Neurosurgery
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Morbidity and mortality rates reported for meningioma resection in the elderly vary widely. Thus, it is difficult for neurosurgeons to compare the risks and benefits of operating on elderly patients against opting for radiosurgery or watchful waiting. To address this issue, we studied the effect of advanced age on outcome after meningioma resection using the Nationwide Inpatient Sample. ⋯ The association between elderly age and adverse outcome after meningioma resection suggests a note of caution before proceeding to surgery with these patients.
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Comparative Study Clinical Trial
Incidence and characteristics of spinal decompression surgery after the onset of symptoms of amyotrophic lateral sclerosis.
The high incidence of spondylosis in patients at the mean age of onset (55.7 yr) of amyotrophic lateral sclerosis (ALS) can make recognition of ALS as a cause of weakness difficult. ⋯ A small but significant number of patients with unrecognized ALS undergo spinal surgery that in retrospect may be inappropriate. The possibility of ALS must be considered in the evaluation of patients with weakness even in the presence of radiographic evidence of spondylosis and nerve root or spinal cord impingement.
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The primary purpose of the study was to investigate the psychosocial effects of harboring a known but untreated unruptured intracranial aneurysm (UIA), information considered important to the decision of whether to treat or not treat an unruptured aneurysm. ⋯ A decrease in overall quality of life was found to be associated with harboring an identified but untreated UIA. Findings from the current study suggest that further investigation of psychosocial outcome in other groups of untreated UIA patients is warranted. Results also suggest that some untreated UIA patients might benefit from psychological intervention.
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Comparative Study Clinical Trial
Detection of root avulsion in the dominant C7 obstetric brachial plexus lesion: experience with three-dimensional constructive interference in steady-state magnetic resonance imaging and electrophysiology.
Preoperative, reliable detection by ancillary investigations of spinal nerve root avulsions in infants with severe obstetric brachial plexus lesions to avoid ineffective operative repair from deceivingly intact but actually avulsed nerve roots. ⋯ 3D CISS MRI provides good images of anterior and posterior spinal roots in infants with obstetric brachial plexus lesions. Images seem to allow accurate prediction of root avulsion in the majority of patients. In this study, electrodiagnostics were of limited value.
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Comparative Study
Nausea and dizziness after vestibular schwannoma surgery: a multivariate analysis of preoperative symptoms.
Nausea and dizziness are very discomforting for patients after vestibular schwannoma surgery and they impair recovery. ⋯ It is possible to identify patients with a higher risk of postoperative nausea and dizziness after vestibular schwannoma surgery. This allows one to inform these patients preoperatively and to initiate an early postoperative drug therapy to ease their symptoms.