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Purpose: The SARS-CoV-2 infection cases are increasing rapidly in neuro-intensive care units (neuro-ICUs) at the beginning of 2023 in China. We aimed to characterize the prevalence, risk factors, and prognosis of critically ill patients treated in neuro-ICUs. Materials and Methods: In the prospective, multicenter, observational registry study, critically ill patients with intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI) admitted to eight Chinese neuro-ICUs between Feb 16, 2023, to Apr 30, 2023 were enrolled for the study. Mortality and ICU stay day were used as the primary outcomes. Results: 131 patients were finally included and analyzed (mean age 60.36 years [SD 13.81], 64.12% male, 39.69% SARS-CoV-2 infected). The mortality is higher in the SARS-CoV-2 infection group without statistical signification (7.69% vs 5.06%, p>0.05). The length of stay (LOS) in neuro-ICUs was significantly longer among the SARS-CoV-2 infection patients (7(1-12) vs 4(1-8), p<0.01), with increased viral pneumonia occurrence (58.54% vs 7.32%, p<0.01). SARS-CoV-2 infection, surgery, and low GCS scores were independent risk factors for prolonged LOS, and respiratory/renal failure were independent risk factors for death. Conclusion: Based on the present neuro-ICU cohort, SARS-CoV-2 infection was a significant risk for the prolonged LOS of neuro-critically ill patients. Trial Registration: Registered with Chictr.org.cn (ChiCTR2300068355) at 16 February 2023, Prospective registration. https://www.chictr.org.cn/showproj.html?proj=188252.
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BACKGROUND: Dermoid cysts are very rare neoplasms in the CNS. The unusual neuroimaging signs and surgical treatment of the tumor are concerned in this case report. CASE DESCRIPTION: A 9-year-old boy complained of slight headache for 2 months, but complete physical examination showed no neurologic deficits on his admission. Computed tomographic scan showed a huge mass with some calcified plaques in the space between the brainstem and the clivus, and the mass was isointense on MR T1-weighted images but hyperintense on T2-weighted sequences. Partial rim enhancement could be found in the superior part of the mass on contrast MR images. The mass was iso- to hypointense on DWI and hyperintense on FLAIR images. A right retrosigmoid approach craniotomy was performed, and the mass was subtotally removed. Pathologic findings indicated that the lesion was a DC with calcification. CONCLUSION: The clinical particularities of our case were the deep location and the unusual signs of neuroimaging. New special MR techniques such as DWI and FLAIR can provide more information about the tumor. Surgery is the only effective treatment to this lesion, and total removal is the surgical goal, but subtotal excision also is a wise choice when total removal is very difficult.