World Neurosurg
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Review Case Reports
What is the utility of postoperative antihelminthic therapy after resection for intraventricular neurocysticercosis?
Neurocysticercosis (NCC) is the most common worldwide parasitic infection of the central nervous system, and ventricular cysts are particularly problematic, carrying the risk of acute obstructive hydrocephalus. Herein, we present a typical case in which complete resection was possible and explore the evidence supporting the use of postoperative oral antihelminthic therapy. ⋯ This review produced surprising results: 1) the generous proportion of patients who underwent medical therapy as first-line treatment for intraventricular NCC (20.8%), and 2) the significant overall mortality. The data found in this review also provided for a strong consensus for the use of postresection antihelminthic therapy, and thus we elected to treat our index case with albendazole, assuming the risk to be low and the potential benefit meaningful.
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Seizures are common among patients with meningiomas and are a significant cause of morbidity and poor quality of life. The factors associated with the onset of seizures as well as factors associated with seizure control remains poorly understood. ⋯ With the widespread availability of various neuroimaging modalities, there will be increased detection of intracranial meningiomas. The identification and consideration of factors associated with seizure onset and prolonged seizure control may help guide treatment strategies aimed at improving the quality of life for patients with meningiomas.
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Review Meta Analysis
Neurotrauma outside the high-income setting: a review of audit and data-collection strategies.
To review the sparse literature that exists on the topic of head injury assessment and management outside high-income settings and attempt to: 1) identify strengths and weaknesses of the currently published clinical data relating to head injuries in lower-income countries; and 2) consider specific objectives for future head injury research in the resource-limited setting. If levels of excellence in neurosurgery are to be sustainably achieved outside high-income countries, there must be good systems of research and audit in place both to identify where development is needed and to evaluate the efficacy of development projects already in progress. ⋯ The use of standardized scoring systems and outcome measures is likely to improve the comparability of data between studies. A multicenter collaborative approach towards data collection in resource-limited settings may be the most efficient and productive strategy for future research.
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Conventionally, the practice of neurosurgery has been characterized by the removal of pathology, congenital or acquired. The emerging complement to the removal of pathology is surgery for the specific purpose of restoration of function. Advents in neuroscience, technology, and the understanding of neural circuitry are creating opportunities to intervene in disease processes in a reparative manner, thereby advancing toward the long-sought-after concept of neurorestoration. ⋯ One of the most exciting prospects in neurosurgery is the technologically driven field of brain-machine interface, also known as brain-computer interface, or neuroprosthetics. The successful development of this technology will have far-reaching implications for patients suffering from a great number of diseases, including but not limited to spinal cord injury, paralysis, stroke, or loss of limb. This article provides an overview of the issues related to neurorestoration using implantable devices with a specific focus on brain-machine interface technology.