World Neurosurg
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The role of inflammatory response in the pathophysiology of subarachnoid hemorrhage (SAH) is being increasingly recognized. This study analyzed the impact of cellular and biochemical markers of early inflammatory response to ictus on outcome after SAH. ⋯ A leukocytosis response to ictus seems to have a significant independent association with both DCI and poor GOS score, and hs-CRP level had a significant independent association with poor GOS score, indicating preeminence of early cellular response in SAH pathophysiology.
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Clinical Trial
Analysis of factors that influence long-term independent living for elderly subarachnoid hemorrhage patients.
The number of elderly subarachnoid hemorrhage (SAH) patients has been increasing. The aim of this study was to analyze long-term outcome for elderly (≥75 years) SAH patients and to establish a treatment strategy. ⋯ Good-grade elderly SAH cases that were independent pre-stroke should have radical intervention performed for aneurysm. Avoiding perioperative complications have a positive influence on long-term independent living.
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To report new results with ethylene oxide sterilization and new experiences with autogenous bone flaps autoclaved at a high or low temperature for preservation of a bone flap after decompressive craniectomy. ⋯ Ethylene oxide and high- or low-temperature autoclave bone sterilization techniques for the preservation of autologous bone flaps after decompressive craniectomy were safe, rapid, and inexpensive.
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Comparative Study
Patterns of recurrence after resection of malignant gliomas with BCNU wafer implants: retrospective review in a single institution.
Bis-chloroethylnitrosourea (BCNU) wafers have been demonstrated to be effective for prolonging survival for patients with malignant glioma and have been approved worldwide. BCNU wafers are implantable and have a unique feature of delivering chemotherapeutic drug at high concentration at tumor margin over time after resection. BCNU wafers presumably, by this mechanistic rationale, have a beneficial effect on local tumor control and thus could change the pattern of recurrence, which is most frequently local. However, no studies have demonstrated such phenomenon after BCNU wafer implants. ⋯ These results suggest that BCNU wafers could have a beneficial effect on local tumor control and may provide BCNU wafers with a new profile that could be considered for establishing future chemotherapeutic strategy for glioma patients.
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Three-dimensional (3D) printing holds promise for a wide variety of biomedical applications, from surgical planning, practicing, and teaching to creating implantable devices. The growth of this cheap and easy additive manufacturing technology in orthopedic, plastic, and vascular surgery has been explosive; however, its potential in the field of neurosurgery remains underexplored. A major limitation is that current technologies are unable to directly print ultrasoft materials like human brain tissue. ⋯ With minor refinements, personalized, deformable brain models created via 3D printing will improve surgical training and preoperative planning with the ultimate goal to provide accurate, customized, high-precision treatment.