World Neurosurg
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This study sought to investigate outcomes after a novel nontransfer protocol for mild traumatic brain injuries patients with small intracranial hemorrhage (ICH) in a rural trauma center without neurosurgical capabilities. ⋯ Our 6-year study corroborates the low neurosurgical rate reported in the literature for mTBI with small ICH. Nontransfer protocols may lead to a more efficient use of hospital resources while providing safe, effective and economical health care.
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A persistent primitive hypoglossal artery (PHA) is a rare congenital caroticobasilar anastomosis with a reported prevalence of 0.027%-0.26%. Intracranial aneurysms occur with a frequency of approximately 26% in the setting of PHAs. ⋯ We review the literature and discuss anatomic implications with respect to the extreme lateral infrajugular transcondylar exposure for clip ligation of a ruptured posterior inferior cerebellar artery aneurysm in the setting of a PHA.
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Patients who survive intracranial hemorrhage (ICH) are at high risk of recurrence. The Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly (Age >65 years), Drugs/Alcohol Concomitantly (HAS-BLED) score has recently been developed to assess bleeding risk. ⋯ This study provided data on the risk of ICH recurrence stratified using the HAS-BLED score in patients after an ICH.
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X-linked dystonia-parkinsonism (XDP) is a progressively debilitating movement disorder that begins with focal dystonia and eventually generalizes. It exclusively affects Filipino inhabitants of the island of Panay. We report a case of XDP successfully treated by deep brain stimulation (DBS) and review the literature. ⋯ The published experience with globus pallidus internus DBS for XDP has been very positive to date. Although long-term follow-up data are needed, early results provide optimism for patients with this debilitating disorder.
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Microsurgical training has become an obligatory part of many neurosurgical training programs. ⋯ The dry off-the-job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills.