World Neurosurg
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To evaluate whether the postoperative neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker for patients with intracerebral hemorrhage (ICH) undergoing surgical hematoma evacuation. ⋯ In patients with ICH undergoing hematoma evacuation, admission Glasgow Coma Scale score, initial hematoma volume, and postoperative NLR were independently associated with 30-day mortality. Postoperative NLR may be a prognostic marker in surgical ICH patients, and future studies are needed to confirm this finding.
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Comparative Study
Predicting In-Hospital Complications Following Anterior Cervical Discectomy and Fusion: A Comparison of the Elixhauser and Charlson Comorbidity Measures.
The objective of this study was to determine the ability of the Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI) to predict postoperative complications after anterior cervical discectomy and fusion (ACDF). ⋯ The ECI was superior to the CCI in predicting 6 of 15 complications in this study. Both are excellent tools for predicting mortality after ACDF.
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There are no current evidence-based recommendations on mechanical thrombectomy (MT) in M2 or other distal occlusions. The objective of this paper was to investigate clinical and radiologic outcomes of MT in distal locations using the new generation of mini-0.017 microcatheter compatible-stent retrievers (SRs) compared with a direct aspiration first pass technique (ADAPT) MT. ⋯ MT in distal locations using the new generation of SR yields comparable results compared with ADAPT in terms of recanalization; however, the use of SR is associated with lower functional independence and higher mortality rate.
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Magnetic resonance-guided laser interstitial thermal therapy is a minimally invasive procedure that uses intraoperative magnetic resonance thermometry (MRT) to generate a thermal damage estimate (TDE) of the ablative area. This study aimed to compare areas produced by the MRT heat map with the system-generated TDE produced by Visualase software. ⋯ The system-generated TDE consistently remains contained within the boundaries of the MRT heat map. At standard factory settings, TDE and the area produced within the periphery of HM63.9 are similar in magnitude. The light blue portion of the MRT heat map may serve as an additional means of predicting when critical structures may be at risk during laser ablation if exposed to further thermal stress.
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Case Reports
Endoscopic Transforaminal Transchoroidal (ETTC) Approach to the Third Ventricle for Cystic and Solid Tumors.
Endoscopic access to the third ventricle is limited by the confinements of the foramen of Monro and can be aided by opening of the choroidal fissure. ⋯ ETTC approach is a safe and effective method for enlargement of the foramen of Monro. The approach improves maneuverability of the endoscope and allows a broad range of movement and increased angulation within the foramen of Monro. Attention to anatomy is paramount to avoid injury to the venous structures and fornix.