{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T20:58:09Z","timestamp":1771707489927,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T00:00:00Z","timestamp":1507680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T00:00:00Z","timestamp":1507680000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T00:00:00Z","timestamp":1507680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R25TW009340"],"award-info":[{"award-number":["R25TW009340"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R25TW009340"],"award-info":[{"award-number":["R25TW009340"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Trauma is a major contributor to global morbidity and mortality, and injury to the central nervous system is the most common cause of death in these patients. While the provision of surgical services is being recognized as essential to global public health efforts, specialty areas such as neurosurgery remain overlooked.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This is a retrospective case review of patients with operable lesions, such as extra\u2010axial hematomas and unstable depressed skull fractures that underwent neurosurgical interventions under local anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 13 patients underwent neurosurgical intervention under local anesthesia. Two and three patients with burr hole decompression of epidural and subdural hematomas, respectively; seven patients had elevation of depressed skull fractures and lastly one patient had an aspiration of a brain abscess. All patients survived with and without residual neurological deficits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Access to resources and staff required to deliver general anesthesia is challenging in resource\u2010poor settings. We have therefore begun performing emergent interventions under local anesthesia, with or without conscious sedation. While some patients had some minor residual weakness after the procedure, the degree of neurological deficit was improved from that observed before the procedure in all patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4285-z","type":"journal-article","created":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T16:16:01Z","timestamp":1507738561000},"page":"1248-1253","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Utility of Local Anesthesia for Neurosurgical Interventions in a Low\u2010Resource Setting: A Case Series"],"prefix":"10.1002","volume":"42","author":[{"given":"Jessica","family":"Eaton","sequence":"first","affiliation":[{"name":"UNC \u2013Project Malawi Lilongwe Malawi"},{"name":"University of Louisville School of Medicine Louisville KY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asma Bilal","family":"Hanif","sequence":"additional","affiliation":[{"name":"Department of Surgery Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzgisam","family":"Mzumara","sequence":"additional","affiliation":[{"name":"Department of Radiology Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Charles","sequence":"additional","affiliation":[{"name":"UNC \u2013Project Malawi Lilongwe Malawi"},{"name":"Department of Surgery Kamuzu Central Hospital Lilongwe Malawi"},{"name":"Department of Surgery University of North Carolina Chapel Hill NC USA"},{"name":"UNC School of Medicine, Gillings School of Global Public Health University of North Carolina 4008 Burnett Womack Building, CB 7228 Chapel Hill NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,10,11]]},"reference":[{"key":"e_1_2_8_2_2","unstructured":"PedenMM McGeeK KrugE(eds) (2000)Injury: a leading cause of the global burden of disease pp1\u201351"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010031811\u2010124558"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e32832e383e"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(13)62345\u20104"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60091\u20105"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-2007-22502"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(10)60392\u20103"},{"key":"e_1_2_8_9_2","unstructured":"AgencyCI. Malawi (2013) (cited 2017)"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2014.09.010"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/msj.20106"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373\u2010198605000\u201000006"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198106183042503"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195169898.001.0001"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004311\u2010198602430\u201000004"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2005.18.4.6"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006123\u2010199801000\u201000006"},{"key":"e_1_2_8_18_2","first-page":"1","article-title":"Use of dexmedetomidine along with local infiltration versus general anesthesia for burr hole and evacuation of chronic subdural hematoma","volume":"00","author":"Surve RMBS","year":"2016","journal-title":"J Neurosurg Anestheiol"},{"key":"e_1_2_8_19_2","unstructured":"SaracenoBAJ PrilipkoL SaxenaS(2004) Atlas: country resources for neurological disorders.Academic Search Complete.http:\/\/www.who.int\/mental_health\/neurology\/epidemiology\/en\/. Accessed 3 October 2017"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010011\u20101080\u20100"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.09.019"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-017-4285-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-017-4285-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-017-4285-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-017-4285-z","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:34:25Z","timestamp":1703604865000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-017-4285-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,11]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1007\/s00268-017-4285-z"],"URL":"https:\/\/doi.org\/10.1007\/s00268-017-4285-z","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,11]]},"assertion":[{"value":"11 October 2017","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}