British journal of neurosurgery
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Randomized Controlled Trial Comparative Study
A prospective study of two methods of closing surgical scalp wounds.
Scalp wounds are commonly closed in two layers, although single layer closure is feasible. This study prospectively compared the two methods of closing scalp wounds. ⋯ The study shows that closing the scalp in one layer is much faster and more cost effective compared to the multilayer closure method. We did not observe significant difference in the complication rates in the two methods of closure. Long-term outcome, especially cosmetic outcome, remains to be determined in this preliminary study.
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Primary pyogenic abscess in the conus medullaris in a healthy adult has never been reported. An urgent MRI scan with contrast and prompt surgical evacuation may lead to good neurological recovery.
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Cranioplasty is carried out for cosmesis, protection and also for neurological improvement following cranial defect. Infection post cranioplasty is problematic. We look at the outcome from 10 years of cranioplasty patients, and aim to see if there is a correlation between infection and time to insertion of cranial plate. ⋯ Cranioplasty carried out at a minimum of 6 months post craniectomy limits the risk of infection.
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We describe the case of a 29-year-old farmer who developed upper limb radiculopathy followed by myelopathy in his lower limbs. MRI findings suggested cervical disc prolapse with cord changes. Despite a successful anterior cervical decompression and fusion his symptoms rapidly returned. Further investigations ultimately diagnosed underlying neurosarcoidosis.
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Clinical Trial
Feasibility of intraventricular nicardipine prolonged release implants in patients following aneurysmal subarachnoid haemorrhage.
Intracisternal nicardipine prolonged release implants (NPRI) have been shown to be effective in the prophylaxis of cerebral vasospasm (VS). However, they cannot be used in patients following coil occlusion of the aneurysm. As a certain dissemination of nicardipine within the cerebrospinal fluid (CSF) has been described, we examined the feasibility of intraventricular use of NPRI in patients that underwent clip and coil occlusion of their aneurysms following aneurysmal subarachnoid haemorrhage (aSAH). By comparison with an historical control group, an estimation of their effectivity in regard to angiographic vasospasm and the development of cerebral infarction has been performed. ⋯ The use of intraventricular NPRI seems to be safe and tolerated well. There is preliminary evidence for effectivity on angiographic VS for clipped patients only. A further increase of the effective dose might also exert efficacy in the subset of patients following coil occlusion.