Journal of neurosurgery
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Hemifacial spasm (HFS) causes both physical and psychological disabilities that significantly impact quality of life. Medical management with serial botulinum toxin injections provides transient spasm relief and is widely reported as highly effective, as compared to no treatment. ⋯ Although the majority of MVD neurosurgeons maintain a low annual case volume, excellent safety and success rates can be achieved with attention to technical nuances and anatomical appreciation of the target facial root exit zone. Attention to better informing patients and optimizing surgical outcomes should lead to a greater role for neurosurgery in the treatment and cure of HFS.
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Journal of neurosurgery · Jan 2024
Hydrocephalus in the emergency department: descriptive nationwide data and analysis of transfer.
Hydrocephalus is a chronic, treatable, but in most cases incurable condition characterized by long periods of stability punctuated by crises. Patients in crisis usually seek care in an emergency department (ED). How patients with hydrocephalus use EDs has received almost no epidemiological study. ⋯ Patients with hydrocephalus make heavy use of EDs, and they make more visits for reasons unrelated to their hydrocephalus than for neurosurgical reasons. Transfer to another acute care facility is an adverse clinical outcome that is much more common after neurosurgical visits. It is a system inefficiency that might be minimized by proactive case management and coordination of care.