World Neurosurg
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The incidence of venous thromboembolism (VT) in neurosurgical practice is astonishingly high, representing a major cause of morbidity and mortality. Prophylaxis strategies include elastic stockings, low-molecular-weight heparin (LMWH), and intermittent pneumatic compression (IPC) devices. ⋯ This study, despite its limitations of the nonrandomized design, seems to suggest that perioperative IPC devices are a non-negligible support in the prophylaxis of clinically symptomatic DVT and PE.
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Diffuse axonal injury (DAI) is a traumatic brain injury and one of the most common causes of unfavorable outcome and death. The aim of this study was to investigate the recovery of patients with pure DAI who remained in a coma for 6 hours or longer after brain injury. ⋯ Mortality was high among patients with DAI, but almost all survivors had favorable outcomes at 6 months. Functional improvement was more pronounced in the first 3 months.
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Recognition of transdural spinal cord herniation has increased over the past decade. This condition remains little known, particularly outside the specialized fields of spinal surgery and neuroradiology, leading to a significant delay in clinical diagnosis and treatment. ⋯ We describe our surgical experience to untether the spinal cord by wrapping a dura graft around the spinal cord. Three case reports and a review of the literature are discussed.
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To investigate effect of July admission on short-term outcome after endovascular coiling of patients with subarachnoid hemorrhage (SAH) owing to ruptured aneurysms. ⋯ Based on findings of this national investigation, patients with SAH owing to ruptured aneurysms who undergo endovascular therapy during the beginning of the academic year in July may not have worse short-term outcome compared with patients with admissions during other months.
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Case Reports
A case of asymptomatic occipital condyle fracture with incomplete occipito-cervical dislocation: how did it happen?
Atlanto-occipital dislocation (AOD) is a lesion rarely observed in a trauma center, because of high mortality in the preclinical phase. The number of AOD survivors is increasing thanks to the improvement in prehospital resuscitation. ⋯ We recommend a rapid immobilization with spine table and cervical collar, the consensual stabilization of hemodynamic and respiratory parameters, and a successive prompt occipitocervical stabilization. C2 should be included in the stabilization because of the ligamentous conformation of craniocervical joint.