World Neurosurg
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This is the first socioeconomic study on traumatic brain injury (TBI) undertaken to determine the sociodemographic factors implicated in the occurrence of TBI and to assess the value of the direct cost of the management of TBI at the initial phase in the Hubert Koutoukou Maga National Teaching Hospital of Cotonou. ⋯ The organization of Benin's health system did not allow for the optimum management of TBI. It seems imperative to develop an insurance system that will allow a proper and effective support for victims of traffic accidents.
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We report surgical results and complications of endoscopic endonasal skull base surgery for giant pituitary adenomas. ⋯ Endoscopic endonasal skull base surgery enables less invasive and safer removal of various extension types of giant pituitary adenomas. Preservation of visual function is essential. Two-stage surgery or partial resection with additional treatments is possible without complications if a sufficient amount of resection is performed. In cases in which insufficient resection may be expected, alternative treatment, including combined-simultaneous resection, should be considered.
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Epidermoid cyst is a benign and congenital lesion of ectodermal origin. Traditionally, microsurgical techniques are used to treat these lesions, and their occurrence in the third ventricle is rare. Here, the authors report a case of epidermoid cyst in the third ventricle that presented with signs and symptoms of intracranial hypertension, which was treated safely and effectively using neuroendoscopic surgery.
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We discuss the rationale of surgical treatment of group B basilar invagination by atlantoaxial facet joint stabilization and segmental arthrodesis. ⋯ The pathogenesis of basilar invagination in group B is related to atlantoaxial instability. The clinical outcome suggests that the surgical treatment in these cases should be directed toward atlantoaxial stabilization and aimed at segmental arthrodesis. Inclusion of the occipital bone in the fixation construct is not necessary. Foramen magnum decompression and procedures involving manipulation of Chiari malformation and syringomyelia are not necessary.
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Patients with aneurysmal subarachnoid hemorrhage (aSAH) are susceptible to various medical complications, including ventriculostomy-associated infections (VAIs) in those who undergo external ventricular drain (EVD) placement. Many preventative strategies for VAIs have been used during the last 20 years, but their overall effect is unknown. Using the Nationwide (National) Inpatient Sample, we examined trends in VAI rates and mortality during a recent 12-year period in the aSAH population. ⋯ Despite numerous VAI-preventative strategies, the national VAI rate in aSAH patients has not changed; however, a reduction in mortality is suggested. Further studies are needed to determine how best to reduce VAIs, and to identify factors influencing observed trends in VAI and mortality.