Neurosurgery
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To propose endoscopic treatment as an effective initial alternative for patients with a trapped fourth ventricle. ⋯ Endoscopic treatment of the trapped fourth ventricle is effective in most cases. In view of the higher-than-expected revision rate with fourth ventricular shunts and an equivalent complication rate, endoscopic treatment is a reasonable initial treatment option for patients with a trapped fourth ventricle.
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In 1992, Winston published the first large series of patients undergoing cranial neurosurgery without hair removal (Winston KR: Hair and neurosurgery. Neurosurgery 31:320-329, 1992). Prompted by this report, the senior author began a prospective trial in 1992 of cranial neurosurgery without hair removal. ⋯ Cranial surgery without hair removal is safe and is not associated with a discernible increased risk of infection. There are simple techniques for keeping hair out of the wound. Patients are highly desirous of keeping their hair and react very positively to this option. We advocate a greater practice of this technique in neurosurgery.
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The purpose of this study was to evaluate three modified, fiberoptic, oxygen saturation catheters as monitors of jugular venous oxygen saturation (SjvO2). ⋯ Catheter 3, which is now being marketed as the Opticath P540-H catheter, represents a significant improvement in performance and may make SjvO2 monitoring in the intensive care unit more practical.
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OBJECTIVE AND IMPORTANCE: Brain stem and cerebellar edema rarely have been described as the principal manifestation of hypertensive encephalopathy. In addition, secondary hydrocephalus has been described in only a few cases in the literature. We present an unusual case of posterior fossa swelling and hydrocephalus resulting from hypertensive encephalopathy. ⋯ Subsequent neuroradiological studies revealed decreased posterior fossa edema as well as marked improvement in the hydrocephalus. Hypertensive encephalopathy can present principally in the posterior fossa and can give rise to obstructive hydrocephalus. Invasive treatment of the hydrocephalus is not necessarily required in this clinical setting because reduction of the blood pressure may result in rapid improvement of the hydrocephalus.
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OBJECTIVES AND IMPORTANCE: Cervical spine compromise by fibrous dysplasia is rare; only 20 cases have been reported. Treatment was surgical in six cases, but the management differed among the other cases. In this retrospective case report, we analyze and discuss the surgical treatment of this condition in the context of previous reports. ⋯ The patient was discharged after 7 days. Three years later, she continued to have no pain, and spine stability was preserved. Good results can be achieved in the surgical treatment of dysplastic tissue with the use of instruments for spine reconstruction and synthetic grafting to prevent invasion.