World Neurosurg
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The safety of spontaneous vaginal delivery in pregnant patients with known unruptured intracranial aneurysms (UIAs) has been supported by increasing evidence over the past two decades. However, the extent to which this increased evidence has since influenced changes, if any, in actual clinical practice, has yet to be studied. ⋯ There was a significant trend over the 2010s toward permitting more spontaneous vaginal deliveries for obstetrical patients with known UIAs.
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A sufficient foraminoplasty is critical in percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation (LDH), which may affect the progress of surgery. This study assessed repeated foraminoplasty (RF) applied in PETD for patients with LDH and lumbar foraminal stenosis. ⋯ Repeated foraminoplasty applied in PETD for patients with LDH and lumbar foraminal stenosis might improve intervertebral foramen enlargement in anterior-posterior diameter, exposure of nerve roots, surgical efficiency, and immediate relief of leg pain after surgery.
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Traumatic brain injury management guidelines vary across regions and there is limited research on real-world adherence to these guidelines. We conducted a global survey to assess the adherence of neurosurgeons to traumatic brain injury guidelines and evidence-based medicine (EBM). ⋯ Neurosurgeons from Europe and North/Central and South America tend to follow EBM guidelines more closely, while those from Asia and Africa often favor individual decision-making approaches.
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Indications for carotid endarterectomy (CEA) and reduction of complications require evaluation of the plaque properties and location of the distal end of the plaque. High cervical location can be predicted from the anatomy of the vertebral body and mandibular bones, and the locations of the posterior belly of the digastric muscle and stylohyoid muscle. Magnetic resonance (MR) imaging without contrast medium is useful for preoperative evaluation of the plaque, arteries, and bone characterization. However, no method for simultaneous evaluation of the muscle, plaque, arteries, and bone using MR imaging has been established. ⋯ M-PAB imaging using MR imaging without contrast medium is useful for preoperative evaluation of CEA. This method does not require contrast agents and avoids radiation exposure.