World Neurosurg
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Traumatic brain injury (TBI) is a serious global public health challenge. We aimed to assess the pattern of TBI in the Middle East, as reported in the last decade. ⋯ The epidemiology of TBI in the Middle East remains understudied. The use of a globally recognized definition of TBI will contribute greatly to improve its reporting, analysis, and interpretation and to establish appropriate injury prevention programs.
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Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is characterized by a highly complex pathophysiology and results in neurologic deterioration after the inciting bleed. Despite its significant consequences, prompt diagnosis can be elusive and treatment is often administered too late. Early brain injury, which occurs within the first 72 hours after ictus, may be an important factor for delayed cerebral ischemia and poor overall outcome. Here, we explore the purported clinical and pathologic manifestations of early brain injury to identify biomarkers that could have prognostic value. ⋯ Some of these markers possess independent value for determining the risk of complications after aneurysmal subarachnoid hemorrhage. However, their use is limited because of a variety of factors, but they do provide an avenue of further study to aid in diagnosis and management.
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Multicenter Study
Congenital Malformations of the Central Nervous System in Rural Western Honduras: A 6-Year Report on Trends.
Central nervous system (CNS) malformations, including neural tube defects (NTDs), are the second most common type of birth defects worldwide and are major causes of childhood disability and mortality. We report the first analysis of birth prevalence in Western Honduras of CNS malformations including NTDs over 6 consecutive years. ⋯ This is the first study reporting disease burden of CNS malformations in Western Honduras. The nationwide birth prevalence of NTDs in rural Honduras may have decreased since the implementation of prenatal health policies in 2005. However, we identified regions with unexpectedly elevated prevalence, indicating high regional prevalence that could be targeted for improved preventive efforts, ultimately decreasing the burden of these conditions.
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Multicenter Study
A multicenter retrospective cohort study of 'talk and die' after traumatic brain injury.
Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. ⋯ Even in modern trauma care systems, some patients still talk and die after TBI. We identified certain risk factors in patients with TBI that elicit the requirement for close observation, even if these patients talk after TBI.
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Intra-axial brain tumors located at anatomically eloquent areas are challenging conditions. On one hand, it is often difficult to pursue maximum extent of resection of tumor in these locations. On the other hand, neuroplasticity occurs in some patients with low-grade glioma, and the primary neural functions are known to sometimes shift from conventional "eloquent cortices." ⋯ This case highlights the importance of preoperative multimodal neurophysiologic imaging in patients with low-grade gliomas in eloquent areas.