World Neurosurg
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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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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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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.
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Basilar invagination can result from systemic diseases that can weaken structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression and posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure; quality of life (QOL) after this procedure has not been reported. ⋯ Patients undergoing posterior decompression and fusion with endonasal odontoidectomy do well after surgery with respect to nasal function and emotional health. Patients who also have severe basilar invagination associated with systemic diseases demonstrate reduced QOL after surgery in areas of physical function and sleep leading to fatigue, irritability, and concentration difficulty, likely related to their systemic disease.
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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.