World Neurosurg
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Traumatic brain injury (TBI) is a recognized risk factor for seizures. In Nigeria, there is paucity of literature on posttraumatic seizure (PTS). This study provides the profile and pattern of PTS in patients with TBI in a rural Nigerian neurosurgical service. ⋯ Severe TBI and computed tomography findings of acute subdural hematoma and cerebral contusions are predictors of PTS in our environment. Progression of immediate/early to late PTS is rare.
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Most aneurysms originating from the clinoidal segment of the internal carotid artery (ICA) are nowadays managed conservatively, treated endovascularly with coiling (with or without stenting) or flow diverters. However, microsurgical clip occlusion remains an alternative. This video demonstrates clip occlusion of an unruptured right carotid cave aneurysm measuring 7 mm in a 39-year-old woman. ⋯ This case demonstrates the importance of anterior clinoidectomy and thorough distal dural ring dissection for effective clipping of carotid cave aneurysms. Control of venous bleeding from the cavernous sinus with fibrin glue injection simplifies the dissection, which should minimize manipulation of the optic nerve. Knowledge of this anatomy and proficiency with these techniques is important in an era of declining open aneurysm cases.
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Review Meta Analysis
Quality Indicators in Cranial Neurosurgery: Which are presently substantiated? - A systematic review.
Owing to the rising costs of health care delivery, the quality of delivered care has become a central issue across all medical specialties. Consequently, there is increasing pressure to create standardized frameworks for measuring quality of care. In the field of cranial neurosurgery, health care administrators have begun applying quality measures that are easily available but might be inaccurate in measuring the quality of care. ⋯ Neurosurgeons need to define their own QIs and actively participate in the validation of these QIs to provide the best possible patient outcomes. More reliable clinical registries, obligatory for all neurosurgical services, should be established as a basis for establishing such indicators, with risk adjustment being an important element of any such indicators.