Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jun 2020
Mental illnesses among patients undergoing elective anterior cervical discectomy and fusion: Analysis from the National Readmissions Database.
Patients with a comorbid mental illness have been observed to have worse outcomes following surgery. However, little is known about the effects of mental disorders on patient outcomes following spinal surgery. In the current study, we sought to investigate the characteristics of patients with mental illness, particularly anxiety, major depressive disorder, concurrent anxiety and schizophrenia, and the impact of these comorbid conditions on outcomes of patients undergoing anterior cervical discectomy and fusion (ACDF) using a national administrative database. ⋯ Our analysis indicates that mental illness comorbidities may be associated with increased rates of procedure related readmission and longer length of stay following elective ACDF.
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Clin Neurol Neurosurg · May 2021
Comparison of ultrasonography and computed tomography for measuring optic nerve sheath diameter for the detection of elevated intracranial pressure.
The main aim of this study was to compare optic nerve sheath diameter (ONSD) measured using ultrasonography (USG) and computed tomography (CT) almost simultaneously in the same patients with suspected elevated intracranial pressure. The other aim of this study was to evaluate the diagnostic ability for detecting elevated intracranial pressure using ONSD measured by USG (USG-ONSD) and by CT (CT-ONSD). ⋯ The ONSD measured using USG and CT were increased in patients with elevated intracranial pressure. Measurement of ONSD by USG and CT showed very high agreement.
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Clin Neurol Neurosurg · Jun 2020
Coronavirus disease 2019 (COVID-19) in neurology and neurosurgery: A scoping review of the early literature.
Coronavirus disease 2019 (COVID-19) is a devastating respiratory illness that has dramatically changed the medical landscape around the world. In parallel with a rise in the number of cases globally, the COVID-19 literature has rapidly expanded with experts around the world disseminating knowledge and collaborating on best practices. ⋯ This scoping review of MEDLINE, EMBASE, SCOPUS, and the Cochrane Library aims to evaluate and summarize the current status of the COVID-19 literature at it applies to neurology and neurosurgery. Neurological symptomatology, neurological risk factors for poor prognosis, pathophysiology for neuroinvasion, and actions taken by neurological or neurosurgical services to manage the current COVID-19 crisis are reviewed.
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Clin Neurol Neurosurg · Dec 2012
Local intraarterial tirofiban after formation of anterograde flow in patients with acute ischemic stroke: preliminary experience and short term follow-up results.
Despite the risk of intracranial hemorrhage, combination therapy with intravenous recombinant tissue plasminogen activator and intraarterial mechanical thrombolysis can be effective for treatment of acute ischemic stroke. We investigated the feasibility and safety of intraarterial tirofiban following formation of anterograde flow after mechanical thrombolysis in acute ischemic stroke. ⋯ Our results suggest that administration of local intraarterial tirofiban after anterograde flow formation is a viable treatment strategy for patients of acute ischemic stroke for reducing the risk of reocclusion after intraarterial thrombolysis.
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Clin Neurol Neurosurg · Nov 2020
Disparities in inpatient costs and outcomes after elective anterior cervical discectomy and fusion at safety-net hospitals.
Characterizing disparities that exist at safety-net hospitals is crucial for crafting national healthcare reform policies. Healthcare disparities in performing elective neurosurgical procedures like anterior cervical discectomy and fusion (ACDF) at safety-net hospitals have not yet been examined. ⋯ Safety net hospitals had greater inpatient costs, but no greater LOS or odds of inpatient adverse events after elective ACDF. These results demonstrate a need for policies that reduce the cost of performing ACDFs at SNHs.