World Neurosurg
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Randomized Controlled Trial Comparative Study
Comparative Study of Cortical Bone Trajectory-Pedicle Screw (Cortical Screw) versus Conventional Pedicle Screw in Single-Level Posterior Lumbar Interbody Fusion: A 2-Year Post Hoc Analysis from Prospectively Randomized Data.
The aim of this study was to report 2-year follow-up outcomes of posterior lumbar interbody fusion (PLIF) with cortical bone trajectory-pedicle screw (CS), in terms of fusion rates, clinical outcomes, surgical outcomes, and complications, and to compare these outcomes with outcomes for PLIF with conventional pedicle screw (PS). ⋯ We suggest that CS in single-level PLIF may be an alternative to PS.
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Collateral artery aneurysms are a source of intracranial hemorrhage in moyamoya disease. Several reports have shown that surgical revascularization leads to the obliteration of collateral artery aneurysms. However, its effect on the prevention of rebleeding has not been established, and the optimal timing of the operation remains unclear. The purpose of the present study is to evaluate the effects of surgical revascularization and to investigate the optimal operation timing in patients with moyamoya disease who have ruptured collateral artery aneurysms on the ventricular wall. ⋯ Because ruptured collateral artery aneurysms on the wall of the lateral ventricle in moyamoya disease are prone to rerupture within 1 month, surgical revascularization may be recommended as soon as the patients are stable and able to withstand the operation.
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Randomized Controlled Trial
Postoperative Intravenous Acetaminophen for Craniotomy Patients: A Randomized Controlled Trial.
To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared with those receiving placebo (normal saline). ⋯ The opioid requirements within the first 24 postoperative hours were similar in the placebo and acetaminophen groups. This study is informative for the design and planning of future studies investigating the management of postoperative pain in patients undergoing craniotomies.
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Review Case Reports
Spinal cavernous angioma associated with Klippel-Trenaunay-Weber syndrome: a case report and literature review.
Klippel-Trenaunay-Weber syndrome (KTWS) is a rare congenital vascular disorder characterized by the classic triad of cutaneous nevi, venous varicosities, and osseous and soft tissue hypertrophy of the affected limb. Various vascular anomalies of the central nervous system have also been described in patients with KTWS. The English language literature to date contains 6 reports of associations between KTWS and spinal cord cavernous angioma (CA), but management of these patients has not been well described. ⋯ This is the first report to provide a detailed pathologic description of the features of spinal CA in a patient with KTWS. Assessment of the clinical features and management of CA associated with KTWS are discussed. This syndrome is rare, and further experience in the treatment of these patients is needed. However, considering that the pathologic findings of spinal CA in patients with KTWS include the typical features of CA, the management of CA in patients with KTWS may be identical to management of isolated CA.
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Current guidelines for the management of hyponatremia in patients with subarachnoid hemorrhage (SAH) are not based on a systematic assessment of the literature. We evaluated published studies on the efficacy and safety of current preventative and treatment strategies for hyponatremia in patients with SAH. ⋯ Current evidence does not demonstrate a benefit of preventative treatment with mineralocorticoids in clinically important outcomes, although a difference cannot be ruled out due to imprecision. Larger well-designed trials are needed to establish the impact of mineralocorticoids and fluid and sodium supplementation strategies on clinically relevant outcomes in the prevention and treatment of hyponatremia in patients with SAH.