World Neurosurg
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Ultrasonographic elastography imaging visualizes the elastic properties of tissues to distinguish pathologic and healthy areas. Real-time elastography measures relative tissue hardness by evaluating changes in local strain in response to external forces. ⋯ We objectively describe the elastographic patterns of different types of brain tumors (i.e., gliomas, metastases, and meningiomas). We have identified differences in both the tumors and the peritumoral areas of these histologic types.
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Cerebral edema is a major cause of morbidity in patients with severe traumatic brain injury (TBI). Intraparenchymal thermal conductivity-based probes that measure local cerebral blood flow can measure percent brain tissue water (%BTW) content, but such measures have been insufficiently characterized in patients with TBI. ⋯ %BTW may be a clinically useful, real-time measurement of cerebral edema in patients with TBI. It is closely associated with the serum sodium concentration and follows a characteristic temporal course with characteristic trajectory and stability over time.
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Comparative Study
Anterior lumbar interbody fusion may provide superior decompression of the foraminal space compared to direct foraminotomy: A biomechanical cadaveric study.
The objective of this cadaveric biomechanical study was to compare the area of the foraminal space during motion in the intact condition, after direct decompression via foraminotomy, and after indirect decompression via anterior lumbar interbody spacer insertion. ⋯ ALIF maintains the foraminal area in extension while direct posterior foraminotomy does not.
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Chronic subdural hematoma (cSDH) is an increasingly common condition due to the growing use of anticoagulation. Currently, there remains a lack of evidence to guide the optimal timing of anticoagulant reinitiation for stroke prevention in atrial fibrillation after cSDH evacuation. We aimed to better understand the perceived risks of hemorrhagic and embolic complications along with current practice patterns on restarting anticoagulation after surgical evacuation of cSDH. ⋯ There is considerable variation in current practice patterns and perceived risks of embolic and hemorrhagic complications with anticoagulation reinitiation after cSDH evacuation. These results demonstrate clinical equipoise that warrant further targeted investigation in large-scale randomized controlled trials.
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Candida auris is an emerging superbug which was recently discovered and has spread widely across the world. With a steady rise in incidence involving multisystems, this presents a unique challenge to caregivers. ⋯ C. auris appears to be an emerging superbug, which is hospital-acquired. All practitioners must be aware of its existence and presentation. Given the low incidence, high mortality, and no clear guidelines of management so far, formulation of any such strategies is complicated. Further studies and research are needed for this superbug.