World Neurosurg
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Observational Study
Hospital volume-outcome relationship in severe traumatic brain injury: a nationwide observational study in Japan.
The hospital volume-outcome relationship in patients with severe traumatic brain injury (TBI) remains unclear. This study investigated the association between the volume of patients with severe TBI and in-hospital mortality. ⋯ Higher hospital volumes were significantly associated with lower in-hospital mortality after severe TBI. Regionalization and referral to higher-volume hospitals are beneficial for severe TBI patients.
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Intraoperative navigation during spine surgery improves pedicle screw placement accuracy. However, limited studies have correlated the use of navigation with clinical factors, including operative time and safety. In the present study, we compared the complications and reoperations between surgeries with and without navigation. ⋯ Navigated surgery patients experienced longer operations owing to a combination of the time required for navigation, more multilevel procedures, and a larger comorbidity burden, without differences in the incidence of infection. Fewer complications and wound washouts were required for navigated lumbar surgery owing to a greater proportion percentage of minimally invasive cases. The combined use of navigation and minimally invasive surgery might benefit patients with the proper indications.
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Case Reports
Intraparenchymal symptomatic cyst formation around the deep cerebellar stimulation electrode.
Intraparenchymal cyst formation around a deep brain stimulation electrode is a rare complication. This is the first report of intraparenchymal cyst formation along a deep cerebellar stimulation electrode in the posterior cranial fossa. The patient was a 27-year-old man with DYT-1 early-onset isolated dystonia who received bilateral deep cerebellar stimulation. ⋯ The cyst fluid was light yellow, sterile, and rich in protein. Despite substantial improvement in nausea and dysarthria within 1 week postoperatively, dizziness required 1 month to recover. Cystic formations gradually decreased with time.
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Nervus intermedius (NI) dysfunction after the management of vestibular schwannoma (VS) is underreported and is experienced by patients undergoing stereotactic radiosurgery and surgical resection. The aim of this study was to present NI outcomes in a series of patients who underwent all treatment modalities for VS and to review the existing literature. ⋯ NI dysfunction is common following treatment for VS and should be included in pretreatment counseling of patients, as it may impact treatment choice and quality of life. Additional studies are warranted to fully characterize NI dysfunction after treatment.
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Case Reports
Exoscopic en bloc Carotid-Sparing Total Temporal Bone Resection: Feasibility Study and Operative Technique.
To delineate the steps of exoscopic en bloc carotid artery-sparing total temporal bone resection for malignancies involving the temporal bone in a cadaveric model. ⋯ Exoscope-assisted en bloc carotid artery-sparing total temporal bone resection is a feasible technique for management of malignancies with temporal bone invasion.