World Neurosurg
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Comparative Study
Cognitive changes in patients with aneurysmal subarachnoid hemorrhage before and early posttreatment: differences between surgical and endovascular.
The main purpose of occluding a ruptured aneurysm is preventing rebleeding, which may be fatal. Microsurgical or endovascular treatments are the main approaches adopted to prevent new bleeding. Among patients presenting with aneurysmal subarachnoid hemorrhage, about 50% had permanent injuries. Cognitive changes are one of the main morbidities from that illness. The type of treatment for the aneurysm (clipping or coil embolization) can also contribute to the genesis of those complications. ⋯ One hundred fifty-one patients were assessed, distributed as 122 surgical and 29 coil embolized. The performances in both groups did not differ in the initial assessment. However, endovascular treatment does not show additional cognitive impairment and had a better performance in language and verbal memory, compared with patients submitted to surgical treatment in an early postoperative period.
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Historical Article
Neurosurgery in Tanzania: a discussion of culture, socioeconomics, and humanitarians.
To elucidate the progress of neurosurgical practices in Tanzania, taking into account humanitarian, socioeconomic, and geographic influences. ⋯ Neurosurgery in Tanzania and Africa more generally has a long history; however, it was not until more recent efforts of certain local pioneers and educational advisors abroad that modernization occurred. The progress of the past 50 years is substantial and with continued efforts advances will continue to be made.
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To highlight pertinent aspects of emergent endovascular management of carotid rupture, or carotid blowout syndrome (CBS), an emergent, life-threatening complication of head and neck cancer and its treatments. ⋯ The treatment of patients with terminal malignant disease and CBS should provide maximum relief and minimize the risks of repeat surgery, morbidity, and mortality. Endovascular management of CBS with deconstructive techniques achieves immediate hemostasis and definitive treatment. The risks of intraoperative mortality and recurrent hemorrhage are low.
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To analyze qualitatively C2 nerve dysfunction after its transection in C1-2 posterolateral instrumented fusions. ⋯ This study is the first series to describe C2 nerve function after posterior atlantoaxial instrumented fusion in adults of all ages. Sacrifice of the C2 nerve root increases fusion surface, allows for better preparation and decortication of the atlantoaxial joint, improves visualization for screw placement, and decreases blood loss and operative time without major clinical consequences.
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Biography Historical Article
Volker K. H. Sonntag, M.D.: pioneer in spinal neurosurgery and consummate educator, colleague, and family man.