World Neurosurg
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Head computed tomography (CT) with perfusion imaging has become crucial in the selection of patients for mechanical thrombectomy. In recent years, machine learning has rapidly evolved and found applications in a wide variety of health care tasks. We report our initial experiences with training a neural network to predict the presence and laterality of a perfusion deficit in patients with acute ischemic stroke. ⋯ The field of machine learning, powered by convolutional neural networks for the task of image recognition and processing, has quickly developed in recent years. We constructed an artificial neural network that can identify and classify the presence and laterality of a perfusion deficit on CT perfusion imaging.
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We compared the mid-term efficacy and safety of anterior cervical discectomy and fusion (ACDF) using a Zero-Profile device for cervical degenerative disc disease (CDDD) with and without osteoporosis. ⋯ ACDF with the Zero-Profile device can be used as an effective and reliable treatment for single-level CDDD with osteoporosis.
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To introduce a method of accurately measuring the equivalent dose received by radiation-sensitive organs using the thermoluminescent dosimeter (TLD) and to provide reference values for future studies associated with radiation protection in patients undergoing lumbar spine surgeries. ⋯ Patients received significantly higher radiation doses from CT scans than from regular digital radiograph examinations. These radiation doses were concentrated in the regional area of scanning. Our results indicate the necessity and benefits of radiation protection measures, especially for the organs researched herein, when patients undergoing lumbar surgeries require radiographic diagnostic examinations.
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Odontoid fractures are the most common acute cervical spinal fractures in the geriatric population. Their rate is increasing along with the rising age of the elderly population. Whereas conservative management with external immobilization is reported as the treatment of choice for type I and III odontoid fractures, there are no clear indications concerning the best treatment for type II fractures. In younger patients surgical management is considered the best choice, but in older adults the rate of good outcomes worsens and operative risk because of comorbidities increases. ⋯ Our study was limited because it was a retrospective review, with a limited number of patients. Nevertheless, the clinical and radiologic outcomes of our patients differ from the results of other studies, suggesting that conservative management of these fractures in this population does not necessarily lead to a bad clinical outcome or delayed surgery.
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Review Case Reports
Radiologic Characteristics and High Risk of Seizures in Infants with Ruptured Intracranial Aneurysms: Case Report and Review of the Literature.
To evaluate the parameters related to the high risk of preoperative seizures in infants (1 year or younger) with ruptured intracranial aneurysms. ⋯ Infant patients with ruptured intracranial aneurysms have a high risk of preoperative seizures. The typical radiologic finding of distal arterial aneurysm with lobe hemorrhage was frequently observed in the MCA, and it might be related to the high risk of preoperative seizures in this population. Microsurgical techniques effectively control postoperative seizures in infants with ruptured intracranial aneurysms.