World Neurosurg
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The current study used polylactic acid molds [developed locally using three-dimensional printers and our software] and polymethyl methacrylate (PMMA) to perform cranioplasty of bone defects in technically demanding areas of the skull while ensuring ideal cosmetic results and functional recovery. The overall aim was to identify the ideal method for standard cranioplasty procedures METHODS: Polylactic acid duplicates of the skull defects were created for eligible patients, after which a two-part negative mold composed of plaster and silicone was used to form artificial bone with PMMA. Thereafter, cranioplasty was performed and the treatment success was assessed by evaluating the percentage of similarity objectively and the body image scale subjectively. ⋯ Cranioplasty operations were performed at an economical price of approximately US$50 dollars, suggesting that this method can be applied widely. Furthermore, preoperative preparation of the PMMA models can help reduce the duration of anesthesia and surgery which, in turn, will minimize the risk of surgical complications. Based on current knowledge in the field, we believe that this method represents the ideal technique.
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This study aimed to investigate factors that influence subdural haemorrhage (SDH) secondary to intracranial arachnoid cysts (IACs) in children. ⋯ IACs are more common in boys than in girls. They can be divided into 3 groups according to their morphological changes on computed tomography images. Image type III and caesarean delivery were independent factors that influenced SDH secondary to IACs.
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Population screening for aneurysms in patients with risk factors and preventive surgical treatment are beneficial according to numerous studies. One of the most significant risk factors is heredity, namely, the presence of first-degree relatives (FDR) with aneurysmal subarachnoid hemorrhage (aSAH). Nevertheless, there are still no generally accepted approaches or evidence bases regarding the benefits of the aneurysm screening strategy. ⋯ Screening and preventive treatment in the general population reduces the prevalence of aneurysms by 1.74% (3.44% in the FDR group) and the prevalence of aSAH by 14.36% (37.48% in the FDR group). Mortality due to aSAH was reduced by 14.44%. The number of disabilities also decreases. The occurrence of deep disability was reduced by 20.2% in the FDR group. Economic analysis of the part of the population consisting of FDRs showed annual savings of ies also decr CONCLUSIONS: The mathematical model demonstrated that screening and preventive treatment of cerebral aneurysms can reduce aSAH-associated morbidity and mortality. In the FDR group, there was decrease in the prevalence of aSAH and decrease in associated mortality. Screening for cerebral aneurysms is cost-effective.
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Influence of Prolonged Duration of Symptoms Prior to MIS-TLIF in a Workers' Compensation Population.
We assessed the potential effect of the preoperative symptom duration on patient-reported outcomes (PROs) for workers' compensation (WC) patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). ⋯ Independently of the preoperative symptom duration, WC patients demonstrated improvement in physical function and pain after MIS-TLIF. Patients with a longer symptom duration reported inferior function and pain preoperatively and were more likely to demonstrate clinically significant improvements in disability and pain postoperatively.
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Dural arteriovenous fistulas at the craniocervical junction (CCJ DAVFs) are a rare vascular disease. Endovascular treatment (EVT) and microsurgery are the primary treatment modalities for CCJ DAVFs. However, incomplete treatment or complications may occur after treatment because of the anatomical complexity. ⋯ In cases of type 1 CCJ DAVF, both microsurgical treatment and EVT may be considered. However, for type 2 and 3 CCJ DAVFs, microsurgery may be a superior treatment modality.