World Neurosurg
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Anterior cervical discectomy and fusion (ACDF) can be performed with and without supportive anterior cervical plating. Fusion rates, incidence of dysphagia, and repeat surgery are concerns when performing ACDF with or without plating. We aimed to compare procedural success and outcomes between patients treated with and without cervical plating for 1-2 level ACDF. ⋯ In this propensity score-matched case-control study, we report comparable effectiveness and outcomes of performing 1-2 level ACDF with and without cervical plating.
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Craniopharyngiomas arise from the Rathke pouch and account for 1.2%-18.4% of pediatric primary brain tumors. Despite relatively good survival outcomes, patients face long-term morbidity from recurrences, visual impairment, and endocrinopathies, which reduce quality of life. We examined the management of pediatric craniopharyngiomas, their recurrences, and subsequent neuroendocrine sequelae in a tertiary center in South-East Asia. ⋯ Long-term management of pediatric craniopharyngioma remains difficult, with multiple recurrences and long-term neuroendocrine sequelae impairing quality of life for patients. Further research into management of recurrences and neuroendocrine sequelae, as well as novel therapies to improve outcomes in these patients, may be warranted.
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Traumatic brain injury (TBI) is the leading cause of mortality and morbidity in children. Previous studies evaluated outcomes of adult patients; however, few assessed outcomes of pediatric TBI patients presenting with herniation. This study investigated outcome data in pediatric patients presenting with TBI and cerebral herniation and the interventional strategies used for each patient in a rural community. ⋯ TBI remains a serious concern in the pediatric population with no clear guidelines on the optimal treatment. This study highlights the advantage of integrating more aggressive surgical intervention, such as decompressive craniectomy, in rural communities earlier in the hospital course. Future studies should explore additional factors that could contribute to outcomes in this patient population.
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Social media has irreversibly impacted global interpersonal connectivity. This study aims to understand how information discussed in condition-specific communities, called "subreddits," on the major social media platform Reddit, can improve education by medical providers. ⋯ Cranial neurosurgical disease can overwhelm patients, leaving them with unaddressed questions. Reddit provides anonymity and camaraderie within condition-specific communities not found at the doctor's office. The ease of access to an Internet community may encourage redditors to seek health information online.
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We retrospectively reviewed and evaluated our treatment protocols in epidural hematoma (EDH) cases to compare surgical versus nonsurgical treatment subsections with their trauma mechanism, injury type, clinical pattern, radiological details, functional outcome, and mortality rates. ⋯ Age, trauma severity, initial neurological statuses, and accompanying comorbidities can affect the functional outcome in acute EDH. We found that urgent surgical intervention and conservative treatment may lead to excellent results in most cases. Thus, EDH can be managed both conservatively and surgically in certain conditions. We made a comparison between pediatric and adult age groups according to treatment modalities. Both rebleeding and mortality rates are relatively lower in the pediatric operated group than in the adult operated group. In the adult observation group, rates of delayed surgery because of growing hematoma seem relatively higher than in the pediatric observation group. During radiological follow-up, we found that the progression rate of EDH in the adult observed group according to time is faster than in the pediatric observed group (P < 0.05).