World Neurosurg
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The objective of this study was to assess the independent effect of complications on 30-day mortality in 32,695 patients undergoing elective craniotomy. ⋯ Of 13 complications analyzed, myocardial infarction, unplanned intubation, prolonged ventilator requirement, stroke, and renal failure showed the strongest association with mortality independent of preoperative risk, independent of other complications, and across all risk-stratified subgroups. These findings help identify causes of perioperative mortality after elective craniotomy. Dedicating additional resources toward preventing and treating these complications postoperatively may help reduce rates of failure-to-rescue in the neurosurgical population.
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Inflammatory lesions of the pituitary gland including hypophysitis are poorly understood, and it is difficult to make a correct diagnosis on the basis of only clinical and radiologic findings. ⋯ To the best of our knowledge, this is the first case report of hypophysitis with radiologic signal changes over a short period. Vigilant attention regarding the clinical diagnosis of such rare entity is paramount.
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In cervical expansive laminoplasty, precise placement of lateral gutters is important. Placing them too medially results in suboptimal canal expansion, and placing them too laterally results in facet joint violation. However, precise placement is often difficult. ⋯ This technique facilitated more precise placement of the lateral gutter in cervical expansive laminoplasty, which resulted in a larger postoperative canal. This technique should be considered as an option in cervical expansive laminoplasty.