World Neurosurg
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This study sought to review the articles published by Iranian neurosurgeons regarding their experiences during the Iraq-Iran conflict and compare them with reports from other conflicts. ⋯ Conservative minimal debridement of the wounds is indicated in patients with small entrance wounds, or those with Glasgow Coma Scale score ≥ 8 and no progressive neurological deficit. To diagnose TA before rupture, angiography is indicated in patients who have shells or bone fragments pass through the crowded vasculature, or have large/delayed hematoma, or if the surgeon has high index of suspicion based on neuroimaging and early debridement surgery. Surgery in a well-equipped nearby hospital after quick and safe evacuation of the victims by trained salvaging ancillary groups and the administration of broad-spectrum antibiotics and proper antiepileptics decrease the morbidity and mortality of casualties after PHW in war situations. The biases of the case selection, data collection, and confounders, and decreasing biases by conducting blinded controlled clinical trials, are discussed.
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To describe the neuroendoscopic technique to deal with intraventricular tumors. ⋯ Intraventricular tumors and related CSF pathway obstructions can be safely and effectively treated with endoscopic techniques. Small tumors may be totally removed via a ventriculoscope.
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The purpose of this review is to describe the magnetic resonance imaging (MRI) findings in patients with noncommunicating hydrocephalus (NCH). ⋯ The first step of the diagnostic work-up consists of the detection of an obstacle hindering CSF flow pathways using both constructive interference in steady state and flow-sensitive MR sequences. CSF volumetry and quantification of ventricular wall movement may also improve the diagnosis and follow-up of patients with NCH.
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Endoscopic third ventriculostomy (ETV) is increasingly prevalent among pediatric neurosurgeons as the initial treatment for hydrocephalus. The combination of ETV and choroid plexus cauterization (ETV/CPC) has improved the success rate among infants with hydrocephalus for whom ETV alone is much less successful. In parts of the developing world where there are economic and human resource constraints, this mode of treatment may be more appropriate than the routine use of shunts, which are prone to failures that require urgent surgical treatment. Here we review indications for the use of ETV or ETV/CPC as the primary treatment for hydrocephalus. ⋯ Primary treatment of hydrocephalus by ETV can avoid shunt-dependence and its complications for many patients. Optimal results depend upon proper patient selection and the use of combined ETV/CPC when treating infants.