World Neurosurg
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Two main surgical techniques are available for corpus callosotomy (CC): conventional microscopic CC and endoscopic CC.1 Microscopic CC is more familiar to neurosurgeons and allows three-dimensional visualization, but it requires a larger craniotomy and has a narrower visual angle in the deep part. Endoscopic CC has only recently been introduced to epilepsy surgery, but it is gaining increasing interest among epilepsy surgeons. The endoscope provides two-dimensional visualization and requires a camera as an additional instrument inserted into the surgical corridor. ⋯ In some cases, this procedure can take a long time. On the other hand, a posterior approach requires less interhemispheric arachnoid dissection, or sometimes none at all, due to the anatomy of the falx cerebri. These reasons have driven the development of a posterior approach for an endoscopic-alone technique.3 Here, we present a 5-year-old girl with medically intractable epileptic spasms that were diagnosed as infantile epileptic spasms syndrome, who underwent endoscopic total CC via a posterior approach to control her seizures (Video 1).
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Tension pneumocephalus (PMC) is a rare and feared complication following the endonasal endoscopic approach (EEA) to skull base procedures. This is a neurosurgical emergency that requires urgent decompression to avoid catastrophic neurologic damage or death. An avoidable cause is the application of positive pressure ventilation (PPV) in EEA patients for postoperative hypoxia. Our institution implemented a hospital-wide protocol in response to this to identify and manage at-risk patients; this paper aims to identify if this protocol was effective in lowering the rates of tension PMC secondary to PPV. ⋯ We found no cases of tension PMC after PPV following EEA skull base surgery in our institution since the implementation of an institution-wide guideline. This underscores the utility of our simple and cost-effective preventative protocol in reducing the overall rates of tension PMC following the inadvertent postoperative application of PPV. Further research is needed to study the comparative risks and benefits of PPV in the post-EEA patient and thus inform future iterations of the protocol.
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To explore the influencing factors of urinary tract infection (UTI) in hospitalized patients with spinal cord injury and to construct and verify the nomogram prediction model. ⋯ ASIA classification level, white blood cell count, and indwelling catheter are independent influencing factors of UTI in hospitalized patients with spinal cord injury. The nomogram prediction model based on the above factors can simply and effectively predict the risk of UTI in hospitalized patients with spinal cord injury, which is helpful for clinical medical staff to identify high-risk groups early and implement prevention, treatment, and nursing strategies in time.
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Medical students often face challenges in choosing a career path due to limited exposure to specialized fields like neurosurgery. Understanding their perceptions and experiences is crucial in addressing the gaps in neurosurgical education and inspiring future neurosurgeons. ⋯ Enhancing neurosurgery education with quality, consistency, and adaptability is essential to bridge gaps and inspire future neurosurgeons. These findings guide improvements in educational programs, preparing a skilled workforce to meet evolving health-care demands.
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Traumatic spinal cord injury (TSCI) is a devastating condition that may result to lifelong complications that affect patient outcome and quality of life. Because of the increasing incidence of TSCI, it is important to comprehend the extent of this condition in terms of demographics, mechanism, and degree of disability to raise awareness and develop strategies in approaching care for these patients. There is a lack of information regarding data on TSCI in Southeast Asia, especially in the Philippines. This study aims to describe the clinical characteristics and outcomes of patients with TSCI in a tertiary care hospital in the Philippines. ⋯ TSCI is common in young adult male patients with motor vehicular crash as the mechanism of injury. Most patients in the study had incomplete spinal cord injury (AIS C), with the cervical region as the most common level. The recorded mean length of hospital stay was 1-2 weeks. The most common co-occurring extra spinal injury was traumatic brain injury. At discharge, most developed sacral ulcer and hospital-acquired pneumonia, with stable neurologic status. A multicenter prospective data collection with a larger population and inclusion of more variables are necessary to formulate a regression model and establish the factors that improve the outcomes of TSCI.