World Neurosurg
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Case Reports Historical Article
Corneal Injury from Pre-surgical Chlorhexidine Skin Preparation.
Chlorhexidine skin preparation has been shown to provide highly effective antimicrobial presurgical skin cleansing. However, there is a significant risk of ocular toxicity when it is used in periocular areas. ⋯ If chlorhexidine gluconate must be employed near periocular areas, great care must be exercised to avoid contact with the eyes, and additional protective measures (e.g., absorbent eye pads along with tightly occlusive dressings) must be used whenever possible.
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Case Reports
Clinical Image: A meningoencephalocele caused by a chronic growing skull fracture in a 76-year old patient.
We present a case of a growing skull fracture in adult male, with an interval of 43 years after initial trauma. This finding is extremely rare, especially because growing skull fractures are mostly seen as an uncommon complication of pediatric head trauma with calvarial fracture. In our patient, this finding was incidental, existed for many years, and had no clinical consequences. Therefore, we advised a conservative treatment for our patient.
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A 10-year (2005-2015) retrospective case series of patients undergoing decompressive craniectomy for malignant middle cerebral artery infarction (mMCAI) was undertaken. ⋯ Decompressive craniectomy for mMCAI is suitable in selected patients, and the local practice is consistent with current evidence.
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To determine the relationship between the severity of stenosis graded using both surgeons' visual assessment of spinal stenosis as well as measurement of dural cross-sectional area on magnetic resonance imaging (MRI), with the patient's disability. ⋯ Although surgeons rely on visual assessment of the severity of stenosis while making surgical decisions, we found that objective and subjective imaging parameters to grade severity of stenosis did not consistently indicate the patient's disability level.
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Case Reports
Risky cerebrovascular anatomical orientation: implications for brain revascularization.
This study documents a risky vascular anatomic orientation that might play an important role in the postoperative hemodynamics following anterior cerebral artery (ACA) revascularization. A 71-year-old woman presented with uncontrollable frequent right lower limb transient ischemic attacks (TIAs) attributed to a left cerebral ischemic lesion due to severe left ACA stenosis. ⋯ The patient awoke satisfactory from anesthesia; however, on postoperative day 1, she developed right-sided hemiparesis. Extensive postoperative investigations disclosed that watershed shift infarction was considered the etiology for this neurologic deterioration.