World Neurosurg
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Comparative Study
Lumbo-peritoneal (LP) and Ventriculoperitoneal (VP) Shunt Surgery for Post-hemorrhagic Communicating Hydrocephalus: A comparison.
This study aimed to compare the efficacy and complications of lumboperitoneal (LP) and ventriculoperitoneal (VP) shunt surgeries in patients with posthemorrhagic communicating hydrocephalus. ⋯ In the treatment of moderate and severe coma patients with posthemorrhagic communicating hydrocephalus, LP shunt surgery is equally as effective as the VP shunt surgery and is associated with fewer complications.
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The LACE+ index (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department [ED] visits in the past 6 months) is a tool used to predict 30-day readmissions. We sought to examine this predictive tool in patients undergoing brain tumor surgery. ⋯ The results of this study demonstrate that the LACE+ index is not yet suitable as a prediction model for 30-day readmission in a brain tumor population.
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Fourth ventricular meningiomas (FVMs) are extremely rare. Here, we report a series of 11 patients at a single institution. A comprehensive literature analysis is conducted. ⋯ FVMs have their own characteristics in age of onset, gender ratio, histologic types, and imaging features. The recommended treatment is surgical treatment via the telovelar approach with suboccipital craniotomy/craniectomy. Adjuvant therapy is needed in some high-grade meningiomas and in patients undergoing partial resection. The prognosis is relatively good, with fewer postoperative complications and a higher rate of total resection.
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We compared the efficacy of a closed suction irrigation system (CSIS) and negative pressure wound therapy (NPWT) for deep surgical site infection (SSI) after lumbar surgery with instrumentation. ⋯ Our results have shown that both NPWT and CSIS are efficient techniques for the management of deep SSI after lumbar surgery with instrumentation. CSIS was more economical and the NPWT system was portable and easier for postoperative nursing care.
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Postoperative visual recovery is a major concern after transsphenoidal surgery. Optical coherence tomography (OCT) can visualize the anatomy of the retina, and retinal nerve fiber layer (RNFL) thinning reflects loss of optic nerve axons. Visual-evoked potential (VEP) is an electrophysiological response that confirms the nerve conductance. Therefore, these factors reflecting the optic nerve condition may be closely associated with the visual outcome after transsphenoidal surgery. ⋯ OCT is a useful diagnostic modality to assess optic nerve condition, and RNFL thickness of the temporal quadrant is correlated with visual outcome after transsphenoidal surgery. Patients with severe visual disturbance may still achieve visual recovery, so surgery should be considered even if optic disc atrophy is evident.