World Neurosurg
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Nigeria has the largest population in Africa and has suboptimal access to neurooncology care. It has been estimated that there is approximately 1 neurosurgeon for every 2.4 million people in the country, with only few of these trained in the neurooncology subspecialty and no dedicated medical or radiation neurooncologists. There is a paucity of information on the field of neurooncology in Nigeria. This manuscript aims to provide an overview of the current state of neurooncology literature in Nigeria. ⋯ There is a small but growing amount of scholarly literature on neurooncology from Nigeria. However, there continues to be room for growth in neurooncology research output. With Nigeria's large patient population, there is potential to learn and add to the academic literature. Although there are logistical obstacles to both patient care and research in neurooncology in Nigeria, there is promise for favorable advancement.
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We sought to identify the morphological features of the relationship between the manubrium and vertebrae of the cervicothoracic junction for use in guidelines for the selection of the appropriate surgical approach. ⋯ Our results have provided insight into the anatomy of the manubrium and vertebrae of the cervicothoracic junction. Furthermore, our results have shown that, for most people, the T1 forms the boundary of the manubriotomy. We found that both the distance and angle differed significantly according to sex. A better understanding of the radiological anatomy of the surgeons' view line will help in the preoperative assessment of patients and in indicating an appropriate surgical approach.
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The development of postcraniotomy hematoma (PCH) after surgery for acute traumatic subdural hematoma (aSDH) has been associated with an increased risk of a poor outcome. The risk factors contributing to PCH remain poorly understood. Our aim was to study the potential risk factors for PCH in a consecutive series of surgically evacuated patients with aSDH. ⋯ The results suggest that alcohol inebriation at the time of injury and hypocapnia during hospitalization are risk factors for the development of PCH.
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The rate of ventriculoperitoneal (VP) shunt infection is reported between 3% and 20%. Vancomycin-resistant enterococci (VRE) are increasingly prevalent nosocomial pathogens worldwide, and they rarely cause infections to the central nervous system. Daptomycin is a cyclic lipopeptide effective antibiotic because of its rapid bactericidal effect. It is a life-saving treatment option for meningitis, bacteremia, sepsis, endocarditis, and urinary system infections caused by VRE. ⋯ The patient was admitted to the medical center with umbilical discharge, and shunt revision was applied with the thought of shunt dysfunction. Intermittent umbilical cerebrospinal fluid (CSF) leakage continued, and the patient experienced a fever 2 weeks after the operation. VRE growth in his CSF culture was treated by meropenem and linezolid. Upon continuation of the growth afterwards, the patient was referred to our hospital and underwent extraventricular drainage, and IV linezolid, IV daptomycin (8 mg/kg per day), and IVT daptomycin (2.5 mg/kg per day) was scheduled as treatment. On the fifth day of treatment, there was no growth in the culture, and no side effects were observed during the treatment. A VP shunt was placed in the patient for the 15 days of IV daptomycin plus IVT treatment, and 36 days of linezolid. No infection was observed in the 8-month follow-up period.
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Super-refractory status epilepticus (SRSE) is a life-threatening neurologic emergency defined as "status epilepticus (SE) that continues 24 hours or more after the onset of anesthesia, including those cases in which the SE recurs on the reduction or withdrawal of anesthesia," which occurs in 10% to 15% of patients with SE and rarely has been resolved surgically. ⋯ The lesionectomy guided by electrocorticography and neuronavigation should be considered as a treatment option for patients with SRSE.