World Neurosurg
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Continuous bedside brain tissue oxygen monitoring is an essential part of managing comatose patients with acute brain injury. Maintenance of adequate brain oxygenation has been established as an important goal in neurocritical care to prevent patients from secondary ischemia. As patients with subarachnoid hemorrhage and traumatic brain injury often require early magnetic resonance imaging, conventionally implanted metal bolts are disadvantageous due to massive artifacts. We hereby report a novel technique of magnetic resonance imaging conditional bedside implantation of a brain tissue oxygenation probe. ⋯ This article describes the feasibility of a novel technique of bedside implantation of a Licox brain tissue oxygenation probe, resulting in a length-adjustable insertion and rigid fixation without metal artifacts in early magnetic resonance imaging.
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Optic pathway and hypothalamic gliomas (OPHGs) are challenging to surgically remove owing to their anatomical relationship. We previously reported on surgical treatment outcomes over a 10-year time frame. The purpose of this study was to update the OPHG clinical outcomes for cases in which chemotherapy has become the primary treatment option. The role of surgery was also revisited. ⋯ OPHG management using less invasive operations and chemotherapy as first-line treatment is feasible. Debulking surgery in patients with OPHGs may be considered in cases with cerebrospinal fluid pathway obstruction, progression despite chemotherapy or radiation, and refractory shunt-related ascites.
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Patients with posttraumatic hydrocephalus (PTH) have a high incidence of infection after ventriculoperitoneal shunt (VPS). In this study, we investigated different risk factors affecting infection after VPS in PTH patients. ⋯ Age, severe hydrocephalus, hypertension, diabetes, DC, as well as duration of operation for VPS (>60 minutes) were factors that significantly and independently correlated with the incidence of infection after VPS. The receiver operating characteristic curve that we have developed can predict the occurrence of shunt infection.
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Despite holding soft tissue away from high-speed drills during surgery, tissue can unexpectedly wrap around the drill shaft. We performed experiments to examine what precipitates such mishaps. ⋯ The pulling force generated by revolving high-speed drill shafts may result in tissue wraparound even when soft tissue is held away from the shaft.
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This meta-analysis assessed the impact of off-hour hospitalization (weekends, and evenings or nighttime on weekdays) on mortality and morbidity in patients with nontraumatic subarachnoid hemorrhage (SAH). ⋯ This meta-analysis has not shown an increased risk of mortality in the short-term and long-term among patients with nontraumatic SAH who were hospitalized during off-hour compared with on-hour periods, despite adjusting for potentially confounding patient factors. The delays to treatment and higher observed rates of pneumonia highlight areas in which hospital services and resources should be targeted during these off-hour periods in patients presenting with nontraumatic SAH.