World Neurosurg
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We sought to report the safety of implementation of a novel standard of care protocol using spinal cord perfusion pressure (SCPP) maintenance for managing traumatic spinal cord injury (SCI) in lieu of mean arterial pressure goals at a U.S. Level I trauma center. ⋯ In our initial experience of 15 patients with acute SCI, standardized SCPP goal-directed care based on LSAD monitoring for 5 days was feasible. There were no SCPP-related complications. This is the first report of SCPP implementation as clinical standard of care in acute SCI.
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Comparative Study
Prognosis comparison of different branches of trigeminal neuralgia.
We explored the remission rate of different branches of the trigeminal nerve after microvascular decompression. ⋯ Postoperative remission rate of non-V2-related branches (V1, V3) are higher than V2-related branches (V2, V1-2, V1-3, V2-3).
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It is generally accepted that larger saccular intracranial aneurysms are at greater risk to rupture. We investigated whether aneurysm location influences the effect of aneurysm size on the propensity of rupture. ⋯ We observed no difference in size between unruptured and ruptured ACOM aneurysms, possibly suggesting a greater susceptibility for ACOM aneurysms to rupture at smaller sizes.
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Obesity has been shown to be associated with higher rates of complications after lumbar spine surgery. However, the evidence regarding the impact of body mass index (BMI) on outcomes following posterior cervical fusions (PCFs) remains limited. ⋯ With the exception of a higher rate of deep surgical site infections seen in obese patients, increased BMI does not seem to have a major impact on 30-day outcomes following PCFs.
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Comparative Study
Neonatal hydrocephalus treatment with ultra-small valve implantation.
Neonatal hydrocephalus remains a difficult condition to manage, due to high failure rates among all management strategies. Neurosurgeons commonly manage hydrocephalus with ventriculoperitoneal shunt (VPS) implantation, and valves of variable sizes and profiles are available for implantation. This study examines primary ventricular shunt valve implantation complication rates based on valve profiles in pediatric patients with hydrocephalus. ⋯ Our review did not find a significant difference in complication rates between ultrasmall and regular valves in patients under 1 year of age. However, the etiology of shunt malfunction did differ between the groups. This work further supports evidence suggesting a surgeon's preference for shunt hardware alone does not significantly impact outcome.