Turk Neurosurg
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Traumatic brain injury (TBI) caused by a gunshot wound is a complex injury with a broad spectrum of symptoms and high rates of mortality and morbidity. This study presents an evaluation of TBI caused by gunshot wounds presenting at a single institution and discusses possible predictive factors for the outcome of surgical intervention. ⋯ Low GCS scores, ventricular injuries and bihemispheric injuries are correlated with poor prognosis. Early and less invasive surgery in conjunction with short transportation time to the hospital could decrease mortality rates.
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We report the case of a 39-year-old woman with unilateral intracranial chronic subdural haematoma that occurred after epidural anesthesia for excision of a skin scar, complicated by postdural puncture headache. The patient had no history of trauma, headache, coagulation abnormalities, or neurological disorders. ⋯ Nonetheless, the symptoms subside within 7 days when treated with analgesics and bed rest in the majority of cases. The presence of a continued postdural puncture headache without neurological deterioration, as in this case, should prompt a search for an intracranial lesion.
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The modern age of psychosurgery can be said to have started with Moniz and Lima. Freeman and Watts subsequently revised and popularised the lobotomy procedure. ⋯ These operations gradually ceased after the discovery and worldwide clinic applications of a modern antipsychotic drug named Chlorpromazine in 1950s, paralleling a similar trend in other countries. Our paper reviews the clinical, psychometric and histopathological results of psychosurgery performed in Turkey in the 1950s.
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Head trauma is associated with an acute phase response which is characterized by leucocytosis due to increased levels of catecholamine and cortisol. Early edema formation following severe head injury may also be associated with microglia activation. Therefore, increased white blood cell (WBC) count after head trauma may be a predictive parameter of the severity of craniocerebral trauma. ⋯ AWBC count exceeding 17.5 x 106/l has a predictive value for poor GCS score, and long hospital stay. CT progression tends to be seen in patients with moderate and severe head injury.
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It is generally accepted that hemifacial spasm (HFS) is caused by vascular compression at the root exit zone (REZ) of the facial nerve. We saw an HFS patient caused by vascular compression of the distal portion of the facial nerve associated with configuration variation of the facial-vestibulocochlear nerve complex. A 50-year-old female with left HFS was admitted to our hospital. ⋯ The patient was completely free of the HFS following surgery. The facial nerve arising away from the vestibulocochlear nerve in the brain stem is rare. It might influence the cause of HFS with compression of the distal portions of the seventh cranial nerve.