World Neurosurg
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Review Historical Article
Henry II of France (1519-1559) and his death from meningoencephalitis following a cranial trauma.
This historical review summarizes the most significant theories regarding the cause of death of King Henry II of France (1519-1559) and the circumstances under which it occurred. Although the historical testimonies are inconclusive and vague, postmortem analysis has shown that the King died of meningoencephalitis, caused by hematoma of a cerebral contusion, with effusion in the cerebral laminae and its surrounding tissue initiated by a periorbital fracture.
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Multicenter Study
Emergency trepanation as an initial treatment for acute subdural hemorrhage: a multicenter retrospective cohort study.
Rapid decompression with trepanation and drainage in an emergency room has been proposed as a potentially effective initial intervention for early-stage acute subdural hemorrhage; however, the actual safety and efficacy of the procedure remain unclear. The aim of this study was to evaluate the feasibility of emergency trepanation as an initial treatment for acute subdural hemorrhage. ⋯ Our results indicate that performing trepanation in an emergency room is associated with a decreased survival rate.
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Multicenter Study Comparative Study
Comparing Quality of Life in Cervical Spondylotic Myelopathy with Other Chronic Debilitating Diseases Using the SF-36 Survey.
Although cervical spondylotic myelopathy (CSM) can be devastating, its relative impact on general health remains unclear. Patient responses to the Short Form Survey 36-Health Survey (SF-36) Physical Component Summary (PCS)/Mental Component Summary (MCS) were compared between CSM and other diseases to evaluate their respective impacts on quality of life. The objective of this study was to compare SF-36 PCS/MCS scores in CSM with population and disease-specific norms. ⋯ CSM affects quality of life to an extent greater than diabetes or cancer. Although mean impact of CSM does not vary with age, younger patients suffer from greater differences in baseline function. This study highlights the impact of myelopathy on patient function, particularly among younger age groups, and suggests that CSM merits a similar caliber of healthy policy attention as more well-studied diseases.
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The absence of evidence-based guidelines for platelet transfusion surrounding invasive neurosurgical procedures leads to uncertainty in management. Multiple studies have illuminated this lack of high quality data, and subsequent reliance on expert opinion. The generally accepted threshold for platelet transfusion has hovered around 100,000/μL. ⋯ The available evidence is sparse and of low quality, but suggests that a platelet count <100,000/μL is associated with increased risk of hemorrhagic complications. In addition, the acuity of thrombocytopenia, magnitude of decrease in platelet count, and responsiveness to platelet transfusions impact the risk of neurosurgical intervention, and should be taken into account when evaluating a patient's surgical candidacy. Higher quality, prospective studies on the subject are unlikely, given a general lack of clinical equipoise on the subject, and the ethical concerns such a study would present.
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Review Case Reports
Iatrogenic vertebral artery injury during anterior cervical spine surgery: A systematic review.
Iatrogenic vertebral artery injury (VAI) during anterior cervical surgery is rare but potentially catastrophic. ⋯ Extensive lateral decompression, loss of landmarks, and anatomic variations or pathologic status of VA increased VAI risk. Evaluation of collateral vessels before definitive treatment helped determine appropriate management and avoid neurologic sequelae. Tamponade was not recommended as definitive treatment. Meticulous preoperative evaluation, cautious intraoperative manipulation, and real-time radiographic guidance reduced VAI risk.