World Neurosurg
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Determining the value of the computed tomographic black hole sign in predicting postoperative rehemorrhage in patients with intracranial hemorrhage (ICH) underwent minimally invasive surgery (MIS). ⋯ The black hole sign on initial CT could predict the postoperative rehemorrhage following the minimally invasive procedures.
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Female sex is a well-known risk factor for aneurysm formation. Although the role of the ovaries and estrogen in aneurysm development has been supported, other organ-hormone pairs unique between sexes also may be implicated. In this study, we aimed to determine whether intracranial aneurysms microsurgically clipped in patients with previous hysterectomies exhibit any unique aneurysm characteristics from those without hysterectomies. ⋯ Female patients with a surgical history of a hysterectomy have a lower rate of large aneurysms, present in better neurologic condition, and are less likely to present with a ruptured aneurysm than females without a hysterectomy.
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Case Reports
Cerebellar tonsillar cysts associated with Chiari malformation in adults: A short series.
Authors analyzed surgical patients with Chiari malformation (CM) associated with cerebellar tonsillar cyst. This association is quite rarely encountered in the literature. ⋯ In the present series, we were able to identify 7% of tonsillar cysts among 60 patients with CM. MRI with Flair and Diffusion sequences should be pre-operatively used for evaluation of tissue characteristics as differential diagnosis of cystic lesion and gliosis. The clinical presentation endorses surgical indication, with a good chance of clinical improvement. This was the first time that the frequency of tonsillar cysts has been evaluated in a series of adult patients.
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Comparative Study
Revised Cardiac Risk Index vs. ASA Status as a Predictor for Non-Cardiac Events Following Posterior Lumbar Decompression.
The Revised Cardiac Risk Index (RCRI) was designed to predict risk for cardiac events after noncardiac surgery. However, there is a paucity of literature that directly addresses the relationship between RCRI and noncardiac outcomes after posterior lumbar decompression (PLD). The objective of this study is to determine the ability of RCRI to predict noncardiac adverse events after PLD. ⋯ RCRI was predictive of a wide range of noncardiac complications after PLD but had a diminished DA to predict a composite of any noncardiac complication than did American Society of Anesthesiologists score. Consideration of the RCRI as a component of preoperative surgical risk stratification can minimize patient morbidity and mortality after lumbar decompression.
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To characterize the learning curve for a single surgeon during his initial phases of performing minimally invasive surgery oblique lumbar interbody fusion. ⋯ Minimally invasive surgery oblique lumbar interbody fusion presents a learning curve to the practicing spine surgeon with regard to operative time, x-ray exposure time, and intraoperative and postoperative complications. Close attention to detail can minimize complications that may be associated with the learning curve.