World Neurosurg
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In some cases of drug-resistant focal epilepsy, noninvasive presurgical investigation may be insufficient to identify the ictal onset zone and the eloquent cortical areas. In such situations, invasive investigations are proposed using either stereotactic electroencephalography (SEEG) or subdural grid electrodes. Meta-analysis suggests that SEEG is safer than subdural grid electrodes, but insular implantation of SEEG electrodes has been thought to carry an additional risk of intraparenchymal hemorrhagic complications. Our objectives were to determine whether an insular SEEG trajectory is a risk factor for intracranial hematoma and to report the global safety of the procedure and provide some guidelines to prevent and detect complications. ⋯ SEEG is a safe procedure. Insular trajectories cannot be considered an additional risk of intracranial bleeding.
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Case Reports
The Feasibility Analysis for Treatment of Infancy Giant Intracranial Benign Tumor by Delayed-Operation.
The survival rate and prognosis in infants with giant intracranial tumors are significantly worse than in older children. This study aimed to analyze the feasibility of delayed operation for infants with giant intracranial benign tumor by evaluating the initial clinical presentations, expectant treatment measures, perioperative vital signs, and recuperation after surgery. ⋯ Delayed operation enabled infant patients to gain a better physical state, with a stage of full preoperative preparation that may reduce intraoperative/postoperative morbidity and mortality.
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Percutaneous endoscopic lumbar discectomy (PELD) with remarkable advancements has led to successful results comparable with open discectomy; however, its application in herniated disc (HD) with migration is still challenging and technically demanding. The purpose of this study is to propose various strategies for PELD according to HD with migration. ⋯ An appropriate strategy for PELD is important for successful removal of HD considering the extent of migration and direction.
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External ventricular drains (EVDs) historically have a high rate of infection, and EVD infections are a cause of significant morbidity and mortality. We have shown previously that a simple infection control protocol reduced the rate of EVD infections during a 3-year period, and the present study examines whether infection rates were durably reduced over an additional 4 years. ⋯ A straightforward EVD infection control protocol substantially and durably reduces EVD infections to a near-zero rate.
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Since the prognostic importance of radical resection was introduced in 1957, the neurosurgery practice has undergone several technologic advancements. The aim of this study was to evaluate whether the prognostic value of the extent of resection is still relevant in modern neurosurgical practice. ⋯ Simpson grade remains a highly significant predictor of RFS in meningioma-resected patients in modern neurosurgical practice. Extent of resection should therefore be emphasized when predicting prognosis and considering postoperative treatment and frequency of radiologic follow-up after surgery.