World Neurosurg
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Surgical closed suction drain (SCSDs) are used in a variety of surgical disciplines to prevent postoperative fluid collections. Use of SCSDs has not been well studied in the neurosurgical literature. Practice patterns have varied within our institution with respect to SCSDs after craniotomies for neurotrauma. In this study we describe SCSD use for patients undergoing evacuation of supratentorial epidural hematomas (EDHs) and examine the effect on patient outcomes and length of hospital stay. ⋯ Use of fewer SCSDs did not affect radiographic outcome after evacuation of epidural hematomas but was associated with decreased intensive care unit length of stay.
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Aplastic or twiglike middle cerebral artery (MCA), a congenital anomaly related to the abnormal development of the MCA, is rare. It is usually unilateral; bilateral lesions are extremely rare. An aplastic or twiglike MCA may lead to cerebral ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage (SAH). In patients with ischemic stroke due to hemodynamic stress, extracranial-intracranial (EC-IC) bypass surgery is indicated. As hemodynamic stress may also elicit SAH, it is important to select the appropriate treatment. EC-IC bypass surgery was successful in a patient with bilateral aplastic or twiglike MCA who suffered SAH due to hemodynamic stress. ⋯ The presence of aplastic or twiglike MCA may lead to stroke due to hemodynamic stress. EC-IC bypass surgery may help to prevent stroke recurrence and SAH.
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Case Reports
Delayed ureter stricture and kidney atrophy after oblique lumbar interbody fusion: a case report.
Oblique lumbar interbody fusion (OLIF) is a surgical technique for lumbar interbody fusion that allows surgeons to use a large cage while preserving the spine muscles. The surgical corridor of OLIF is close to the ureter in the retroperitoneal space and therefore entails a potential for injury to this organ. Although there are some published cases of ureteral injury that were identified during OLIF, to our knowledge, there have been no reports about delayed ureteral strictures and kidney atrophy after OLIF. We report a case of ureter stricture and ipsilateral kidney atrophy that was incidentally identified a few months postoperatively without signs of ureter injury during the operation. ⋯ Ureter injury may be observed with several months' delay after OLIF in patients without symptoms or laboratory abnormalities, even if no direct injury was noted during the procedure.
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We explored the risk factors for the occurrence of delayed facial paralysis (DFP) after microvascular decompression (MVD) for hemifacial spasm (HFS). ⋯ Although DFP frequently occurred after MVD, it can recover spontaneously. The longer the course of HFS, the more frequently DFP will occur after MVD. The earlier that DFP develops, the shorter will be the time to recovery.
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Comparative Study
Is it necessary to perform the second surgery stage of anterior debridement in the treatment of spinal tuberculosis?
In this retrospective comparative study, the efficacy and clinical outcomes of long posterior instrumentation, with or without laminectomy, were evaluated and the necessity of the second stage of anterior debridement in the treatment of spinal tuberculosis (TB) was discussed. ⋯ Single-stage long posterior instrumentation, with or without laminectomy, is a safe, effective, and feasible method for the treatment of spinal TB. The second stage of anterior debridement surgery may not be necessary for every spinal TB treatment.