World Neurosurg
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To identify if there are cultural, medical, educational, economic, nutritional and geographic barriers to the prevention and treatment of spina bifida and hydrocephalus. ⋯ Our study highlights some of the cultural, educational, geographic, nutritional, and economic difficulties in the prevention and management of spina bifida and hydrocephalus in Tanzania.
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This 46-year-old female patient presented after a 6-month progressive right-sided visual loss, with a visual acuity of 20/60, a temporo/infranasal visual field deficit, and optic atrophy. The magnetic resonance imaging disclosed a tuberculum sella meningioma with minimal right medial canal invasion, however, no encasement of carotid arteries. Tuberculum sella meningiomas represent 5%-10% of intracranial meningiomas and are surgically challenging tumors that can severely hinder vision. The endoscopic approach allows for early coagulation of the tumor meningeal supply, and importantly, facilitates gross total removal without any manipulation of the optic nerve while preserving the superior hypophyseal arteries.1-9.
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The conventional retrosigmoid and lateral supracerebellar approach was used for surgery in 5 select cases of large chordomas. ⋯ Radical resection of all the tumors was achieved.
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External ventricular drain (EVD) placement is a life-saving procedure performed frequently by neurosurgical residents. The July effect is a theoretic decline in quality of health care sometimes perceived in teaching hospitals at the start of an academic year. We sought to quantify the learning curve of ventriculostomy drain placement in teaching hospitals and determine its impact on patient outcomes, health care utilization, and cost. ⋯ There was no evidence of a July effect on EVD complication rates in outcomes for patients admitted in the beginning of an academic year versus the end.