World Neurosurg
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Randomized Controlled Trial Comparative Study
Normal pressure hydrocephalus and parkinsonism: preliminary data on neurosurgical and neurological treatment.
Idiopathic normal pressure hydrocephalus (iNPH) may present, besides the classic triad of symptoms, with extrapyramidal parkinsonianlike movement disorders. We present a randomized prospective study comparing adjustable ventriculoperitoneal (VP) shunt insertion plus dopamine oral therapy (group A) versus VP shunt alone (group B) in patients affected by iNPH associated with parkinsonism. ⋯ iNPH associated with parkinsonism may be a frequent finding. In these cases, patients may benefit from VP shunt plus dopamine oral therapy.
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Google is the most popular search engine, with about 100 billion searches per month. Google Trends is an integrated tool that allows users to obtain Google's search popularity statistics from the last decade. Our aim was to evaluate whether Google Trends is a useful tool to assess the public's interest in specific neurosurgical topics. ⋯ Google Trends is a useful source to elicit information about general trends in peoples' health interests and the role of different diseases across the world. The Internet presence of neurosurgical units and surgeons can be guided by online users' interests to achieve high-quality, professional-endorsed patient education.
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Conventional approaches to deep-seated cerebral lesions range from biopsy to transcortical or transcallosal resection. Although the former does not reduce tumor burden, the latter are more invasive and associated with greater potential for irreparable injury to normal brain. Disconnection syndrome, hemiparesis, hemianesthesia, or aphasia is not uncommon after such surgery, especially when lesion is large. By contrast, the transsulcal parafascicular approach uses naturally existing corridors and a tubular retractor to minimize brain injury. ⋯ This technique is safe and effective for the treatment of intraventricular and periventricular lesions. Surgery-related morbidity is minimal and often transient. Lesions are satisfactorily resected and residuum occurs only when the neoplasm involves vital structures. The tubular retractor minimizes trauma to brain incident in the surgeon's path.
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Review Meta Analysis
The use of closed suction drainage in lumbar spinal surgery: is it really necessary?
Closed wound suction drainage after spine surgery is commonly used in clinical practice. However, no consensus has been reached for using drainage versus nondrainage after lumbar spinal surgery until now. ⋯ Based on this systematic review and meta-analysis, there is insufficient evidence to suggest routine use of prophylactic closed suction drainage after lumbar spinal surgery. However, a decision to use or not use drainage should be individualized for each patient because many factors affect the outcomes.
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Review Case Reports
Spontaneous extradural haemorrhage in patient with chronic kidney disease: a case report and review of literature.
Spontaneous extradural hemorrhage is a rare entity. It is usually reported in association with locoregional disease, which is often infective, inflammatory, and hematologic. Chronic kidney disease with hemodialysis is one of the most infrequent causes. The exact association or pathogenesis remains elusive, although possible mechanisms have been suggested. The presentation, associated comorbid conditions, and management vary among the reported cases. ⋯ We report a rare case of spontaneous bilateral frontal extradural hemorrhage in the immediate postoperative period in a patient on hemodialysis. In addition, we review the existing literature on the topic.