World Neurosurg
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Randomized Controlled Trial
Effect of Ondansetron on post-operative shivering after craniotomy.
Postoperative shivering (POS) is an early complication after craniotomy. Preventive pharmacologic drugs are the mainstay of treatment. Meperidine is the drug of choice but with increased risk of apnea, nausea, and increased intracranial pressure. Some reports have suggested that ondansetron and meperidine have similar anti-shivering effects. ⋯ Ondansetron can effectively decrease POS after craniotomy. This effect is not mediated through maintenance of the core or peripheral temperature. Ondansetron probably acts by a central inhibitory mechanism on POS through 5-hydroxytryptaminergic pathways, not by changing thermoregulatory set points.
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Central nervous system (CNS) tumors are the most common cause of cancer-related death in children. Little is known about the demographics and treatment of pediatric brain tumors in low- and middle-income countries (LMICs). ⋯ We present the first operative series of childhood CNS tumors in Nepal. Children often had delayed diagnosis and treatment of a tumor, despite symptoms. More comprehensive data are required to develop improved treatment and management algorithms in the context of a given country's demographics and medical capabilities for childhood CNS tumors.
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Review Biography Historical Article
Julius Caesar's epilepsy: Was it caused by a brain arteriovenous malformation?
Julius Caesar (100-44 BC) was one of the most charismatic political figures in history. Best remembered for his military achievements, he was also a writer, historian, and statesman. ⋯ In this essay, we highlight the life of Julius Caesar, with emphasis on the potential origin of his sickness. Although a definitive diagnosis obviously cannot be made, as new published studies showed a possible cerebrovascular etiology, a new hypothetical diagnosis is presented.
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Randomized Controlled Trial
Retractorless surgery for anterior circulation aneurysms via pterional keyhole approach.
Brain retraction is required during many intracranial procedures to provide more working space. However, it is difficult to avoid brain retraction injury. Here, we report on retractorless surgery for anterior circulation aneurysms via a pterional keyhole approach. ⋯ Furthermore, the proportion of brain retraction injuries in group I (5.3%) was lower than that in group II (34.6%). In addition, a better prognosis was obtained in patients who underwent retractorless surgery. With the careful and accurate use of a handheld suction device and operating instruments, the retractorless technique can replace fixed retraction, reduce brain retraction injury, and is applicable to surgeries on anterior circulation aneurysms via pterional keyhole approaches.