World Neurosurg
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Randomized Controlled Trial
Combined External Ventricular Drainage and Endoscope-Assisted Microsurgery using the middle frontal gyrus approach in severe ventricular hemorrhage with the casting of the fourth ventricle.
To investigate combined external ventricular drainage and endoscope-assisted microsurgery using the middle frontal gyrus approach in patients with severe ventricular hemorrhage with casting of the fourth ventricle and patients' recovery after this treatment. ⋯ Combined external ventricular drainage and endoscope-assisted microsurgery using the middle frontal gyrus approach can effectively improve severe ventricular hemorrhage with casting of the fourth ventricle and enhance patients' neurological function and recovery.
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Liver cirrhosis is associated with an increased risk of aneurysmal subarachnoid hemorrhage (aSAH). However, large studies analyzing the prognosis of cirrhotic patients after aSAH treatment are lacking. This study explores factors associated with inpatient mortality among aSAH patients with cirrhosis. ⋯ Cirrhosis was a predictor of inpatient mortality among aSAH patients and was a stronger predictor than DCI or a poor Hunt and Hess grade among patients in this study.
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We aim to compare perioperative/postoperative clinical outcomes between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and anterior lumbar interbody fusion (ALIF) in patients presenting for revision surgery. ⋯ Patients undergoing revision fusion via MIS-TLIF or ALIF reported similar 1-year postoperative mean outcomes and rates of meaningful clinical achievement for physical function, mental health, disability, and back/leg pain. However, patients undergoing revision MIS-TLIF reported improved physical function at 12 weeks and 6 months. Perioperatively, patients undergoing revision MIS-TLIF were noted to consume significantly greater quantities of narcotics.
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Preoperative embolization of intracranial meningiomas is an accepted treatment modality and offers many advantages for subsequent surgery. It has also been used as a primary therapy without subsequent surgery in selected cases. In this study, the authors share their experience of this procedure with minimal resources carried out in cases where definitive surgery was not advisable. ⋯ In resource-restricted settings, by introducing such innovative methods it is possible to perform selected endovascular procedures. Embolization can be used as a primary treatment modality avoiding subsequent surgery in selected cases with a good outcome.
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External ventricular drainage (EVD)-related infection (ERI) represents an important condition with potential high morbidity with significant impact on patient outcomes. Prophylactic systemic antibiotics are routinely administered to patients with EVD, but they do not significantly lower the incidence of ERIs. Intraventricular treatment with vancomycin appeared to be safe and effective, but most reports are case-reports/-series and retrospective studies. ⋯ In this first prospective study on this topic, we found that intrathecal Vancomycin administration in EVDs does not reduce the occurrence of ERI compared with intravenous cefazolin prophylaxis, but induces selection of gram-negative bacteria.