World Neurosurg
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The optimal surgical and antimicrobial treatment for intracranial infections after neurosurgery is unknown. We investigated the clinical, laboratory, and microbiological characteristics of intracranial infections after neurosurgery. In addition, treatment outcome in patients treated according to a standardized algorithm was evaluated. ⋯ Most (95%) intracranial infections were associated with foreign material and required surgical intervention and biofilm-active treatment. Via a standardized treatment approach, the infection-free survival after 12 months was good (87%), independent of the infection site or type of micro-organism.
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Multicenter Study
Extended Experience with Neuroendoscopic Lavage for Posthemorrhagic Hydrocephalus in Neonates.
Previous studies have described neuroendoscopic lavage (NEL) as a procedure for the treatment of posthemorrhagic hydrocephalus in newborn infants. This report describes complications and results in an extended case series from 2 separate hospitals. ⋯ NEL avoided shunt placement in 43% of newborn infants with posthemorrhagic hydrocephalus. In the shunted cohort, NEL may have also decreased the frequency of subsequent shunt revisions. The influence of NEL on neurodevelopment and safety remains to be investigated further in a multicenter setup.
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Transarterial embolizatioin with transvenous balloon protection has been described as a promising technique for intracranial dural arteriovenous fistula. The aim of our study was to report our preliminary experiences of this technique with regard to its safety and efficacy and to emphasize the procedure-related complications. ⋯ The transvenous balloon protection offers an alternative to treat complex dural arteriovenous fistula, but further investigation are needed to lower related complications.
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Postoperative dysphagia is a known complication of anterior cervical surgery, but its incidence and possible mechanisms are seldom reported after occipitocervical fusion (OCF). Our objective was to study the relationship between craniocervical alignment and the development of dysphagia after OCF for the treatment of basilar invagination with atlantoaxial instability. ⋯ O-C2 angle plays an important role in the development of postoperative dysphagia after OCF procedure. Careful intraoperative alignment of the O-C2 angle may help to reduce the incidence and severity of postoperative dysphagia after OCF.
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After severe traumatic brain injury (sTBI) associated with uncontrollable high intracranial pressure (ICP), today the main challenge for neurosurgeons remains to identify who may obtain benefit from decompressive craniectomy (DC) and which factors after DC influence the prognosis of these patients. The aim of this paper was to identify the pre- and postoperative determinants of outcome after DC. ⋯ In our study, the development of hydrocephalus after DC for sTBI and delayed cranial reconstruction were associated with unfavorable outcome.