World Neurosurg
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To evaluate the role of neoadjuvant chemotherapy and radiotherapy in the treatment of central nervous system germinomas in 38 patients who received definitive treatment and were followed-up >5 years between 1980 and 2009. ⋯ Chemotherapy followed by whole ventricle radiotherapy, with or without local boost, and with use of neuroendoscopy results in good disease control without late complications in patients with germinomas.
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Lumbar fusion is a widely used procedure for degenerative spine diseases but frequently is accompanied with substantial surgical blood loss. We aimed to investigate the risk factors for significant intraoperative blood loss and the influence of excessive bleeding on postoperative complications in patients undergoing fusion for degenerative lumbar spines. ⋯ Because substantial bleeding in lumbar fusion is associated with a greater incidence of morbidities and prolonged length of hospital stay, attention to the risk factors for significant blood loss is important in the preoperative assessment and postoperative guidance for the level of care.
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This study investigated whether functional neuronavigation can be used to remove lesions in the lateral ventricle while preserving patients' neurologic functionality. ⋯ Functional neuronavigation preserved neurologic functionality and was especially beneficial for protecting optical functionality and for the rapid recovery of patients.
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Primary intradural extramedullary ependymomas are very rare tumors and have never been described in children. ⋯ Although a rare entity, intradural extramedullary ependymomas should be included in the differential diagnosis of intradural extramedullary lesions in children. Surgical treatment seems to play a pivotal role in the prognosis of these rare tumors, with a possible role for adjunctive radiotherapy in the case of recurrence, anaplastic transformation, and metastasis.
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Hydrocephalus in sub-Saharan Africa, including Mozambique, is still a significant health care problem. ⋯ Efforts to improve prevention, early diagnosis, treatment, and follow-up are of utmost importance in Mozambique.