Turk Neurosurg
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Previous studies have not identified a preferred surgical technique to treat posttraumatic syringomyelia. Both syringopleural shunting and arachnoidolysis are used in neurosurgery practice for the surgical treatment of posttraumatic syringomyelia. In this study, we present a new technique designed to achieve a better outcome following surgery. ⋯ This is a report of minimal-access insertion combining syringopleural with subarachnoid-subarachnoid bypass shunt insertion. This minimally invasive technique seems to be an effective and safe method.
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Intracerebral haematoma and brain ischaemia are rare life-threatening complications of cardiovascular surgery. The aim of this study is to present the experience with the neurosurgical treatment of patients with cerebrovascular complications of heart surgery. ⋯ Minimally invasive neurosurgery techniques appear to be beneficial for selected patients with intracerebral haematoma after heart surgeries even when considering the limited number of patients. Decompressive craniectomy should be considered strictly individually.
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Computed tomography perfusion (CTP) has recently been used to identify regions of potential ischemia due to cerebral vasospasm, and CTP parameters are able to quantitatively evaluate brain parenchymal perfusion. We performed a meta-analysis as an update of a previous paper published in 2010 and aimed at evaluating the diagnostic accuracy of CTP and CTP parameters for vasospasm after aneurysm rupture. ⋯ CT perfusion has a great diagnostic value to detect cerebral vasospasm compared with DSA in patients with aneurysmal subarachnoid hemorrhage (aSAH). As CTP parameters, CBF and MTT quantitatively evaluate brain parenchymal perfusion.
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Randomized Controlled Trial
Choice for the removal of bloody cerebrospinal fluid in postcoiling aneurysmal subarachnoid hemorrhage: external ventricular drainage or lumbar drainage?
External ventricular drainage (EVD) and lumbar drainage (LD) are the most widely used procedures for continued bloody cerebrospinal fluid drainage. Each has his own advantages and disadvantages. Here, we compared complications and clinical outcomes in patients with World Federation of Neurosurgical Societies (WFNS) grade III aneurysmal subarachnoid hemorrhage (aSAH) who underwent coil placement followed by EVD or LD. ⋯ In order to improve the clinical outcomes of patients with aSAH, we suggest that LD is better than EVD for patients with WFNS grade III aSAH who underwent coil placement.
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Randomized Controlled Trial Comparative Study
Comparison of patient satisfaction and cost in spinal and general anesthesia for lumbar disc surgery.
The aim of this study was to evaluate patient satisfaction and cost in spinal and general anesthesia for lumbar disc surgery. ⋯ We conclude that successful LDH surgery can be performed using either anesthesia type. As long as patients are selected carefully, spinal anesthesia is a safe, comfortable, and a more economical alternative.