World Neurosurg
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Medicare reimbursements for otolaryngology and neurosurgery procedures have generally declined since 2000. We explore Medicare reimbursement trends for anterior cranial fossa, middle cranial fossa, posterior cranial fossa, pituitary surgery, and skull base reconstruction surgery from 2000-2022. ⋯ While nominal per-service Medicare reimbursement has increased for skull base surgery codes, there has been a downward trend in inflation-adjusted procedural reimbursement. This parallels findings in other otolaryngology and neurosurgery procedures. Despite this, surgical volume in all skull base surgery subfields has increased, indicating increased utility and adoption of these techniques.
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Only a few articles have been published about the lateral posterior choroidal artery (LPChA), and yet none of them contains data regarding the thalamic branches. ⋯ This is the first description of the LPChA thalamic branches to date. Their microanatomic features are important for understanding the neurologic symptoms following vessels occlusion, for precise radiologic diagnoses, and for safe neurosurgical and endovascular interventions.
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Chronic posthemorrhagic hydrocephalus often arises following spontaneous subarachnoid hemorrhage (SAH). Timely identification of patients predisposed to develop chronic shunt-dependent hydrocephalus may significantly enhance clinical outcomes. ⋯ ML models, including logistic regression, demonstrate strong predictive capability for early chronic shunt-dependent hydrocephalus following spontaneous SAH, which may potentially contribute to more timely shunt placement interventions. This predictive capability is supported by our web interface, which simplifies the application of these models, aiding clinicians in efficiently determining the need for shunt placement.
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This study examined radiographic changes in local and global spinal alignments and clinical outcomes following tumor resection without spinal fixation in patients with lumbar dumbbell tumors (LDTs). ⋯ Tumor resection without spinal fixation had no substantial impact on local and global spinal alignments and led to satisfactory clinical outcomes, suggesting that spinal fixation may not always be necessary when resecting LDTs.
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Areas of increased signal intensity, known as T2 hyperintensities (T2Hs), observed on T2-weighted magnetic resonance imaging (MRI) scans, are linked to a spectrum of brain abnormalities in children with neurofibromatosis type 1 (NF1). Defining the radiological characteristics that distinguish non-neoplastic from neoplastic T2Hs in children with NF1 is crucial. Then, we could identify lesions that were most likely to require oncologic surveillance. ⋯ Low-risk and medium-risk tumor lesions can both be classified as unidentified bright objects . Unidentified bright objects constituted the majority of T2Hs in children with NF1. High-risk tumor lesions should be considered as probable tumors. With the application of standardized radiologic criteria, a high prevalence of probable brain tumors will be identified in this at-risk population of children, which underscores the importance of vigilant and appropriate oncological surveillance to ensure timely detection and intervention for these tumors.