World Neurosurg
-
Historical Article
Neurosurgery in Tanzania: a discussion of culture, socioeconomics, and humanitarians.
To elucidate the progress of neurosurgical practices in Tanzania, taking into account humanitarian, socioeconomic, and geographic influences. ⋯ Neurosurgery in Tanzania and Africa more generally has a long history; however, it was not until more recent efforts of certain local pioneers and educational advisors abroad that modernization occurred. The progress of the past 50 years is substantial and with continued efforts advances will continue to be made.
-
Randomized Controlled Trial Comparative Study
A randomized outcome study of enteral versus intravenous nimodipine in 171 patients after acute aneurysmal subarachnoid hemorrhage.
Delayed ischemic neurologic deficit (DIND) is a serious complication of acute aneurysmal subarachnoid hemorrhage (aSAH). Although oral nimodipine is accepted as standard care for the prevention of DIND, the intravenous route is preferred by several centers. In the present study we compared the clinical efficacy between enteral and intravenous nimodipine after aSAH. ⋯ Our pilot study suggested no differences in the clinical efficacy of enteral and intravenous nimodipine after aSAH. However, a much larger phase III clinical trial would be needed to show or exclude meaningful clinical differences.
-
To highlight pertinent aspects of emergent endovascular management of carotid rupture, or carotid blowout syndrome (CBS), an emergent, life-threatening complication of head and neck cancer and its treatments. ⋯ The treatment of patients with terminal malignant disease and CBS should provide maximum relief and minimize the risks of repeat surgery, morbidity, and mortality. Endovascular management of CBS with deconstructive techniques achieves immediate hemostasis and definitive treatment. The risks of intraoperative mortality and recurrent hemorrhage are low.
-
The transoral transpharyngeal surgical approach is a recognized technique for management of ventral lesions at the clivus and upper cervical spine. This report examines the use of neuronavigation and intraoperative magnetic resonance imaging as surgical adjuncts for lesions in this region. ⋯ Intraoperative MRI and neuronavigation are valuable adjuncts that allow selective surgical exposure and confirmation of surgical objectives within the narrow surgical corridor provided by a transoral approach to the craniovertebral junction.