World Neurosurg
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Multicenter Study
Decompressive craniectomy and early cranioplasty for the management of severe head injury: a prospective multicenter study on 147 patients.
In emergency care of patients with severe blunt head injury, uncontrollable high intracranial pressure is one of major causes of morbidity and mortality. The purpose of this study was to evaluate the efficacy of aggressive surgical treatment in managing uncontrollable elevated intracranial pressure coupled with early skull reconstruction. ⋯ A prompt aggressive surgery, including a wide decompressive craniectomy coupled with early cranioplasty, could be an effective treatment method to improve the outcome after a severe closed head injury reducing, perhaps, many of the complications related to decompressive craniectomy.
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Comparative Study
A comparative anatomic study of a modified temporal-occipital transtentorial transpetrosal-ridge approach and a transpetrosal presigmoid approach.
To evaluate the anatomic features of a modified temporal-occipital transtentorial transpetrosal-ridge approach versus the conventional approach for surgery of petroclival tumors. ⋯ The modified temporal-occipital transtentorial transpetrosal-ridge approach is a feasible surgical approach to remove petroclival tumors.
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To review notable aneurysm cases that required complex decision making from a single institution and to examine available literature when relevant to highlight evidence-based paradigms for treatment of complex aneurysms. ⋯ Innovations in both arms of the cerebrovascular field will continue to advance the field and provide novel approaches to these complex lesions.
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The Japanese Society of Neurotraumatology announced guidelines for management of severe traumatic brain injury (TBI) in 2000. To evaluate subsequent implementation of these guidelines, we investigated current severe TBI practices in Japan. ⋯ Neurosurgeons in Japan are positively involved in management of severe TBI, but few medical centers monitor TBI patients. Many medical centers find it difficult to conform to the guidelines due to lack of neurosurgeons and equipment. These problems can be addressed by consolidation of neurosurgeons into centralized centers and improvement of the medical insurance system.