Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2015
ReviewEarly cranioplasty vs. late cranioplasty for the treatment of cranial defect: A systematic review.
Cranioplasty is considered as a routine procedure in everyday neurosurgical practice for the patient with cranial defect, however, there is no established consensus on optimal surgical timing. ⋯ Early CP can only reduce the duration of operation, but cannot reduce the complications of patients and even increase the risk of hydrocephalus. More evidence from advanced multi-center studies is needed to provide illumination for the timing selection of CP surgery.
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Clin Neurol Neurosurg · Sep 2015
Risk factors for predicting complications associated with growing rod surgery for early-onset scoliosis.
To identify risk factors for postoperative complications associated with growing rod surgery for early-onset scoliosis (EOS). ⋯ The occurrence of postoperative complications in growing rod surgery for EOS is most likely multifactorial and is related to curve magnitude in last follow-up and duration between growing-rod lengthening procedures.
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Clin Neurol Neurosurg · Sep 2015
Novel technique for cranial reconstruction following retrosigmoid craniectomy using demineralized bone matrix.
A versatile neurosurgical approach, the retrosigmoid craniectomy (RS) has traditionally been associated with high rates of post-operative cerebrospinal fluid (CSF) leak, headaches, and aesthetic defects. We introduce a simple surgical strategy for bony cranial reconstruction designed to minimize peri-operative complications and improve cosmetic outcomes. ⋯ DBM-augmented reconstruction of posterior fossa defects resulted in low rates of post-operative headaches, better cosmetic outcomes, and represents a simple and effective cranioplasty option for skull base surgeons.
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Clin Neurol Neurosurg · Sep 2015
Impact of elective versus emergent admission on perioperative complications and resource utilization in lumbar fusion.
The notion of higher complication rate and mortality in emergency surgeries is well established. There is a paucity of literature demonstrating the impact of emergent versus elective admissions for spinal surgery on the perioperative outcomes. We aim to evaluate the influence of the type of admission (elective or emergent) and day of surgery (same day versus other days within the emergent group) on the incidence, pattern of perioperative complications and hospital charges in the patients undergoing lumbar fusion for degenerative spine disease. ⋯ 'Emergent admission' and surgery performed on the 'other days' in lumbar fusion are independent risk factors for the higher incidence of perioperative complications. Complicated hospital course and longer stay of the patients in the emergent admission and 'other days' group seems to be associated with higher total hospital charges.
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Clin Neurol Neurosurg · Sep 2015
Management of idiopathic intracranial hypertension with a programmable lumboperitoneal shunt: Early experience.
To evaluate the clinical outcomes and complications rate among idiopathic intracranial hypertension (IIH) patients who underwent lumboperitoneal (LP) shunt insertion with a programmable Strata valve. ⋯ LP shunts with programmable Strata valve systems are a potential alternative to conventional LP and programmable ventriculoperitoneal shunt systems as well as optic nerve sheath fenestration, due to their potential in avoiding brain injury, lower failure and complication rates, lower intracranial hypotension incidence, and flexibility in adjusting valve pressure settings post-operatively evading under- and overdrainage complications. They should be considered for the management of IIH instead of early design LP systems and VP shunts. A randomized multi-center trial should be conducted to compare the efficacy of these surgical techniques.