World Neurosurg
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Metastasis to the pituitary gland is uncommon. With life expectancy after cancer diagnosis improving, we sought to understand the effects of treating pituitary metastasis in the modern era of advanced cancer treatment. ⋯ In the selected population, metastasis-directed therapy was associated with improved OS. Either correct patient selection for additional therapy or surgery and/or radiation therapy directly benefited patients' OS.
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Cerebrospinal fluid (CSF) leak remains the primary concern of endoscopic skull base surgery (ESBS). Pneumocephalus seen in postoperative images has been linked to CSF leak in some reports; however, few studies have looked at the extent to which it is indicative of CSF leak. In the current study, we aim to examine the size and location of post-ESBS pneumocephalus in the early postoperative period and determine their association with postoperative CSF leak. ⋯ In post-ESBS patients, both the volume and location of the pneumocephalus are potentially predictive of CSF leak. In patients with a larger volume of intra-axial air and/or multiple air locations, an impending CSF leak should be anticipated.
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The burden of traumatic brain injury (TBI) disproportionately affects low- and middle-income countries. In Cameroon, the estimated annual incidence rate is 572 cases per 100,000 people. This study investigated factors associated with adverse outcomes in the management of Cameroonian patients with TBI. ⋯ We identified factors associated with unfavorable outcomes among Cameroonian patients with TBI. These results can inform triage and referral practices and aid policymakers in developing context-specific prehospital guidelines.
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Surgery of eloquent area gliomas is challenging and requires monitoring of the nearby white fiber tracts. In the present study, we analyzed 102 patients with eloquent region gliomas and discussed the concept of intraoperative dynamic white fiber tract navigation and monitoring. ⋯ The use of intraoperative neuronavigation and neurophysiological assessment can help achieve maximal tumor resection of eloquent area gliomas. Use of the integrated suction stimulator navigator provided dynamic navigation and mapping of the peritumoral eloquent fibers.
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Despite the significant clinical consequences and socioeconomic costs of gunshot wounds to the head (GSWH), studies examining prehospital risk factors, geospatial patterns, and economic cost are lacking. ⋯ In the first analysis of GSWH with the inclusion of both hospital and ME data in a representative urban setting, our findings show prehospital risk factors and the unequal distribution of the significant economic costs of GSWH.