World Neurosurg
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Intracranial aneurysms are a common asymptomatic vascular pathology, the rupture of which is a devastating event with a significant risk of morbidity and mortality. Aneurysm detection and risk stratification before rupture events are, therefore, imperative to guide prophylactic measures. ⋯ In the present review, we explored the role and limitations of deep learning, a subfield of artificial intelligence, in the aneurysm patient journey. We have also briefly summarized the application of deep learning models in automated detection and prediction in cerebral arteriovenous malformations and Moyamoya disease.
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Primary spine paragangliomas are rare tumors. Surgical resection plays a role, but aggressive lesions are challenging. We reviewed the literature on primary spine paragangliomas. ⋯ Surgical resection is effective and safe in treating primary spine paragangliomas; however, adjuvant treatments may be needed for aggressive lesions.
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Review
Historical Overview of the only Neuro-Psycho-Pathology Center in the Democratic Republic of Congo.
The Neuro-Psycho-Pathology Center (NPPC) in the Democratic Republic of Congo is a 450-bed neuropsychiatric clinic that pioneered efforts to synergize various disciplines: neurology, neurosurgery, neuropsychiatry, and psychiatry. It serves the brain and behavioral health needs of Congolese patients, and at its peak, the NPPC was a major domestic neuropsychiatry center that averaged 320 admissions annually. Financial and resources shortages have curtailed its functions at 10% of its real capacity. Our report accounts the NPPC's early vision, and we also highlight the ongoing challenges faced by this institution.
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Spinal cord injury (SCI) is a serious disease of the central nervous system, often with irreversible loss of motor or sensory functions. Failure of axon connection and inhibition of the microenvironment after SCI severely hinder the regeneration of damaged tissue and neuron function. Therefore, a new perspective in the treatment of SCI is reconstruction of the neural circuit. ⋯ They also can secrete various factors to regulate the host microenvironment and play a therapeutic role. Biomaterials can fill the cavity at the site of SCI, load therapeutic drugs, provide adsorption sites for transplanted cells, and play a bridging role. In this review, the therapeutic role of stem cells and biomaterials is discussed, together with their properties, advantages, limitations, and future perspectives, providing a reference for basic and clinical research on SCI treatment.
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Randomized Controlled Trial
Assessment of Patients' Willingness to Participate in a Randomized Trial of Spinal versus General Anesthesia for Lumbar Spine Surgery.
Prospective nonrandomized studies have found less postoperative fatigue and improved quality of life in patients undergoing awake spine surgery under spinal anesthesia compared with general anesthesia. Randomized trials are needed to validate these findings. ⋯ Sixty percent of patients stated that they were either definitely or probably willing to participate in the randomized trial. Subjects lacking strong preferences for the anesthesia technique stated a greater willingness to enroll than those with strong preference.