World Neurosurg
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Guidelines may reduce practice variation and optimize patient care. We aimed to study differences in guideline use in the management of traumatic brain injury (TBI) patients and analyze reasons for guideline non-adherence. ⋯ There is substantial variability in the use and implementation of guidelines in neurotrauma centers in Europe. Further research is needed to strengthen the evidence underlying guidelines and to overcome implementation barriers.
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Penetrating brain injury is 1 type of traumatic brain injury. Brain abscess is a common complication after penetrating brain injury, and fragments increase the risk of occurrence of brain abscess. It is uncommon to see the migration of bone fragments in the brain in clinical cases. We report a rare case of brain abscess with migration of bone fragments after traumatic brain injury.
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Bony anomaly of axis (C2) vertebra is well known. However, expansion of the posterior element is less documented. We describe a case of additional bony ring attached to the posterior spinous process in a 10-year-old male who presented with the complaint of progressive swelling at the upper cervical region. ⋯ Complete surgical excision of the mass was done. Anomalous expansion of the spinous process of the C2 vertebra may remain silent. Surgery may be necessary for cosmetic purposes.
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Infectious pseudoaneurysm of the intracavernous carotid artery is rare, often caused by sphenoid sinusitis or transsphenoidal surgery. Management of intracranial infectious aneurysms (IIAs) remains a controversial topic lacking randomized controlled trials to guide clinical decision making. ⋯ Unfortunately, the patient died because the IIA recurred and ruptured. Therefore we speculated that stent-assisted coil placement for the treatment of ruptured infectious pseudoaneurysms of the internal carotid artery may not be safe.
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Depression is a prevalent and disabling condition associated with spinal cord injury (SCI). Such associated negative factor warrants the use of valid and reliable psychological assessment tools among this group. One of the available assessment means is the Patient Health Questionnaire-9 (PHQ-9), a short screening measure that evaluates depression status. Our aim is to test the psychometric properties of the Arabic version of the PHQ-9 including validity and reliability among Lebanese individuals with SCI. ⋯ Our findings suggest that the PHQ-9 has good psychometric properties and is a valid and reliable measure of depression among the Lebanese individuals with SCI.