World Neurosurg
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Placement of ventriculoperitoneal shunt is a well-accepted neurosurgical procedure for the management of obstructive hydrocephalus. The purpose of this study is to evaluate our long-term experience in the management of obstructive hydrocephalus in adult patients with ventriculoperitoneal shunts. ⋯ The results of this retrospective study show that ventriculoperitoneal shunting is effective in the management of adult patients with obstructive hydrocephalus. The overall incidence of shunt revision was comparable with previously reported studies in the literature. However, the high proportion of patients experiencing shunt failure after shunt placement is still a concern.
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To evaluate the long-term imaging and clinical outcomes of patients with brainstem arteriovenous malformations (AVMs) treated with Gamma Knife surgery (GKS). ⋯ Given the poor surgical outcome of brainstem AVMs, the results of 59% nidus obliteration and 6% permanent neurologic deficits make GKS a reasonable management of these difficult lesions.
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Video-assisted thoracic surgery (VATS) is a less-invasive alternative to open thoracotomy. According to evidence-based medicine methodology, VATS is associated with better outcomes and the same complication rate as open thoracotomy. ⋯ The two presented cases show that VATS is not without severe complications, as evidence-based medicine methodology suggests. Surgical findings in our patients imply that if this type of complication happens, early surgical exploration could be the best option for the patients.
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Over 75,000 patients have undergone deep brain stimulation (DBS) procedures worldwide. Magnetic resonance imaging (MRI) is an important clinical and research tool in analyzing electrode location, documenting postoperative complications, and investigating novel symptoms in DBS patients. Functional MRI may shed light on the mechanism of action of DBS. MRI safety in DBS patients is therefore an important consideration. ⋯ The importance of MRI in modern medicine places pressure on industry to develop fully MRI-compatible DBS devices. Until then, the literature suggests that, when observing certain precautions, cranial MR images can be obtained with an extremely low risk in patients with implanted DBS hardware.