World Neurosurg
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Case Reports
Spontaneously resolving symptomatic subdural hygromas after cerebellopontine angle tumor surgery.
Subdural hygroma is a rare disease most commonly encountered in posttraumatic patients. Even more rarely, it has been described as a complication of cerebellopontine angle tumor requiring surgical evacuation. ⋯ These 2 cases highlight the 2 principal pathogenesis theories for the development of subdural hygromas (arachnoid tear and effusion) and suggest a theory for their sudden and spontaneous resolution: the pressure equilibrium opening the valve created by the arachnoid tear. Eventhough surgical treatment remains the recommended attitude, these cases show that conservative treatment can be an option in some cases.
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Severe traumatic brain injury (sTBI) is a significant global health problem disproportionately affecting low- and middle-income countries (LMICs). Management of intracranial hypertension in sTBI is crucial to survival and optimal recovery. Practitioners in high-income countries routinely use intracranial pressure (ICP) monitors although their usefulness has been questioned. ICP monitors are usually unavailable in LMICs. No consensus-based/tested protocols or literature exists for sTBI treatment without ICP monitoring. ⋯ We derived consensus-based guidelines for sTBI treatment without ICP monitoring, and introduced a research method to a large multidisciplinary group of LMIC clinicians naive to such methods.
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Case Reports
Symptomatic Vasospasms as a life-threatening complication after transsphenoidal surgery.
To identify symptomatic vasospasms as a rare complication after transsphenoidal surgery, with emphasis on management and outcomes. ⋯ Although a rare complication, vasospasms after transsphenoidal surgery can lead to severe and multilocular ischemic infarctions with a wide variety of neurologic impairments. This rare complication should be considered in patients with unexpected postoperative neurologic deficits. Computed tomography (CT)/magnetic resonance imaging and (contrast-enhanced) CT/magnetic resonance angiography are appropriate diagnostic tools. Treatment of vasospasms, including the option of intra-arterial spasmolysis, should not be delayed.
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The aim of this study is to determine whether preoperative scores on a screening measure for cognitive status (the Saint Louis University mental status examination), were associated with discharge to a location other than home in older patients undergoing surgery for deformity. ⋯ In geriatric patients undergoing surgery for deformity correction, cognitive screening before surgery can identify patients with impaired cognitive status who are less likely than those with normal cognitive status to return home after surgery.
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The objective of this article is to evaluate whether newly developed calcium phosphate cement (CPC), mounted around the titanium plates, is useful for aesthetic cranial reconstruction by using 2 methods. ⋯ Use of CPC was expected to bring better aesthetic outcomes after neurosurgical cranial reconstructions.