World Neurosurg
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Posterior cerebral artery (PCA) aneurysms are rare but clinically significant due to their critical location and complex management. The risk factor of the PCA aneurysms rupture remains unclear. This study aimed to investigate the associated factor of PCA aneurysms rupture in a large Chinese cohort. ⋯ This is the first multicenter study to highlight the coexistence of ICAO as a major associated factor for PCA aneurysm rupture in the Chinese population.
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This study aimed to investigate the accuracy of large language models (LLMs), specifically ChatGPT and Claude, in surgical decision-making and radiological assessment for spine pathologies compared to experienced spine surgeons. ⋯ The study highlights the potential of LLMs in assisting with radiological interpretation and surgical decision-making in spine surgery. However, the current limitations, such as the lack of consideration for patient-specific factors and inaccuracies in treatment recommendations, emphasize the need for further refinement and validation of these artificial intelligence (AI) models. Continued collaboration between AI researchers and clinical experts is crucial to address these challenges and realize the full potential of AI in spine surgery.
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Subarachnoid hemorrhage (SAH) is a severe neurologic event with high mortality. The choice of sedatives in SAH management may influence patient outcomes. This study aimed to investigate the association between sedatives and in-hospital mortality among patients with SAH. ⋯ Dexmedetomidine is associated with significantly lower in-hospital mortality in patients with SAH. These findings underscore the importance of sedative choice for patients with SAH, suggesting that dexmedetomidine could enhance patient outcomes.
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Cerebral aneurysm rupture is a major cause of potential years of life lost. Research on rupture risk has often compared unruptured and ruptured aneurysms, with the implicit assumption that the rupture event does not significantly change aneurysm morphology. However, aneurysm morphology is charged by rupture, although precisely how remains a matter of debate. ⋯ All aneurysms in our cohort increased substantially in volume after rupture when measured with a semiautomated artificial intelligence volumetric measurement tool. However, linear measurements showed both increases and decreases in size. The rupture site was easy to detect in all cases by qualitative volumetric assessment.
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Ophthalmic artery (OphA) aneurysms, occurring at the junction of the internal carotid artery and the OphA orifice, present significant treatment challenges due to their location and complex anatomy. This systematic review and meta-analysis aimed to evaluate endovascular therapy and microsurgery in managing OphA aneurysms. ⋯ Our comparison of endovascular therapy and surgery for OphA aneurysms showed no significant difference in clinical outcomes. However, visual complications were more common with surgery, while mRS >2 was higher with endovascular therapy. Flow diversion reduced visual deficits compared to clipping and coiling, but further studies are needed.