Journal of neurosurgery
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Journal of neurosurgery · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of rapid and gradual weaning from external ventricular drainage in patients with aneurysmal subarachnoid hemorrhage: a prospective randomized trial.
The goal of this study was to compare rapid and gradual weaning from external ventricular drainage in patients with aneurysmal subarachnoid hemorrhage (SAH) in a prospective, randomized trial. ⋯ Compared with rapid weaning, gradual, multistep EVD weaning provided no advantage to patients with aneurysmal SAH in preventing the need for long-term shunt placement and prolonged ICU and hospital stays.
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Journal of neurosurgery · Feb 2004
Cortical dysplastic lesions in children with intractable epilepsy: role of complete resection.
The authors conducted a study to determine seizure-related outcomes in a group of pediatric patients with pathologically proven focal cortical dysplasia (FCD) treated by focal cortical resections and multiple subpial transections (MSTs). ⋯ Complete resection of FCD results in good seizure outcome in a majority of children. When conducted in conjunction with incomplete cortical resection, MSTs do not improve seizure outcome in patients with FCD. Focal cortical dysplasia located outside of eloquent cortex and complete excision of the lesion are the most important predictors of seizure outcome.
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Journal of neurosurgery · Feb 2004
Comparative StudyCerebral hemispherectomy in pediatric patients with epilepsy: comparison of three techniques by pathological substrate in 115 patients.
Cerebral hemispherectomy for intractable seizures has evolved over the past 50 years, and current operations focus less on brain resection and more on disconnection. In addition, cases involving cortical dysplasia and Rasmussen encephalitis are being identified and surgically treated in younger individuals. Few studies have been conducted to compare whether there are perioperative differences based on hemispherectomy technique and/or pathological substrate in pediatric patients with epilepsy. ⋯ The authors found differences in perioperative risks and hospital course but not postsurgery seizure control, which vary by hemispherectomy technique and/or disease process. The modified lateral hemispherotomy approach offers various advantages related to operative blood loss and reoperation compared with anatomical and functional hemispherectomies that are especially relevant in younger patients with cortical dysplasia and Rasmussen encephalitis with small and/or malformed ventricles.