World Neurosurg
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Review Case Reports
Post-traumatic bifrontoparietal extradural hematoma with superior sagittal sinus detachment: a case report and review of the literature.
To present, to our knowledge, the first case of a single bilateral extradural hematoma due to superior sagittal sinus detachment that was treated conservatively with an excellent outcome. ⋯ Bilateral extradural hematomas due to superior sagittal sinus injury almost always require surgical intervention. We present a patient who was treated conservatively with an excellent outcome and we also perform a review of the current literature.
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Review Meta Analysis
Economic analysis of deep brain stimulation in Parkinson's disease: systematic review of the literature.
Parkinson disease (PD) is a chronic multifaceted neurodegenerative disorder of adult onset that affects quality of life and places a burden on patients, caregivers, and society. In early disease, dopaminergic therapy improves motor symptoms, but as the disease progresses, symptoms tend to increase in frequency and severity, even with best medical treatment (BMT). Deep brain stimulation (DBS) becomes an option for certain patients, but cost becomes an important issue. ⋯ DBS is a cost-effective intervention for patients with advanced PD, but it has a high initial cost compared with BMT. However, DBS reduces pharmacologic treatment costs and should also reduce direct, indirect, and social costs of PD on the long term.
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Review Meta Analysis
Endovascular embolization of intracranial aneurysms: to use stent(s) or not? A systematic review and meta-analysis.
We sought to review the literature concerning stent-assisted coiling (SAC) in comparison with coiling without stents for treating intracranial aneurysms and to evaluate the safety and effectiveness of SAC by conducting a meta-analysis of published studies. ⋯ Compared with coiling without stent, stent-assisted coiling of intracranial aneurysms achieved satisfactory results, with higher long-term angiographic occlusion rate and lower recurrence rate. However, ischemic stroke remains a problem that cannot be ignored.
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Review Meta Analysis
How best to manage the Spinal Epidural Abscess? A Current Systematic Review.
A spinal epidural abscess is a medical emergency. Despite urgent surgical intervention and adjuvant antibiotic therapy, neurologic prognosis remains variable and guarded. The optimal approach to managing this condition is debated with substantial variability in clinical practice, dependent on patient demographic and pretreatment neurologic status as well as radiologic appearance. ⋯ Surgery with adjuvant antibiotics remains the optimal treatment for the neurologically symptomatic patient with spinal epidural abscess. If antibiotic therapy alone is considered for the neurologically intact patient, we recommend interdisciplinary medical and surgical consultations with an in-depth dialogue on the potential for failure in isolated medical management and the recommendation for close neurologic monitoring.
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Review Case Reports
Co-existent supra and infratentorial subdural hygromas with hydrocephalus after Chiari decompression surgery: review of literature.
Foramen magnum decompression (FMD) is the standard procedure for Chiari I malformation. Although seemingly a straightforward procedure, recent articles have reported an increase in various complications. We describe a rare complication of coexistent supratentorial and infratentorial subdural hygromas (SDHs) with hydrocephalus noted after FMD and provide a detailed review of the literature on this topic. ⋯ Coexistent supratentorial and infratentorial SDHs with hydrocephalus after Chiari decompression is a very rare occurrence. Treatment needs to be individualized based on the predominant symptomatic lesion, and surgical options need to be judiciously considered. Good prognosis is the rule in most cases.