World Neurosurg
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To determine short-term outcome of endoscopic third ventriculostomy (ETV) in pediatric patients. ⋯ In resource-limited countries, ETV can be performed with acceptable results and less mortality and morbidity. Myelomeningocele and aqueductal stenosis were the most common causes of hydrocephalus. In patients <1 year old, the outcome success in patients undergoing combined ETV and CPC (53%) was significantly better compared with patients undergoing ETV alone (25%).
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Cranioplasty via use of the patient's autologous bone is performed often after craniectomy procedures. Bone resorption remains a matter of concern in patients with native bone cranioplasty. The objective of this study was to evaluate the rate of native bone resorption in adults and review associated factors that may increase the risk of resorption. ⋯ The rate of autologous bone flap resorption in adult patients undergoing cranioplasty is low even after a mean interval for cranioplasty of 6 months.
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The aim of this study was to identify the risk factors for subsequent hemorrhage in patients with untreated cerebellar arteriovenous malformations (AVMs). ⋯ Childhood at diagnosis, large AVM size, and AVMs with exclusively deep venous drainage are independent risk factors for subsequent hemorrhage in patients with cerebellar AVMs. Previous rupture may increase the hemorrhagic risk during the first 5 years after diagnosis but may not significantly increase the risk in the following years.
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Long-term results of sympathectomy in patients with complex regional pain syndrome (CRPS) type 2 varies widely among studies due to nonspecific or vague criteria of diagnosis and absence of outcome predictors that help good patient selection. The objective was to determine the predictors of long-term outcome of sympathectomy in patients with upper limb CRPS type 2. ⋯ Thoracic sympathectomy may prove more effective than reported in carefully selected CRPS patients with prominent sympathetic overactivity, no or early allodynia, and pain relief >2 days after SGB.
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Cerebral metabolism can be disrupted by venous congestion in patients with intracranial dural arteriovenous fistula (DAVF), which may lead to adverse neurological outcomes. However, there are no clear indicators to guide cerebral evaluation and treatment selection in cases of DAVF. We describe a patient with a DAVF whose proton magnetic resonance spectroscopy ((1)H-MRS) findings were associated with improvements in clinical status. ⋯ (1)H-MRS may be useful for pretreatment detection of increased lactate levels, decreased NAA levels, and/or decreased NAA/creatinine ratios. These findings may indicate poorer cerebral metabolism, and show a need for more aggressive treatment. Furthermore, (1)H-MRS may be useful for evaluating the effect of conservative treatment and for indicating conversion to a more aggressive treatment.