World Neurosurg
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Observational Study
Potentially Harmful Ionizing Radiation Exposure (PHIRE) from Diagnostic Tests and Medical Procedures in Patients with Aneurysmal Subarachnoid Hemorrhage.
Patients with aneurysmal subarachnoid hemorrhage (aSAH) may have significant potentially harmful ionizing radiation exposure (PHIRE) from diagnostic tests and medical procedures (DTMP) during their initial hospitalization. ⋯ On the basis of our data, PHIRE occurs in approximately 35% of aSAH patients. The reduced-variable logistic regression model had the greatest predictive accuracy for PHIRE. Future studies should validate our findings and predictive models and, if our conclusions hold, further clarification of the risks of PHIRE and methods to reduce PHIRE should be investigated.
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Primary central nervous system neuroblastoma (PCNSN) is a rare disease, and its incidence, treatment modalities, and survival remain poorly understood. ⋯ We updated epidemiologic information of PCNSN and showed that age, histologic type, tumor extension, and surgery were independent prognostic factors. Moreover, treatment modalities of these tumors are influenced by patient and tumor characteristics.
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A 9-French (Fr) sheath is routinely used during mechanical thrombectomy (MT) for treating acute ischemic stroke (AIS). However, the use of a large sheath is a risk factor for access site complications (ASCs). Previous studies focused on preventing intracranial complications, and only a few have explored ASCs. We investigated the technical feasibility and efficacy of a sheathless procedure for AIS (SPAIS) that uses a 9-Fr balloon-guiding catheter as a guiding sheath to reduce the sheath size and prevent ASCs during MT. ⋯ SPAIS is a feasible technique that effectively reduces MT-associated ASCs; thus, this approach should be adopted to improve patient outcomes.
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The treatment of traumatic brain injury (TBI) in Myanmar is a major health issue. Comprehensive appreciation of the pathology is limited given the lack of granular metadata available. In this proof-of-concept study, we analyzed demographic data on TBI generated from a novel, prospective, online database in a lower-middle income country. ⋯ Despite a lack of formal training in electronic medical records or research, the resident team was able to capture the majority of admissions with granular-level data. This helped shed light on the etiology and severity of TBI in Myanmar. As a result, more effective transport systems and access to trauma care must be achieved. Accessible regional trauma centers with investment in intensive care units, operative care, anesthesia, and imaging resources are necessary.