World Neurosurg
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We investigated the ability of early alteration of cerebral perfusion-computed tomography (PCT) parameters to predict the risk of vasospasm, delayed cerebral ischemia (DCI), and clinical outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). ⋯ Early alterations in PCT parameters and high Barrow Neurological Institute grade may identify a subgroup of patients at high risk of developing DCI and vasospasm after aSAH, thus prompting more robust preventative measures and treatment in this subgroup.
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To evaluate the clinical and radiographic outcomes of an anterior-only approach for the correction of severe cervical kyphotic deformities. ⋯ Preoperative and intraoperative skull traction combined with anterior-only cervical operation may be a safe and effective technique for treating severe cervical kyphosis. If the postoperative correction is >80%, sufficient decompression could be achieved.
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Os odontoideum is a smooth, independent ossicle separated from a hypoplastic odontoid process located cranially in the expected position of the odontoid tip. The pathogenesis of os odontoideum remains controversial, and several etiological theories have been suggested for congenital, developmental, and traumatic origins. ⋯ When examining the etiology of os odontoideum, checking for the existence of a traumatic history is important. However, a more important matter is to consider morphological segmentation abnormalities of the proatlas. Segmentation abnormalities of the proatlas could be closely connected to the development of familial os odontoideum.
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Observational Study
Post-interventional sedation worsens functional outcomes in acute ischemic stroke patients treated with endovascular therapy.
Postinterventional sedation is commonly used in clinical practice to ensure patient safety and comfort. Although sedation or anesthesia during thrombectomy has been well studied, the association between postinterventional sedation and functional outcomes in endovascularly treated patients with acute ischemic stroke (AIS) has yet to be investigated. We describe the association between postinterventional sedation and functional outcomes in patients with AIS treated with endovascular therapy (EVT). ⋯ Postinterventional sedation worsens functional outcomes in patients with AIS with large-vessel occlusions treated with EVT. Whether the sedation is a causative factor or a surrogate for poor functional outcomes remains to be determined.
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Overlapping surgery, performed by the same primary attending surgeon asynchronously, has gained significant attention from the government and media as potentially harmful to patients. Therefore, the goal of this study was to evaluate the outcomes and safety of overlapping versus nonoverlapping microvascular decompression (MVD) operations. ⋯ Overlapping MVD operations may be performed safely at our institution. Further prospective studies are needed to understand the association of overlapping surgery among MVD operations.