A 6‐year‐old girl with persistent headaches and the visual problem was diagnosed as a delayed onset cranial pansynostosis with concurrent type 1.5 Arnold‐Chiari malformation. She underwent multi‐sutural reconstructive surgery and followed. The headache was greatly decreased and tonsillar‐brain stem herniation and syrinx were resolved.
AimPatients with chronic subdural haematoma (CSDH) are at a significant risk for venous thromboembolism (VTE). Surgeons should weigh the advantages versus disadvantages of anticoagulants in the postoperative period.Patients and MethodsThis study was a randomized clinical trial conducted in Isfahan, Iran, from May 2016 to April 2021. Patients with CSDH eligible for bur‐hole craniostomy were primarily enrolled. All of them underwent bilateral lower limb Doppler ultrasonography (DUS) for deep venous thrombosis (DVT) screening. The patients were randomized into the case (n = 66, enoxaparin initiation 24 h after operation) and control (n = 70, enoxaparin initiation 72 h after operation) groups. Routine postoperative brain computed tomography scans were obtained 1 and 3 days after surgery. A second DUS was performed 96 h after operation to screen newly developed venous thrombosis; P value <.05 was defined significant.ResultsA total of 73 patients (59.8%) were female and 49 (40.2%) were male. The mean age was 65.1 ± 10.19 years; 9.9% of the patients had previously used antiplatelets. One patient had asymptomatic preoperative DVT. The mean values for enoxaparin dosage were 40.4918 ± 5.43 mg/day. Postoperative DVT or rebleeding prevalence was 0% in both groups. The mean follow‐up duration was 19.139 ± 2.2 months. Long‐term recurrence rate was 2.4% (n = 3). Postoperative pneumocephalus was associated with a higher recurrence rate (P = .031).ConclusionIn terms of VTE chemoprophylaxis, following bur‐hole craniostomy for CSDH, enoxaparin will effectively prevent VTE development without any clinically significant rebleeding.
Introduction: Low back pain is one of the most common diseases that the general population of adults faces various physical, mental, economic and social problems. Patients underwent lumbar disc surgery. Due to the fact that patients experience various degrees of disability during this period, the present study was conducted to determine the Quality of life and functional outcome in patients with lumbar disc herniation undergoing Lumbar disc surgery with foraminotomy approach. Method: This study was a descriptive study before and after the intervention. The study population included patients undergoing lumbar disc surgery who referred to Kashani Educational-Medical Center in Isfahan in 2021 who were included in the study by census. 120 people were included in the study by census method. They were followed up for one year. Three months after surgery, 116 patients, six months later, 112 patients, and one year later, 104 patients remained in the study. Patients were assessed preoperatively,3, 6 and 12 months postoperatively by standard questionnaires:SF12, Austrian Functional Disability Questionnaire, European Quality of Life Questionnaire and DASS. the date were analyzed in SPSS22. Result: all physical and mental dimensions of quality of life, except for three mental dimensions (SF, RE, MH) before surgery and 12 months after surgery were significantly different (P < 0.05). The preoperative and 12 months postoperative functional incapacity index showed a significant difference. The EQ-5D index improved after 12 months and was significantly different from before surgery(P < 0.05). depression and anxiety after 12 months did not show a significant difference compared to before surgery (P < 0.05). the results revealed that there was a significant relationship between ODI and body mass index (P = 0.002), and age (P = 0.01), as well as between depression and gender (P = 0.003). The individuals at older ages and with higher body mass index (overweight and obese) showed higher degrees of disability. Women showed more incidence of depression compared to men. Conclusion: According to the present study results, it can be stated that in today's world, the physical aspects and physical ability of patients cannot solely reflect improvement of disease status in patients.
Background: COVID-19 quickly spread around the world as an epidemic with potentially unknown hazards. Like its impacts on various occupations, neurosurgery has undergone changes due to the virus, including changes in surgical planning, inpatient and outpatient clinics, emergency management, and even academic activities. Objectives: The present study was performed to determine neurosurgery challenges during the COVID-19 pandemic in Iran. Methods: The present study was conducted as a mixed qualitative and quantitative study in 2021. In the qualitative section using the targeted sampling method, 11 members of the target community were selected using the available sampling method and completed a questionnaire. The qualitative part was conducted in two stages of reviewing texts and interviewing experts and in the quantitative part we evaluated the validity of the structure and the reliability of the questionnaire. Results: This study examined in detail all aspects of the effects of COVID-19 on neurosurgery. 9 dimensions and 61 items were identified as the challenges of neurosurgery during the COVID-19 pandemic. In order of importance, the aspects were: treatment outcome, manpower, management psychological and physical diseases, education and research, tools and physical space, ethics, financial implications and information technology. Conclusion: The outbreak of epidemics has different risks for specialties, among them neurosurgery. Accordingly, to observe patien
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