British journal of neurosurgery
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A 14-year old X linked congenital hydrocephalus presented with unexplained headaches and vomiting. He had external ventricular drain and intracranial pressure monitoring (ICP). ⋯ On retrieval of peritoneal catheters a double knot was noted between his two distal catheters. This case illustrates a rare cause of ventriculoperitoneal shunt malfunction.
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To assess surgical results and quality of life after removal of tumours causing ventral compression of the brainstem using the presigmoid or combined presigmoid/retrosigmoid approaches. ⋯ We found favourable surgical results when using the presigmoid approach alone or combined with the retrosigmoid route for large-sized extrinsic tumours causing ventral compression of the brainstem, both regarding complication profile, degree of tumour removal and functional outcome. However, impact of disease and surgery on quality of life appears to be more significant when assessed subjectively by the patients.
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The aim of this manuscript is to review the current state of knowledge regarding C-reactive protein (CRP) kinetics after standard neurosurgical procedures, and to determine the value of CRP as a screening test for early post-operative infectious complications as opposed to other more commonly used tests, and as a marker of peri-operative surgical insult. ⋯ The results of this study suggest that CRP is a more reliable screening test for post-operative infectious complications in the practice of neurosurgery than other more commonly used tests (WCC and ESR). Furthermore, the results suggest that peak post-operative CRP levels mirrors the level of incurred intra-operative surgical insult.
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External ventricular drain (EVD) placement is standard of care in the management of aneurysmal subarachnoid haemorrhage-associated hydrocephalus (aSAH). However, there are no guidelines for EVD placement and management after aSAH. ⋯ Nevertheless, there are no definitive practice guidelines for EVD placement and management techniques in aSAH patients. Large prospective randomised trials are needed to definitively address important gaps in our understanding of EVD management principles in the neurocritical care setting.
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Waterjet dissection is accomplished with Helix Hydro-Jet, but a new device with improved operative handling and potentially superior dissection qualities has been developed. ⋯ The new developed applicator of the Erbejet 2 also improves the intraoperative results of the so far applied Helix Hydro-Jet. The new Erbejet 2 provides some advantages for practicability; but in combination with the new applicator, the Helix Hydro-Jet accomplished almost identical superior dissection qualities of the Erbejet 2.