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4 find more +/- 2.1 months (range 1 to 12). Mean operative time and fluoroscopic screening time were similar in the 2 groups (p > 0.05). However, mean operative time per cm 2 stone and fluoroscopic screening time per cm(2) Stone were significantly prolonged in the post-ESWL group (p < 0.05). At a mean followup of 5.6 +/- 1.2 months (range 3 to 6) an overall success rate of 89% was achieved. Success and complication rates were comparable in the 2 groups.

Conclusions: Although similar success and

complication rates were achieved with percutaneous nephrolithotomy after failed ESWL, percutaneous nephrolithotomy is usually more difficult with prolonged operative time and fluoroscopic screening time per cm(2) stone due to the tissue effects of ESWL and scattered stone fragments in the pelvicaliceal system.”
“BRAINSTEM CAVERNOUS MALFORMATIONS (CMs) continue to present a considerable source of controversy in the neurosurgical community, with an accumulating volume of literature detailing their natural history and their surgical and radiosurgical management. As part of a systematic review of the literature, 12 natural history studies, 52 surgical series, and 14 radiosurgical series were tabulated. Annual bleeding rates for brainstem CMs ranged from 2.3% to 4.1% in natural history studies and from IWP-2 supplier 2.68% to 6.8% in surgical series before intervention. Rebleed rates as

high as 21.5% in natural history studies and

greater than once per year in surgical series were reported. A total of 684 of 745 CMs (92%) were documented as completely resected in 46 series that provided specific information on resection rates. Early postoperative morbidity ranged from 29% to 67% in larger surgical series, although it was often transient. Defactinib research buy Thirty of 61 partially resected lesions rebled; 4 of these rebleeds were fatal. Twelve additional patients died from surgically related causes for a combined postoperative rebleeding and Surgically related mortality rate of 1.9%. Across 45 series (683 patients), 85% of patients were reported as the same or improved, 14% were worse, and 1.9% died from surgically related causes at long-term follow-up. Patients with anterolateral pontine lesions generally appeared to have a better functional recovery, whereas those requiring excision via the floor of the fourth ventricle had relatively worse long-term outcomes. Radiosurgical series demonstrated conflicting data; some reported a statistically significant decrease in CM rebleeding rates after 2 years, whereas others did not, partially related to dosimetry. Postradiosurgical morbidity was nonetheless significantly greater for CMs than for arteriovenous malformations.

Please refer to the online version of this article for a more detailed natural history and radiosurgical review and a discussion of brainstem CM clinical presentation and diagnostic evaluation.

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