Journal of neurosurgery
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Journal of neurosurgery · Nov 2010
Analysis of the subdural evacuating port system for the treatment of subacute and chronic subdural hematomas.
The subdural evacuating port system (SEPS; Medtronic, Inc.) is a minimally invasive means of draining subacute or chronic subdural fluid collections. The purpose of this study was to examine a single institution's results with the SEPS. ⋯ The SEPS is a safe and effective treatment option for draining subacute and chronic SDHs. The system can be used quickly with local anesthesia only, making it ideal in elderly or sick patients who might not tolerate the physiological stress of a craniotomy under general anesthesia. Computed tomography is useful in predicting which subdural collections are most amenable to SEPS drainage. Specifically, hypodense subdural collections drain more effectively through an SEPS than do mixed density collections. Although significant bleeding after SEPS insertion was uncommon, 1 patient in the series required urgent surgical hematoma evacuation due to iatrogenic injury.
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Journal of neurosurgery · Nov 2010
Survey of the h index for all of academic neurosurgery: another power-law phenomenon?
The h index is a recently developed bibliometric that assesses an investigator's scientific impact with a single number. It has rapidly gained popularity in the physical and, more recently, medical sciences. ⋯ A survey of the h index for all of academic neurosurgery is presented. Results can be used for benchmark purposes. The distribution of the h index within an academic population is described for the first time and appears related to the ubiquitous power-law distribution.
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Journal of neurosurgery · Nov 2010
Trigeminal neurinomas with extracranial extension: analysis of 28 surgically treated cases.
The object of this paper was to review the authors' experience with 28 cases of trigeminal neurinomas having an extracranial extension. ⋯ Extracranial extensions of trigeminal neurinomas have a well-defined meningeal covering. In most cases resection was performed via a minimally invasive cranial avenue (a "reverse skull base approach"). Radical resection was associated with an excellent long-term outcome.
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Journal of neurosurgery · Nov 2010
Review Meta AnalysisTreatment decision making based on the published natural history and growth rate of small meningiomas.
Definitive data allowing clinicians to predict which meningioma patients will fail to respond to conservative management are lacking. To address this need, the authors systematically reviewed the published literature regarding the natural history of small, untreated meningiomas. ⋯ This systematic review of the literature regarding the clinical behavior of untreated meningiomas suggests that most meningiomas ≤ 2.5 cm in diameter do not proceed to cause symptoms in the approximately 5-year period following their discovery. Those that do cause symptoms can usually be predicted with close radiographic follow-up. Based on these findings, the authors suggest the importance of observation in the early course of treatment for small asymptomatic meningiomas, especially those with an initial diameter < 2 cm.