Journal of neurosurgery. Pediatrics
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J Neurosurg Pediatr · Jan 2008
ReviewAntibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: a systematic review.
Systemic antibiotics and antibiotic-impregnated shunt (AIS) systems are often used to prevent shunt infection. The authors conducted a systematic review to evaluate its effectiveness of antibiotics in patients who underwent placement of intracranial ventricular shunts. ⋯ The authors found a benefit of systemic prophylactic antibiotics in preventing shunt infection, regardless of the patient's age and the type of internal shunt used. The benefit of its use after the first 24 hours postoperatively remains uncertain. Future trials should be conducted to evaluate the effectiveness of different regimens of systemic antibiotics rather than placebo, namely single preoperative dose versus multiple doses. It should also be mandatory to evaluate the effectiveness of systemic prophylactic antibiotics for external ventricular drains. Evidence suggests that antibiotic-impregnated catheters reduce the incidence of shunt infection, although more well-designed clinical trials are needed.
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Craniopagus twins represent a rare phenomenon of congenital misfortune. Modern neurosurgical techniques have created opportunities for successful separation and the promise of a normal existence for these children, who in the past were often left as historical footnotes or put on display as oddities of nature. The authors document a brief history of conjoined twinning and discuss the modern science of craniopagus epidemiology, classification, and separation. In particular, the strategies used and the rationale for staged surgical separation are highlighted.
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J Neurosurg Pediatr · Jan 2008
Case ReportsMultiple ruptured cerebral aneurysms in a child with Takayasu arteritis.
The authors report the case of an 18-month-old girl who presented with a ruptured anterior communicating artery aneurysm, and who was later diagnosed with Takayasu arteritis. Her initial aneurysm was successfully treated with clip application. ⋯ Aneurysmal subarachnoid hemorrhage is a rare presentation of Takayasu arteritis. To the authors' knowledge, this is the youngest reported patient with Takayasu arteritis to present with a ruptured cerebral aneurysm.
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J Neurosurg Pediatr · Jan 2008
Analysis of neuronal cell death in the cerebral cortex of H-Tx rats with compensated hydrocephalus.
Some cases of compensatory hydrocephalus have been reported in which cognitive deficiency progresses despite the absence of progressive ventricular dilation. In this study, the differentially expressed genes in compensated hydrocephalic H-Tx rat cortices were determined. A molecular mechanism that induces neuronal death in the cerebral cortex of compensated hydrocephalus is proposed. ⋯ The accumulation of phosphorylated tau protein in the cerebral cortex may be one of the mechanisms by which later cognitive dysfunction develops in patients with compensated hydrocephalus. More work needs to be done to determine if the accumulation of phosphorylated tau in the cortex can help predict which patients may decompensate thus requiring more aggressive treatment for compensated hydrocephalus.
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Relationships between industry and neurosurgeons engaged in both clinical practice and research have become increasingly complicated due to increased utilization of expensive devices in day-to-day neurosurgical practice. The Journal of Neurosurgery Publishing Group (JNSPG) has always had a policy of demanding open disclosure of any real, potential, or even perceived conflict of interest by authors submitting scientific manuscripts. ⋯ In addition, we felt that such a policy should be extended to all reviewers of articles submitted for publication to JNSPG journals-both members of the editorial boards and ad hoc reviewers. To clarify, extend, and specify the JNSPG's policy in this respect, the editor and editorial boards developed a task force on "Conflict of Interest." The task force, after considerable discussion with the full editorial boards, developed the following Conflict of Interest policy as well as the forms that submitting authors, editorial board members, and other reviewers are now required to complete.