British journal of neurosurgery
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Observational Study
Cranioplasty outcomes and associated complications: A single-centre observational study.
The resurgence of decompressive craniectomy has led to recent published reviews of the safety of cranioplasties. To date there is a wide range of reported mortality and morbidity. This observational study reports the outcomes of the cranioplasty operations from a single centre and evaluates the factors involved in their management. ⋯ Some potentially preventable complications have been addressed with a resulting rate of complications lower than other published reports. We use two standard adjuncts: the presence of a senior surgeon and strict antimicrobial regimens. We believe that our results could be transferrable to other units by following similar guidelines.
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External ventriculostomy-related infection (VRI) of cerebrospinal fluid (CSF) is a source of significant morbidity and mortality. In previous trials, antibiotic-impregnated ventricular catheters have been associated with lower incidence of CSF infections. We undertook this retrospective observational study to evaluate whether the introduction of antibiotic-impregnated external ventricular drains (EVDs) in 2004 has decreased VRI in our neurosurgical unit. ⋯ Our study demonstrates that there was no statistically significant difference in the infection rates for the Standard and antibiotic-impregnated external ventriculostomy catheters. The duration of catheterization was significantly higher for the Antibiotic-impregnated catheter group. The antibiotic-impregnated catheter infections tended to occur later as compared with the Standard catheter group.
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Observational Study
Predicting outcomes of decompressive craniectomy: use of Rotterdam Computed Tomography Classification and Marshall Classification.
Data on the evaluation of the Rotterdam Computed Tomography Classification (RCTS) as a predictor of outcomes in patients undergoing decompressive craniectomy (DC) for trauma is limited and lacks clarity. ⋯ RCTS is an independent predictor of unfavourable outcomes and mortality among patients undergoing emergency DC.