World Neurosurg
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To describe an approach to the analysis of deep brain stimulation (DBS) of the subthalamic nucleus (STN) using a hidden semi-Markov model (HsMM) and early results of the analysis of microelectrode recordings for STN DBS. ⋯ Further clinical work must be done; however, based on these data, HsMMs may be best suited to computer-assisted anatomic delineation for DBS.
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To define and grade neurosurgical and spinal postoperative complications based on their need for treatment. ⋯ The authors present a simple, practical, and easy to reproduce way to report negative outcomes based on the therapy administered to treat a complication. The main advantages of this classification are the ability to compare surgical results among different centers and times, the ability to compare medical and surgical complications, and the ability to perform future meta-analyses.
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Brain abscess (BA) is a neurosurgical emergency and despite significant medical advances, it remains a surgical challenge. A single institution's two decade computed tomography era management experience with BA is reported. ⋯ Optimal management of BA involves surgical drainage for medium-to-large abscesses (≥2.5 cm) with simultaneous eradication of the primary source, treatment of associated hydrocephalus, and administration of high doses of intravenous antibiotics. The incidence of BA is directly related to poor socioeconomic conditions and therefore, still poses a public health challenge in developing countries.
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To review a series of patients who underwent Gamma Knife surgery (GKS) to identify prognostic factors for local growth control and survival. ⋯ GKS for melanoma brain metastasis provides a high rate of local tumor control. Survival is longest for well-functioning patients with absence of extracranial metastases or with an intracerebral total tumor volume less than 5 cc.