Neurosurgery
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Neurocognitive changes postsurgical clipping (SC) or endovascular coiling (EC) of unruptured aneurysms is not well studied. We aim to understand whether patients who undergo EC perform better on neurocognitive assessments in comparison with patients who undergo SC, and if such a difference exists how long the difference persists. ⋯ The SC group had greater decline in neurocognitive functioning but were generally able to return to baseline functioning within 3 to 6 months.
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Stereotactic radiosurgery (SRS) is a well-accepted treatment for patients with intracranial metastases, but outcomes with volumetric modulated arc radiosurgery (VMAR) are poorly described. ⋯ Single-isocenter, frameless VMAR for multiple intracranial metastases is a promising technique that may provide similar clinical outcomes compared with conventional radiosurgery.
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This report describes the stereotactic technique, hospitalization, and 90-day perioperative safety in patients who underwent bilateral deep brain stimulation (DBS) of the fornix for the treatment of mild probable Alzheimer disease. ⋯ Accurate targeting of DBS to the fornix without direct injury to it is feasible across surgeons and centers. At 90 days after surgery, bilateral fornix DBS was well tolerated by patients with mild probable Alzheimer disease.
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Our recent study showed that maintaining a higher hemoglobin threshold after severe traumatic brain injury (TBI) offers no clinical benefit. The present study aimed to determine if a higher transfusion threshold was independently associated with an increased risk of progressive hemorrhagic injury (PHI), thereby contributing to higher rates of morbidity and mortality. ⋯ Our analysis shows that a higher transfusion threshold of 10 g/dL after severe TBI increased the risk of severe PHI events. These results indicate the potential adverse effect of using a higher transfusion threshold after severe TBI.
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Moyamoya is a rare disease, and thus there have been few published studies with sufficient power for outcomes analyses of bypass surgery performed in the modern era. ⋯ Increased length of stay, increased number of procedures done in-hospital, and the presence of certain comorbidities were associated with a higher incidence of complications among pediatric patients undergoing bypass surgery for Moyamoya disease.