World Neurosurg
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Review Meta Analysis
Is urgent decompression superior to delayed surgery for traumatic spinal cord injury? A meta-analysis.
Traumatic spinal cord injury (SCI) is a common disease in current clinical practice. Previous studies have reported that early surgical decompression was better to improve neurologic outcomes than that of late surgery. However, most of the studies set early surgery within 72 hours. Is urgent surgery within 24 hours superior to late surgery for SCI? It remains controversial. ⋯ On the basis of this meta-analysis, urgent surgery within 24 hours for SCI significantly improved the neurologic outcomes compared with late surgery. It is suggested that urgent decompression within 24 hours is superior to delayed surgery for SCI.
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Review Case Reports
Orbitocranial low-velocity penetrating injury: A personal experience, case series, review of the literature; and a proposed management plan.
Orbitocranial penetrating injuries (OPI) are an unfamiliar subset of head injury and are particularly rare in clinical practice. They are usually the result of falls or motor vehicle collisions and occur more commonly in children, who are prone to trauma while playing games improperly. ⋯ Computed tomography, magnetic resonance imaging, and computed tomography angiography are key imaging modalities that are frequently used to determine the course of the foreign object and the extent of brain tissue injury as well as to rule out vascular injury in these types of cases. Early surgical exploration by a multidisciplinary team approach is essential to attain good recovery and a favorable outcome.
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Review Historical Article
Renaissance Neurosurgery: Italy's Iconic Contributions.
Various changes in the sociopolitical milieu of Italy led to the increasing tolerance of the study of cadavers in the late Middle Ages. The efforts of Mondino de Liuzzi (1276-1326) and Guido da Vigevano (1280-1349) led to an explosion of cadaver-centric studies in centers such as Bologna, Florence, and Padua during the Renaissance period. ⋯ With increased understanding came new techniques to address various neurosurgical problems from skull fractures to severed peripheral nerves. The present study aims to review the major developments in Italy during the vibrant Renaissance period that led to major progress in the field of neurosurgery.
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Biomarkers ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) may help detect brain injury, assess its severity, and improve outcome prediction. This study aimed to evaluate the prognostic value of these biomarkers during the first days after brain injury. ⋯ GFAP and UCH-L1 are significantly associated with outcome, but they do not add predictive power to commonly used prognostic variables in a population of patients with TBI of varying severities.
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The transsylvian approach is a standard method of approach for anterior circulation aneurysms or paraclinoid tumors. Care must be taken, however, to avoid inadvertent obliteration of sylvian veins to prevent postoperative brain swelling and venous infarction. Sometimes, the superficial sylvian veins have complex connections or are not visible because of the thickness of the arachnoid membrane, especially in the case of subarachnoid hemorrhage (SAH). The present report describes a simple method to dynamically visualize the sylvian vein via indocyanine green (ICG) angiography for the purposes of appropriately wide dissection of the sylvian fissure. ⋯ ICG videoangiography is an easy and useful method for identifying the connections and tributaries of the superficial sylvian veins from a transsylvian approach. This method allows wide opening of the sylvian fissure while preserving the sylvian veins.