World Neurosurg
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Evaluation of lumbar canal dimensions in a Chicago population born in 2 different decades. ⋯ As seen in European cohorts, our data suggest that patients born in the 1940s have both larger canal area and larger anterior-posterior diameter compared with the younger generation. These data suggest that significant differences exist between ethnicities. These differences highlight the importance of studying normal anatomical dimensions within different geographical populations and the importance of studying non-modifiable factors as they relate to spinal dimensions and spine patients. Furthermore, spinal canal growth seems to be negatively influenced in younger generations, a rather unexpected but worrying finding.
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Frailty is associated with postoperative morbidity in multiple surgical disciplines. We evaluated the association between frailty and early postoperative outcomes for brain tumor patients using a national database. ⋯ Frailty is associated with in-hospital complications and nonroutine disposition after craniotomy for benign and malignant brain tumors. Additional work is needed to identify prehabilitation or in-hospital strategies to improve the care and outcomes of these at-risk patients.
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Shunt overdrainage is a potential complication in pediatric hydrocephalus. The addition of adjustable gravitational units to previous shunt systems has been proposed as effective management for this problem. These devices have been traditionally implanted over the occipital bone. We propose chest implantation as an easier, safer, and more stable alternative in the pediatric population, especially in those cases with parieto-occipital shunts. ⋯ In our experience, chest implantation for adjustable gravitational devices was a suitable shunt modification in pediatric patients suffering from overdrainage.
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Case Reports
Continuous Interrupted Double Throw Suturing Method: A novel suturing technique for Extracranial-Intracranial Bypass.
Despite failure of the EC/IC Bypass Study Group to demonstrate effectiveness in minimizing future stroke events, superior temporal artery-medial cerebral artery (STA-MCA) bypass remains an essential treatment for complex giant intracranial aneurysms, tumors, moyamoya disease with ischemia, and atherosclerotic steno-occlusive disease with hemodynamic cerebrovascular insufficiency. The objective of this report is to describe a novel suturing technique for STA-MCA bypass that helps reduce donor-recipient anastomosis time, allowing for a well-organized systematic workflow. ⋯ We describe a novel technique for interrupted STA-MCA bypass suturing that adds efficiency, safety, organization, and operative ease compared with the conventional method of interrupted vessel suturing.