Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jan 2021
Neutrophil to lymphocyte ratio - A novel prognostic marker following spontaneous intracerebral haemorrhage.
Inflammation plays a role in secondary brain injury after intracerebral haemorrhage (ICH). Peripheral biomarkers of inflammation especially the neutrophil-to-lymphocyte ratio (NLR) have been shown to influence outcome following ischemic stroke and traumatic brain injury. Role of NLR in outcome prognostication following haemorrhagic stroke has not yet been conclusively established. This study analyses the prognostic significance of admission neutrophil to lymphocyte ratio on mortality and 90-day outcome in patients admitted with acute SICH. ⋯ Elevated levels of admission NLR were independently related to poor mortality and 90-day outcome after ICH. NLR is a novel, easily available and cost effective prognostic biomarker following ICH.
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Clin Neurol Neurosurg · Jan 2021
Do safety-net hospitals provide equitable care after decompressive surgery for acute cauda equina syndrome?
Safety-net hospitals provide care to a substantial share of disadvantaged patient populations. Whether disparities exist between safety-net hospitals and their counterparts in performing emergent neurosurgical procedures has not yet been examined. ⋯ Emergent decompressive surgery for CES performed at SNHs is associated with greater inpatient costs, but not greater inpatient adverse events or LOS. Differences in workflows at SNHs may be the drivers of these disparities in cost and warrant further investigation.
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Clin Neurol Neurosurg · Jan 2021
Comparative StudyComparison of equiosmolar doses of 10% hypertonic saline and 20% mannitol for controlling intracranial hypertention in patients with large hemispheric infarction.
We conducted this prospective self-crossover controlled trial to compare the efficacy and safety of 10 % hypertonic saline (HS) and 20 % mannitol in doses of similar osmotic burden for the treatment of increased intracranial pressure (ICP) in patients with large hemispheric infarction (LHI). ⋯ Both the drugs can serve as first-line agents for treating intracranial hypertension caused by LHI and should be selected rationally according to the differences in efficacy and adverse effects.
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Clin Neurol Neurosurg · Dec 2020
Randomized Controlled TrialPercutaneous pulsed radiofrequency treatment of dorsal root ganglion for treatment of lumbar facet syndrome.
Percutaneous radiofrequency denervation of the medial dorsal branch is often used for treatment of chronic low back pain originating from intervertebral facets, which is sometimes associated with a low success rate and a higher incidence of recurrence of pain. We theorized that implementing pulsed radiofrequency treatment to dorsal root ganglion would increase the probability of successful pain relief. ⋯ In CLBP of facet origin, pulsed radiofrequency treatment of the dorsal root ganglia provides both a higher incidence as well as an extended period of pain relief compared to radiofrequency ablation of the medial dorsal branch of the facet joint.
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Clin Neurol Neurosurg · Dec 2020
Observational StudyClinical characteristics and admission patterns of stroke patients during the COVID 19 pandemic: A single center retrospective, observational study from the Abu Dhabi, United Arab Emirates.
To compare ischemic and hemorrhagic stroke patients with COVID-19 to non-COVID-19 controls, and to describe changes in stroke admission patterns during the pandemic. ⋯ Stroke continues to occur during this pandemic and stroke pathways have been affected by the pandemic. Stroke occurs in approximately 5% of patients with COVID-19. COVID-19 associated ischemic stroke occurs in predominantly male patients who are younger, with fewer vascular risk factors, can be more severe, and have higher rates of LVO. Despite an increase in LVO during the pandemic, treatment with mechanical thrombectomy has not increased. COVID-19 associated hemorrhagic stroke does not differ from non-COVID-19 hemorrhagic stroke patients.