Neurosurgery
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THE PRACTICE OF "head-shrinking" has been the proper domain not of Africa but rather of the denizens of South America. Specifically, in the post-Columbian period, it has been most famously the practice of a tribe of indigenous people commonly called the Jivaro or Jivaro-Shuar. ⋯ Moreover, although not true shrunken heads, trophy heads found in late pre-Columbian and even post-Columbian graves of the region demonstrate techniques of display very similar to those used by the Jivaro-Shuar, at least some of which are best understood in the context of head-shrinking. Regardless, the Jivaro-Shuar and their practices provide an illustrative counterexample to popular myth regarding the culture and science of the shrinking of human heads.
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Hydrocephalus, vasospasm, and frontobasal injury are common complications after aneurysmal subarachnoid hemorrhage (SAH) from anterior communicating artery aneurysms. Previous studies have suggested that fenestration of the lamina terminalis (FLT) during surgery may be associated with reduced rates of shunt-dependent hydrocephalus and vasospasm. We report 106 patients affected by anterior communicating artery aneurysms and Fisher Grade 3 aneurysmal SAH and the affect of FLT on shunt-dependent hydrocephalus, vasospasm, and frontobasal injury. ⋯ FLT was associated with statistically significant decreases in shunting rates, incidence of vasospasm, and better outcomes. We recommend its routine use in patients with Fisher Grade 3 anterior communicating artery aneurysmal SAH.
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Multicenter Study
Concussion in professional football: injuries involving 7 or more days out--Part 5.
A 6-year study was conducted to determine the signs, symptoms, and outcome of concussions with 7 or more (7+) days out from play or extended postconcussion recovery in the National Football League (NFL). ⋯ The most vulnerable players for 7+ days out with concussion were quarterbacks and the secondary in professional football. Although 8.1% of concussions involved 7+ days out, only 1.6% involved a prolonged postconcussion syndrome. They recovered from symptoms and had a consistent return to play in the NFL.
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To evaluate the feasibility of detecting bacterial pathogens directly from the clinical brain abscess specimens by polymerase chain reaction (PCR) amplification and sequencing of bacterial 16S ribosomal deoxyribonucleic acid (rDNA). ⋯ Bacterial 16S rDNA sequences provide reliable clues to the identification of unknown pathogens. PCR analysis of 16S rDNA and sequencing may identify pathogens to the species level directly from brain abscesses. This approach is rapid and is useful especially in the identification of slow-growing and fastidious organisms.