Neurosurgery
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To evaluate patients' clinical outcome, survival, and performance status, at the long-term follow-up evaluation after aggressive microsurgical resection of petroclival meningiomas. ⋯ This series has the largest number of patients with the longest follow-up period, to our knowledge, reported in the literature to date. The excellent quality of life at the time of the long-term follow-up examination for these patients warrants aggressive but judicious tumor resection, with or without radiosurgical treatment of tumor remnants.
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Approximately 20 to 30% of patients undergoing carotid endarterectomy (CEA) subsequently develop cognitive impairment. The purpose of the present study is to determine whether or not malondialdehyde (MDA)-modified low-density lipoprotein (LDL), a biochemical marker of oxidative damage, concentrations in the jugular bulb during CEA correlates with development of postoperative cognitive impairment. ⋯ MDA-LDL concentration in the jugular bulb during CEA correlates with development of postoperative cognitive impairment.
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Surgical error is common and contributes to complications for patients, necessitating detailed prospective collection and analysis of error data that emphasizes prevention. ⋯ Surgical errors are common, often preventable, and frequently lead to clinical impact. In addition, the type of procedure and characteristics of the patient are important factors to consider when addressing surgical error. For individual surgeons to maintain quality control and contribute to the safety of the health care system, they must track and analyze errors to ensure that systems may be developed to prevent their occurrence.
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Sports medicine clinicians commonly use multiple tests when evaluating patients with concussion. The specific tests vary but often include symptom inventories, posturography, and neurocognitive examinations. The sensitivity of these tests to concussion is vital in reducing the risk for additional injury by prematurely returning an athlete to play. Our study investigated the sensitivity of concussion-related symptoms, a postural control evaluation, and neurocognitive functioning in concussed collegiate athletes. ⋯ Currently recommended concussion-assessment batteries accurately identified decrements in one or more areas in most of the athletes with concussion. These findings support previous recommendations that sports-related concussion should be approached through a multifaceted assessment with components focusing on distinct aspects of the athlete's function.
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To assess the clinical and radiological long-term outcome after aneurysmal subarachnoid hemorrhage (SAH) in a defined referral area regarding recurrent SAH and de novo aneurysm formation. ⋯ From this epidemiological survey of patients with aneurysmal SAH, it was found that none of the patients experienced a recurrent subarachnoid bleed from the treated aneurysm during a 20-year follow-up period. Thus, a routine extreme long-term follow-up period is not necessary. De novo aneurysm formation and possible enlargements of aneurysm base remnants were observed in almost 2% of patients per person year and should, therefore, be subject of a routine, long-term follow-up.