World Neurosurg
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Currently, it remains controversial about guidelines for the application of low-molecular-weight heparin (LMWH) in patients with acute ischemic stroke (AIS). Therefore this meta-analysis was carried out, aiming to systematically investigate the short-term and long-term safety and efficacy of LMWH in AIS patients. ⋯ To sum up, on the basis of limited studies available currently, the early use of LMWH in AIS patients aged older than 70 years should be cautious because it may increase the risk of all-cause mortality. For patients younger than 70 years old, the early use of LMWH significantly reduces the short-term risk of DVT, but there is no significant relationship in the long term. In terms of DVT prevention, enoxaparin and danaparoid are probably more effective. Nonetheless, more future randomized controlled trials are warranted to verify and support this conclusion.
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Multicenter Study Observational Study
The new fully radiopaque Aperio Hybrid Stent-Retriever: Efficient and safe? An early multicenter experience.
To investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions. ⋯ Mechanical thrombectomy with the APH appeared feasible, efficient, and safe. Full-length device radiopacity may facilitate thrombectomy or support to adapt the course of action during retrieval, if required.
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Pharyngoesophageal injury during anterior cervical spine surgery is a rare and potentially life-threatening complication; generally it is the result of intraoperative manipulation or hardware erosion and sometimes may be due to weakness of the pharyngoesophageal wall from pre-existing pathologic conditions, such as diabetes, gastritis, or obesity. ⋯ Appropriate treatment for pharyngoesophageal perforations is controversial and not investigated in detail. There is a lack of prospective studies comparing initial conservative versus surgical approaches to treatment. In addition, endoscopic management is growing as a therapeutic option, but no consensus concerning the indications for an endoscopic approach in the treatment of pharyngoesophageal injury in anterior cervical spine surgery is currently reached. A common theme proposed in the literature is that early recognition and aggressive investigation and treatment are essential to ensure a good outcome. A customized interdisciplinary surgical approach is essential for successful treatment. Use of the transoral endoscopic approach is a useful noninvasive method to treat this rare but potentially devastating complication.
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Review Case Reports
Minimally-invasive Parafascicular Surgical (MIPS) Approach for the Management of a Pediatric Third Ventricular Ependymoma: Case Report and Review of Literature.
Minimally invasive parafascicular surgery (MIPS) has evolved into a safe alternative to access deep-seated subcortical and intraventricular pathologies. We present a case of a port-mediated resection of a pediatric third ventricular tumor. ⋯ The patient improved from baseline, with no remaining visual deficits, headaches, or balance issues. Pathology reported a World Health Organization grade II tanycytic ependymoma. To our knowledge, few cases have reported the utilization of port-based MIPS in pediatric patients.
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Review Case Reports
Polymicrobial Intracerebral Abscess Growing Mycobacterium avium complex and Achromobacter xylosoxidans: Case Report and Literature Review.
Mycobacterium avium complex (MAC) and Achromobacter xylosoxidans (AX) are uncommon sources of neurosurgical infections, particularly in immunocompetent hosts. We report the first published case of intracranial AX abscess and polymicrobial AX-MAC abscess, as well as the fourth MAC abscess in a non-immunocompromised patient. ⋯ AX and MAC are rare causes of intracranial infection. Patients with these pathogens identified in the central nervous system require a multidisciplinary approach for successful management.