World Neurosurg
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The incidence of primary traumatic oculomotor nerve palsies in craniocerebral trauma is approximately 1.2% and is usually persistent and associated with loss of consciousness, other neurologic deficits, and skull base or orbital fractures. This case is a rare demonstration of complete left third nerve palsy from uncal herniation after trauma without any loss of consciousness.
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Approximately 30% of patients treated with foramen magnum decompression (FMD) for Chiari I-associated syringomyelia will show persistence, recurrence, or progression of the syrinx. ⋯ SSS for persistent, recurrent, or increasing syrinx following FMD for Chiari I malformation is a safe and effective surgical treatment when performed selectively by an experienced neurosurgeon.
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To determine whether antibiotic prophylaxis (AP) can reduce the postoperative infection rate and identify the risk factors for postoperative infection in shunt surgery. ⋯ In our study, a preventive effect of AP on postoperative infection was not observed in shunt surgery. However, AP reduced the rate of positive bacterial cultures. A logistic regression analysis demonstrated that a history of brain infection and previous ventriculostomy were independent risk factors for postoperative infection and that AP was a nonprotective factor.
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Osteopetrosis is a heterogeneous group of uncommon congenital disorders that causes bony sclerosis and remodeling. Patients who are symptomatic can show significant neurologic consequences with the involvement of cranial nerves and symptoms of increased intracranial pressure (ICP). ⋯ In conclusion, in patients with symptomatic osteopetrosis, cranioplasty can be considered as an option to treat high ICP-related symptoms.
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Distal anterior cerebral artery (DACA) aneurysms, also known as pericallosal artery aneurysms, are present in 1.5%-9% of all intracranial aneurysms. Here we characterize the important microsurgical anatomy of DACAs; describe the surgical approach to treating these aneurysms with a minimally invasive surgical technique, the mini anterior interhemispheric approach (MAIA); and examine the nuances of aneurysm clipping in this region. ⋯ Surgical clipping through a MAIA approach is an excellent treatment option for pericallosal artery aneurysms.