World Neurosurg
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Despite effective treatment for aneurysmal subarachnoid hemorrhage (aSAH), delayed cerebral ischemia (DCI) is a common complication that has a significant impact on the recovery of neurologic function. In this study, we aimed to investigate the efficacy of hyperbaric oxygen therapy (HBOT) in the rehabilitation treatment of aSAH. ⋯ In summary, early HBOT reduced the DCI rate in aSAH patients and consequently promoted improvement of the executive control function of ANT.
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To investigate the biomechanical properties of pedicle screw reinsertion along the same trajectory in a previously validated synthetic bone model. ⋯ Despite a significant decrease in insertion torque, there is no significant loss of pedicle screw performance when a screw is removed and reinserted along the same trajectory.
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To investigate factors influencing the long-term prognosis of patients with sacral Tarlov syndrome after nerve root cuff reconstruction. ⋯ Patients with sacral Tarlov cysts undergoing nerve root cuff reconstruction, particularly those with longer preoperative disease duration and dysuria, are at increased risk of poor long-term prognosis.
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Direct common carotid puncture (DCP) is conventionally used as a bailout technique in stroke patients. However, little is known about the relevant anatomy. Our objective was to examine the relationship of the common carotid artery (CCA) to surrounding structures based on different DCP trajectories passing through the artery's center. ⋯ DCP performed 2 cm above the clavicle at 0° on the right, and 90° on the left appears to minimize encounters with the IJV and thyroid gland, reducing potential complications. However, despite these findings, ultrasound guidance remains vital for DCP safety. Further focus on endovascular device safety in DCP is needed.
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Spinal arteriovenous fistulae (AVFs) of the craniocervical junction are rare lesions that have variable angioarchitecture. These lesions are generally characterized by arteriovenous shunting at a single fistulous point, the disconnection of which is generally curative.1 We present a case of bilateral dural AVF at the C2 level treated with surgical ligation (Video 1). Our patient was an elderly woman who presented after cervical magnetic resonance imaging was performed as part of work-up for right-sided shoulder tingling. ⋯ She was then taken back to surgery for ligation of the second fistula. Instances of multiple, distinct, and synchronous arteriovenous fistulae have been rarely reported in the literature.2 In addition to demonstrating the nuances of surgical treatment of AVFs at this location, this case demonstrates the potential for synchronous AVFs and emphasizes the importance of thorough postoperative angiography. The patient provided consent to the production of this surgical video.