British journal of neurosurgery
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Non-neurological complications like acute kidney injury (AKI) can affect outcome of traumatic brain injury (TBI). This study aims to analyze the incidence, predictive factors, and impact of AKI in operated patients with severe TBI. ⋯ Reversible AKI without need for RRT occurred in nearly 12% of patients with severe TBI requiring surgical intervention. Aminoglycoside therapy was the only predictive factor for the occurrence of AKI. Patients with AKI have a longer period of mechanical ventilation, longer ICU and hospital stay, and poorer GCS at discharge.
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We present a case of recurrent vago-glossopharyngeal neuralgia after previous surgery, treated successfully with microvascular decompression using intra-operative neurophysiology monitoring.
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Review Meta Analysis
A systematic review and meta-analysis of surgeries performed for treating deep-seated cerebral cavernous malformations.
The clinical benefit of surgery for treatment of deep-seated cerebral cavernous malformations (CCMs) is still a matter of debate. Although the surgical removal of CCMs is widely accepted, the benefits of reducing the rate of haemorrhage must be balanced against the risk of peri-operative morbidity. Here, we provide a systematic review and meta-analysis of the clinical benefits of surgery for treating deeply localised CCMs. ⋯ Our meta-analysis demonstrates post-surgical haemorrhage rate and complications related to surgeries on deep-seated CCMs. The post-surgical haemorrhage rate was low with a relatively high rate of post-surgical complications.
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Review Meta Analysis Comparative Study
Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion - systematic review and meta-analysis.
To assess the clinical and radiographic outcomes and complications of anterior lumbar interbody fusion (ALIF) versus transforaminal lumbar interbody fusion (TLIF). ⋯ ALIF and TLIF appear to have similar success and clinical outcomes, with different complication profiles. ALIF may be associated with superior restoration of disk height and lordosis, but requires further validation in future studies.
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Neurosurgery remains amongst the highest malpractice risk specialties. We aimed to better understand the medicolegal burden in neurosurgery by analysing a large volume of claims recorded by the National Health Service Litigation Authority (NHSLA). ⋯ Neurosurgical litigation in NHS hospitals has significantly increased over the last decade, predominantly due to spinal claims. A neurosurgical claim has a very high likelihood of success, and even for unsuccessful claims, associated legal fees are considerable. Causes of claims are differently distributed between cranial and spinal neurosurgery, although overall, delay to diagnosis accounted for the predominant share of claims volume and damages. There was a significant medicolegal burden associated with serious long-term injury and need for life-long care as in the case of brain damage as compared with death as an outcome. This analysis represents the largest U.K. study on litigation in surgery to date.