World Neurosurg
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Observational Study
Postoperative Changes in Moderate to Severe Nonspecific Low Back Pain After Cervical Myelopathy Surgery.
Cervical myelopathy patients sometimes experience concurrent nonspecific moderate to severe low back pain (msLBP). However, postoperative changes in msLBP after cervical myelopathy surgery have rarely been reported. Awareness of postoperative changes in msLBP may be helpful in consultation. Therefore, the objective of this study was to examine postoperative changes in msLBP. ⋯ Although the exact pathophysiology was not demonstrated, cervical myelopathy surgery may directly and indirectly improve msLBP.
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Traumatic brain injury (TBI) is a major cause of mortality in many countries. According to the World Health Organization, traffic crashes are a leading cause of death, with 1.25 million deaths worldwide in 2013. A 2013 global road safety report listed 68 low-to-middle income countries that had an increased mortality rate owing to traffic accidents. The aim of this study was to analyze feasibility of use of an online prognostic model from the Medical Research Council Corticosteroids Randomization After Significant Head Injury (CRASH) trial collaborators in our center. ⋯ The online CRASH model is a good prognostic model that can be used for patients with TBI in many developing countries.
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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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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.