World Neurosurg
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Control of bleeding in the confined area of the skull is imperative for successful neurosurgery and the prevention of devastating complications such as postoperative hemorrhage. This paper reviews the historical evolution of methods to achieve successful hemostasis in neurosurgery from the early1800s to today. The major categories of hemostatic agents (mechanical, chemical and thermal) are delineated and discussed in chronological order. The significance of this article is in its detailed history of the kinds of hemostatic methods that have evolved with our accumulating medical and surgical knowledge, which may inform future innovations and improvements.
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Meta Analysis
Prognostic Factors and Survival of Gliomatosis Cerebri: A Systematic Review and Meta-Analysis.
Gliomatosis cerebri (GC) is a fatal diffusely infiltrating glioma. Because of its rarity, only scarce evidence is available regarding outcome predictors and the proper management of GC. ⋯ In the largest study to date on GC, we have identified clinical, imaging, and molecular outcome predictors that are similar to other gliomas and highlight the beneficial effect of chemotherapy and surgical resection, when feasible, on outcomes.
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Review Case Reports
Multiple Cavernous Malformations of Brain, Chest, and Skin: A Rare Case of an Infant and Literature Review.
Cerebral cavernous malformations (CCMs) are vascular malformations that account for 5%-15% of all central nervous system vascular malformations. However, multiple CCMs, which can be sporadic or familial, are rare, with a prevalence of 0.1%-0.5%. ⋯ CCMs were pathologically diagnosed through the total resection of the pineal regional lesion. We also observed a spontaneous regression of the remaining lesions during a follow-up period of 2 years. To our knowledge, this is the first case of CCMs in an infant in the English-language literature.
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The emergence of multidrug-resistant pathogens has resulted in difficult-to-treat ventriculitis/meningitis (VM). We used a meta-analysis to study the role of intraventricular (IVT) antibiotic administration as an adjunct (IVT plus intravenous [IV]) to the classic intravenous antimicrobial therapy (IV-only) in the management of VM in terms of infection control, functional outcome, microbial eradication, complications, cost-benefit analysis, infectious mortality, and overall mortality. ⋯ Combined IVT plus IV treatment did not prove superior to standard IV-only treatment in the management of VM. Nevertheless, weak evidence showed that IVT treatment might serve as an adjunct in the management of carbapenem-resistant pathogens.
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Review Biography Historical Article
Dominique Jean Larrey (1766-1842) and his Contributions to Military Medicine and Early Neurosurgery.
Dr. Dominique Jean Larrey was a pioneer in the field of military surgery. ⋯ Larrey has often been referred to as "the father of emergency medical services" and "the father of modern military medicine." His contributions to medicine continue to live on in common procedures and healthcare systems today, such as aspiration of pericardial effusion and drainage of hemothorax and empyema. Based on his own writings, he treated multiple cases of intracranial injury, making him an early, but often forgotten, pioneer of neurosurgery.