World Neurosurg
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Slit-ventricle syndrome (SVS) is a recognized complication of ventricular shunt malfunction, resulting in cyclical symptoms without ventricular dilatation. We present a case of SVS with transient, repetitive, and progressive signs of brainstem herniation evidenced by pupillary dilatation, posturing, and unresponsiveness, with diffuse voltage attenuation on electroencephalogram (EEG). ⋯ SVS can lead to severe intermittent brainstem herniation syndrome in the setting of shunt malfunction. Seizure diagnosis should be reserved for cases with proven functional shunt and EEG confirmation of epileptiform activity.
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Case Reports
Hemostatic thrombin-gelatin matrix leading to intracranial cyst formation : case report.
Local hemostatic agents have been used in the neurosurgical field for many years; it is safe and efficient with no fatal complication reported in the literature. We routinely used a gelatin-thrombin hemostatic agent (FloSeal Hemostatic Matrix) for hemostasis in minimally invasive endoscopic-assisted surgery for more than 500 patients with intracerebral hemorrhage. However, 2 cases with sterile cyst formation were encountered. ⋯ These sterile cysts were very close to the ventricle wall on images. We hypothesized that cyst wall may be formed not only by hemostatic agent-related fibrosis and inflammation according to the previous literature review but also by the presence of the check valve mechanism between the cyst and the ventricle, which caused further dilation of the cyst.
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Medical publications reflect the development of training, research, and health services. No objective data are available regarding neurosurgical publications from Morocco. Bibliometrics were used to evaluate the contribution of Moroccan neurosurgeons (MONSs) in neurosurgical journals worldwide and to discuss the strategies that can be applied to increase the quantity and quality of publications on this subject. ⋯ Academic neurosurgeons in Morocco should prepare their residents and young researchers on research methodology and medical writing. Moroccan neurosurgical research should be more focused on modern neurosurgical topics by highlighting our particularities. More high level of evidence studies should be reported in English-language neurosurgical journals with a high impact factor and good scientific reputation. MONSs should continue to collaborate more often with each other and with foreign centers to further improve the quality and number of international publications, regardless of the difficulties they face.
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Disturbances in the reward network of the brain underlie addiction, depression, and obsessive-compulsive disorder. The ventral capsule/ventral striatum and nucleus accumbens (NAc) region is a clinically approved target for deep brain stimulation for obsessive-compulsive disorder. ⋯ The caudal part of the NAc passing through the IC-AC junction may be an effective target for deep brain stimulation to improve behavioral symptoms associated with obsessive-compulsive disorder.
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Review
A review on the management of cerebral vasospasm following aneurysmal subarachnoid haemorrhage.
Despite decades of research, cerebral vasospasm (CV) continues to account for high morbidity and mortality in patients who survive their initial aneurysmal subarachnoid hemorrhage. ⋯ Proactive and preventive strategies such as oral nimodipine and endovascular rescue therapies can reduce the morbidity and mortality associated with CV.