World Neurosurg
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The modality of intraoperative neuromonitoring (IONM) in lateral approaches for interbody fusion varies. We aim to examine the types of neuromonitoring used in lateral approaches for lumbar interbody fusion and associated neurologic complications. ⋯ Neurologic complication rates in LLIF remain high despite utilization of IONM. Use of IONM did not benefit neurologic outcomes. More prospective studies with different IONM modalities and without IONM are needed before determining specific benefits or shortcomings of each IONM modality.
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Anorexia nervosa and obesity are common appetite disorders, which may be life threatening if not treated and often coincide with psychiatric disorders. We sought to investigate whether deep brain stimulation (DBS) of specific regions within the brain could aid in the treatment of these disorders. This review aims to organize the literature regarding the feasibility of DBS via clinical outcomes and synthesize the data on patient demographics and electrode parameters for future optimization. ⋯ DBS seems to be a promising solution in addressing treatment-refractory anorexia, but additional prospective studies are still needed to confirm this same usefulness for the treatment of obesity. Primary limitations included the apparent lack of data on DBS for obesity as well as the dearth of cohort studies assessing efficacy of DBS compared with control treatments. Although these limitations could not be addressed in the current review, this study may incentivize future trials to assess DBS in patients with appetite disorders in a more controlled fashion.
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Multicenter Study
International Survey of Antiseizure Medication Use in Patients with Complicated Mild Traumatic Brain Injury: A New York Neurotrauma Consortium Study.
Seizures and epilepsy after traumatic brain injury (TBI) negatively affect quality of life and longevity. Antiseizure medication (ASM) prophylaxis after severe TBI is associated with improved outcomes; these medications are rarely used in mild TBI. However, a paucity of research is available to inform ASM use in complicated mild TBI (cmTBI) and no empirically based clinical care guidelines for ASM use in cmTBI exist. We aim to identify seizure prevention and management strategies used by clinicians experienced in treating patients with cmTBI to characterize standard care and inform a systematic approach to clinical decision making regarding ASM prophylaxis. ⋯ This study is the first to characterize factors influencing clinical decision making in ASM prophylaxis after cmTBI based on multidisciplinary multicenter provider practices. Prospective controlled studies are necessary to inform standardized guideline development.
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Randomized Controlled Trial
The effects of supplemental dexmedetomidine anesthesia on intracranial aneurysm patients undergoing intracranial interventional embolization.
Intracranial aneurysm (IA) has been identified in approximately 0.4%-3% of the population and associated with 3%-10% mortality. IA is the major factor attributing to spontaneous subarachnoid hemorrhage. We aim to investigate that whether employing dexmedetomidine (DEX), an α2 adrenergic receptor agonist, as a supplementation could impact the outcomes of patients with intracranial interventional embolization. ⋯ Our study demonstrated that employing DEX as supplementation during anesthesia could effectively reduce surgical stress and improve cognitive function, ultimately improving patients' recovery from intracranial interventional embolization.