Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2017
The prognostic value of preoperative participation in activities of daily living on postoperative outcomes following lumbar discectomy.
In other surgical fields, preoperative level of participation in activities of daily living (ADLs) has been found to be important in predicting outcomes. To date, postoperative ADL measurements have only been used to characterize outcomes following lumbar discectomy. The present study's goal was to determine if patients' preoperative ability to perform ADLs correlates with their postoperative outcomes after lumbar discectomy at 3 months and 1 year. ⋯ This is the first study to suggest that lower preoperative ability to take part in personal care might predict better surgical outcomes after discectomy. The current data might prompt reassessment of the importance of ADLs in pre-operative patient evaluation and may help anticipate outcomes following lumbar discectomy.
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Clin Neurol Neurosurg · Apr 2017
A prospective study of diffusion weighted magnetic resonance imaging abnormalities in patients with cluster of seizures and status epilepticus.
To study the frequency, imaging characteristics, and clinical predictors for development of periictal diffusion weighted MRI abnormalities. ⋯ Diffusion abnormalities on MRI are common in patients with cluster of seizures and status epilepticus and were highly concordant with clinical semiology and EEG activity. Patients with longer duration of seizures/status were more likely to have PMA.
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Clin Neurol Neurosurg · Apr 2017
ReviewBlood transfusion indications in neurosurgical patients: A systematic review.
Neurosurgical procedures can be complicated by significant blood losses that have the potential to decrease tissue perfusion to critical brain tissue. Red blood cell transfusion is used in a variety of capacities both inside, and outside, of the operating room to prevent untoward neurologic damage. ⋯ Recently, a paradigm shift has occurred in neurocritical intensive care units, whereby restrictive transfusion is increasingly favored over liberal transfusion but the ideal strategy remains in clinical equipoise. The authors of this study perform a systematic review of the literature with the objective of capturing the changing landscape of blood transfusion indications in neurosurgical patients.
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Clin Neurol Neurosurg · Apr 2017
Comparative StudyA comparison of local bone graft with PEEK cage versus iliac bone graft used in anterior cervical discectomy and fusion.
Anterior cervical discectomy and fusion (ACDF) is a popular procedure for patients with cervical spondylotic myelopathy, but few studies reported the clinical outcomes of cervical local bone graft with a PEEK cage used in it. This retrospective study was performed to compare the clinical and radiological outcomes of using local bone graft with a PEEK cage versus iliac bone graft in ACDF. ⋯ Based on this study, patients receiving ACDF with local bone graft combined with a PEEK cage had significant shorter operation time, lower perioperative complications rate, and better radiological results comparing with those with an iliac bone graft alone. It seems that the local bone graft with a PEEK cage appears to be a safe alternative to the iliac bone graft for ACDF.