World Neurosurg
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The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patient quality of life. The aim of this study was to analyze the effect of conventional surgery supported by intraoperative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined the postoperative Karnofsky Performance Status Scale (KPS) scores and tumor resection grades. ⋯ IOUS may improve postoperative KPS scores and decrease residual tumor volumes in CM surgeries. These findings should be confirmed in future studies.
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Case Reports
Intraoperative eptifibatide administration during urgent arterial bypass in neurosurgery - two case reports.
In some cases when risk of occlusion of a blood vessel is greater than risk of bleeding when patients undergo urgent or unplanned bypass during neurosurgery, the use of eptifibatide may be an option. We describe 2 patients who underwent arterial bypass in whom eptifibatide was used successfully intraoperatively during neurosurgery for prevention of bypass occlusion. ⋯ Future studies are needed to test the safety and potential efficacy of eptifibatide in intraoperative settings.
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Complications worsen the prognosis of hydrocephalic children who undergo surgery. The main objective of this study was to determine factors associated with postoperative complications in Haitian infants with hydrocephaly. ⋯ Hydrocephalus in Haitian infants is diagnosed late and inadequately investigated, treated, and monitored. Ventriculoperitoneal shunts are significantly related to more postoperative complications than endoscopic third ventriculostomy.
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Comparative Study
Posterior Multilevel Instrumentation of the Lower Cervical Spine: Is Bridging the Cervico-thoracic Junction Necessary?
Multisegmental cervical instrumentations ending at the cervicothoracic junction may lead to significant adjacent segment degeneration. The purpose of this study was to compare the extent of sequential pathologies in the lower adjacent segment between patient groups with a primarily cervical instrumentation ending at C7 versus an instrumentation including the cervicothoracic junction ending at T1 or T2. ⋯ Patients with multisegmental posterior cervical fusions ending at C7 showed a greater rate of clinically symptomatic pathologies at the adjacent level below the instrumentation. On the basis of our data and with its limitations in mind, one may consider to bridge the cervicothoracic junction and to end the instrumentation at T1 or T2 in those cases.
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Linear accelerator stereotactic radiosurgery is one of the modalities available for the treatment of central nervous system arteriovenous malformations (AVMs). The aim of this study was to describe our 15-year experience with this technique in a single tertiary center and the analysis of outcome-related factors. ⋯ In the long-term, linear accelerator-based radiosurgery is a useful, valid, effective, and safe modality for treatment of brain AVMs.