World Neurosurg
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Cerebral abscesses after brain surgery are rare but severe and life-threatening complications. We sought to analyze the clinical aspects of those patients and thereby reveal risk factors and the relevant aspects for their future therapy. ⋯ Secondary brain abscess is a rare complication and occurs mainly in patients with tumors and patients receiving emergency surgery. In total, 41% of the patients suffered from a S. aureus infection. Isolation of the responsible microorganisms is often possible and leads to improved outcomes.
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Observational Study
What is the best electrophysiological marker of the outcome of the subthalamic nucleus stimulation in Parkinson's disease?
Deep brain stimulation of the subthalamic nucleus (STN) is advocated in patients with advanced Parkinson disease. Intraoperative microelectrode recordings (MER) and stimulation or imaging are applied to confirm electrode targeting. The study objective was to evaluate which intraoperative electrophysiologic marker, MER, stimulation, or local field potentials (LFP) was the most predictive of the clinical efficacy. ⋯ Motor improvements emerged as most related to β oscillations, before trajectory length within the STN, whereas stimulation thresholds of rigidity or of motor tract excitation failed to show any relationship. The study encourages LFP measurement to confirm STN electrode location.
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Spinal cord ischemia is a serious and catastrophic clinicopathologic condition. Despite studies reported over the last 20 years, alternative and efficient treatment options remain unclear. We examined the neuroprotective effects of vigabatrin on a spinal ischemia-reperfusion model. ⋯ Neuroprotective effects of vigabatrin are shown. For clinical use, further studies are needed.
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Cranioplasty is a routine procedure, but it carries a significantly higher complication rate over standard clean cranial surgery. Surgical site infection is the most common but severe complication. Risk factors for surgical site infection are still debated. ⋯ Surgeons should lower the hemostasis standard for cranioplasty, as this would promote wound healing and reduce operative time, which subsequently decreases SSI rate.
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To introduce our technique and results of retropleural/peritoneal lateral pediculectomy for the decompression of thoracolumbar fractures and reconstruction using an expandable titanium cage and circumferential fixation at a single stage. ⋯ In this study, we suggest lateral pediculectomy as a distinct anatomic landmark to access and remove bony fragments effectively and safely in unstable thoracolumbar burst fractures. This provides a more straightforward access to the burst fragment and helps the surgeon to make better intraoperative decompression strategies. Moreover, this circumferential instrumentation with anterior support and fusion revealed better restoration of the thoracolumbar spine alignment compared with posterior-only surgery, with acceptable complications rates.