J Neurosurg Sci
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Randomized Controlled Trial
Normal saline versus balanced-salt solution as intravenous fluid therapy during neurosurgery: Effects on acid-base balance and electrolytes.
This prospective, randomized controlled study compared the changes in acid-base balance and serum electrolytes with the use of intravenous balanced and non-balanced crystalloid solutions intraoperatively during elective neurosurgery. ⋯ A balanced solution (Sterofundin®ISO) provided significantly better control over acid-base balance, sodium and chloride levels when used as intraoperative fluid maintenance and replacement during elective neurosurgery.
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In patients with a glioblastoma (GBM), few unselected data exists using actual standard adjuvant treatment and contemporary surgical techniques like iMRI. Aim of study is to assess impact of EoR and recurrent surgery on survival and outcome. ⋯ Surgery in a contemporary setup using iMRI, brain mapping and modern adjuvant treatment, has a higher OS and lower complication rates as previously published. A maximum but safe resection should be the goal of surgery since a perioperative complication significantly decreases OS. Recurrent surgery has a beneficial effect on OS without an increase of complications.
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As many as 360,000 people suffer yearly from skull base fractures (SBF). These may be associated with a dural tear, hemosinus, otorrhea or rhinorrhea. The most common causative agent of post-traumatic meningitis is Streptococcus Pneumonia (Pneumococcus). PNEUMOVAX 23 is a potent vaccine against Pneumococcus, but head trauma involving any skull fractures are not defined indications for its use. Our aim was to identify the effect of PNEUMOVAX on the natural course and incidence of infections and infectious prognosis following SBF. ⋯ We suggest that patients with a more severe status upon admission may benefit from a prophylactic treatment with the PNEUMOVAX vaccine.
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Degenerative disorders of the cervical spine requiring surgical intervention have become increasingly more common over the past decade. Traditionally, open surgical approaches have been the mainstay of surgical treatment. More commonly, minimally invasive techniques are being developed with the intent to decrease surgical morbidity and iatrogenic spinal instability. ⋯ Based on the currently available literature it appears that the DTRAX® expandable cage system is an effective minimally invasive posterior cervical technique for the treatment of single-level cervical radiculopathy. Minimally invasive posterior cervical techniques continue to expand with the improvement of surgical instrumentation, microsurgical techniques and improved understanding of spinal biomechanics. While several MIS approaches already exist, there is a need for advanced and improved techniques for use in posterior cervical surgery.
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Endovascular treatment of acutely ruptured aneurysms requires the administration of antiplatelet and/or anticoagulant medication to prevent thrombosis. For patients who require an external ventricular drain (EVD) insertion to treat hydrocephalus stemming from aneurysm subarachnoid hemorrhage (aSAH), the administration of the medication may increase risk of hemorrhage in patients. It has become a practice for neurosurgeons to insert EVDs in patients with aSAH before endovascular treatment. However, the benefits and risks of this practice have not been fully assessed. The aim of this study was to compare and quantify the hemorrhagic risks associated with endovascular treatment of patients with sSAH before and after EVD. ⋯ EVD-related hemorrhage risk may increase with administration of antiplatelet and/or anticoagulant medication for endovascular treatment of ruptured aneurysms in aSAH patients.