Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Jul 2015
The Impact of a Standardized Sodium Protocol on Incidence and Outcome of Dysnatremias in Neurocritical Care.
Dysnatremias are common and prognostically serious in neurocritical care. We studied whether a standardized sodium protocol would improve our neurocritical care of dysnatremias. ⋯ The standard sodium protocol lowered the frequency of SIADH, which was encountered in only one patient over 5 years. However, it did not significantly reduce the incidence and improve the outcome of hyponatremia. Hypernatremia occurred more often and had a higher mortality and worse outcome than hyponatremia, but these patients were neurologically worse upon its onset. The prospective study confirmed that CSW, SIADH, and CDI were not common in our neurocritical care.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2015
The Fate of Type II Odontoid Fractures after Posterior Atlantoaxial Fusion: Where Does Healing Occur?
Anderson and D'Alonzo type II odontoid fractures often require surgical intervention. Our goal was to understand the pattern of healing in patients who had a posterior atlantoaxial fusion for a type II odontoid fracture. ⋯ There is a high rate of fusion across the fracture site of a type II odontoid fracture after posterior atlantoaxial fixation. In young patients with acute type II fractures who are not candidates for anterior screw fixation, posterior atlantoaxial instrumentation without fusion may be sufficient for fracture healing, thus allowing for the possibility of implant removal and preservation of C1-C2 motion.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2015
Case ReportsMicrosurgical and Endoscopic Posterior Transcortical Keyhole Approach to the Atrium of the Lateral Ventricle: A Cadaveric Study.
Accessing large lesions located in the atrium of the lateral ventricle without causing a neurologic deficit can be challenging. The aim of this study was to evaluate a modification of the posterior transcortical approach that may create sufficient exposure to the atrium of the lateral ventricle with less injury to the brain cortex and fibers using a technique that combines a microscope with an endoscope. ⋯ The microsurgical posterior transcortical keyhole approach could provide an ideal exposure to the atrium and the posterior part of the body of the lateral ventricle. The endoscopic posterior transcortical keyhole approach demonstrated a wider viewing range compared with the microscope. An endoscopic-controlled or -assisted surgery may reduce damage to normal brain tissue, facilitate total resection of the lesion, and improve the surgical outcome.