T. Harting, Fernando Jimenez, Hasan Xue, Uwe M. Fischer, James Baumgartner, Pramod K. Dash and Charles S. Cox Jr.

C ell therapy has garnered significant interest as a treatment strategy for a wide range of diseases over the last decade. Heart disease, peripheral vascular disease, bone disease, cancer, hepatic disease, and neurological disease have all been the focus of promising cell therapy breakthroughs. 7 , 15 , 23 , 24 , 34 , 40 , 48 Traumatic brain injury is one area in which positive preclinical evidence has led to the initiation of early clinical trials ( www.clinicaltrials.gov ). Although cell therapy has been hailed as one of the next frontiers in modern

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Neurosurgical Forum: Letters to the editor To The Editor T. C. Origitano , M.D., Ph.D. Loyola University Medical Center Maywood, Illinois 800 801 The work by Shimoda, et al. (Shimoda M, Oda S, Tsugane R, et al: Intracranial complications of hypervolemic therapy in patients with a delayed ischemic deficit attributed to vasospasm. J Neurosurg 78: 423–429, March, 1993) comprehensively documented the potential complications of hypervolemic therapy when applied late in a patient's ischemic course. Excess volume in

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Clemens M. F. Dirven, Jacques Grill, Martine L. M. Lamfers, Paul van der Valk, Angelique M. Leonhart, Victor W. van Beusechem, Hidde J. Haisma, Herbert M. Pinedo, David T. Curiel, W. Peter Vandertop and Winald R. Gerritsen

surgical risk. Radiation therapy is effective for both malignant and benign meningiomas. 15, 50 In more than half of patients, however, the tumor will recur within 5 years, and almost half of those with atypical and malignant tumors will die within 10 years after diagnosis. 10, 22 In patients with residual or recurring benign tumors, there is increasing concern about radiation-related side effects that may occur even with highly accurate therapies such as radiosurgery. 33 Chemotherapy and hormonal therapy have not acquired a place in the standard treatment of

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Christopher M. McPherson, Justin Brown, Angela W. Kim and Franco Demonte

R osai –D orfman disease was first described in 1969 as a systemic histioproliferative disorder with massive lymphadenopathy. 19 Since then this pathological entity has been well described, including many cases with extranodal involvement. Central nervous system involvement of RDD is rare and occurs as enhancing dural-based lesions mimicking meningiomas. Although options such as radio-therapy and chemotherapy have been reported, the primary form of treatment for CNS RDD according to the literature remains surgical. We report on the first case of CNS RDD

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Brian T. Ragel, William T. Couldwell, Robert D. Wurster and Randy L. Jensen

C omplete resection is the treatment of choice for intracranial meningiomas but may not be possible when the tumor invades critical structures such as the cavernous sinus or sagittal sinus. This is confounded even more by the fact that up to 20% of meningiomas exhibit an aggressive phenotype that does not respond to standard therapies. 19 Thus, adjuvant therapies are critical for patients with this subset of meningiomas. Radiation therapy and stereotactic radiosurgery are good adjuvant therapies but are limited by radiation neurotoxicity, tumor size

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Douglas Hamilton, John D. S. McKean, John Tulip, Donald Boisvert and Judy Cummins

treatment the tumors measured 1.5 to 2.0 cm in diameter. In 1978, Signorelli, et al. , 8 reported on the photoradiation therapy (PRT) of human glioma cells in tissue culture. Cells from glioblastoma multiforme tumors were incubated in 10 −5 M hematoporphyrin derivative (HPD) and then exposed to light from 11 15-W neon light bulbs. Microscopic examination after treatment showed degenerative changes when compared to control cells. The cells tended to lose their cytoplasmic processes, showed large nuclear and cytoplasmic vacuoles, and lost their gliofibrillary structure