World Neurosurg
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Traumatic brain injury (TBI) is one of the major challenges in health care, representing the third most frequent cause of death. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies. Here we describe cisternostomy, an emerging surgical treatment for the treatment of TBI. ⋯ In the current common practice, the surgical measures for TBI include external ventricular drainage insertion and decompressive craniectomy. There is evidence that both of these measures reduce intracranial pressure but the effect on the outcome, particularly in the long term, is equivocal. A new line of evidence supports cisternostomy as an emerging surgical treatment for TBI.
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One of the goals of calvarial reconstruction after craniectomy is optimization of cosmesis. A simple technique for intraoperative generation of an implant based on the patient's native skull contour for immediate skull reconstruction after craniectomy is described. ⋯ In selected cases, this technique for in situ cranioplasty before craniectomy generates an implant that mimics the patient's calvarium and results in excellent cosmetic outcomes.
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To investigate the healing effects of erythropoietin (EPO) and stem cells (SCs) in traumatic brain injury (TBI). ⋯ Separately given, SCs and EPO have a positive effect on TBI, and our findings suggest that their coadministration is even more powerful.