World Neurosurg
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The secondary phase of spinal cord injury (SCI) is characterized by ischemic injury. Spinal cord perfusion pressure (SCPP), calculated as the difference between mean arterial pressure (MAP) and intrathecal pressure (ITP), has arisen as a therapeutic target for improving outcomes. Cerebrospinal fluid drainage (CSFD) may reduce ITP and thereby increase SCPP. Randomized controlled trial to evaluate the safety and feasibility of CSFD to improve SCPP and outcomes after acute SCI. ⋯ CSFD is a safe, effective mechanism for reducing ITP and improving SCPP in the acute period post-SCI. The favorable safety profile and preliminary efficacy should help drive recruitment in future studies.
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To investigate the possibility of histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating microcystic meningioma (MM) from intracranial solitary fibrous tumor (SFT). ⋯ MM and SFT show overlapping conventional MRI features. ADC histogram analysis helps to differentiate between MM and SFT, with ADC1 being the optimal parameter with the best discrimination performance.
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Interbody cages for spinal fusions are primarily constructed from polyetheretherketone or titanium compositions. However, these crude macroscopic materials pose limitations for improving the rates of bony fusions. The authors aimed to compare the fusion rates and postoperative complications in patients who underwent 2-level or 3-or 4-level anterior cervical discectomy and fusion (ACDF) performed with the use of a novel biomimetic surface titanium cage. ⋯ Radiographic and clinical outcomes were equivalent in 3-or 4-level and 2-level ACDFs in which these biomimetic surface titanium cages were used. Furthermore, the use of this technology led to high fusion rates with no requirement for posterior supplemental fusions.
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Contrary to previous assumptions, there is increasing evidence that small intracranial aneurysms carry a relevant risk of rupture. The aim of this study was to identify angiographic characteristics of small ruptured aneurysms ≤7 mm and to evaluate their significance for clinical decision making. ⋯ Of the numerous factors associated with aneurysm rupture, we propose aneurysmal location, aspect ratio (cut-off: 1.5), and aneurysm inclination angle as the most important morphological factors for assessing the rupture risk of small aneurysms because these factors have high AUC values and are robust to changes after rupture.
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In the past decade, many machine learning (ML) models have been used in the management of normal pressure hydrocephalus (NPH). This study aims at systematically reviewing those ML models. ⋯ Though highly accurate, there are many challenges to current ML models necessitating the need to standardize the ML models to enable comparison across the studies and enhance the NPH decision-making and care.