World Neurosurg
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Subdural drains are used to reduce recurrence after surgical evacuation of chronic subdural hematoma. There is a small risk of parenchymal injury. We hypothesize that using subgaleal drains with low active suction (-50 mm Hg to -100 mm Hg) may be a safer alternative and still maintain efficacy in preventing recurrence. ⋯ The use of subgaleal drains with low active suction led to significantly lower complication rates compared with the use of subdural drains and maintained its efficacy in preventing recurrence.
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Symptomatic intracranial hemorrhage (sICH) after mechanical thrombectomy (MT) is associated with worse outcomes. We sought to develop and internally validate a machine learning (ML) model to predict sICH prior to MT in patients with anterior circulation large vessel occlusion. ⋯ An ML model accurately predicted sICH prior to MT. It performed better than a standard statistical model and previously described clinical prediction models.
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Endovascular transmural targeting of cervical and cranial perivascular structures is a novel approach for minimally invasive delivery of therapeutics. Components of the autonomic nervous system are in close anatomic proximity to major cervical vasculature and, therefore, represent potential targets for intervention. The superior cervical ganglion (SCG) is a discrete structure of interest for this approach, as sympathetic blockade may have therapeutic effects for various conditions. Variability of SCG location and its relationship to large cervical vessels, and the feasibility of endovascular transmural targeting has not been elucidated. ⋯ This is the first anatomical study to provide pertinent targeting information for endovascular transmural access to the SCG using computed tomography angiography. In most cases, endovascular transmural access to the SCG is anatomically feasible from the proximal cervical ICA.
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A Comprehensive Bibliometric Analysis and Visualization of Publication Trends in Hip-Spine Syndrome.
Hip-spine syndrome (HSS) was first described in 1983 as a syndrome characterizing the concurrent symptoms of lumbar and hip joint degenerative disease. This study aims to elucidate the research trends, hot topics, and influential publications in HSS through bibliometric analysis. ⋯ Over the past 4 decades, the volume of publications on HSS has steadily increased. The United States leads both in the quality and quantity of published articles. The most influential works have enhanced our understanding of the pathogenesis and surgical decision-making in HSS. This study provides a comprehensive review of the trends and influential research in HSS.
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Neurosurgical procedures require meticulous preparation, including extra measures to ensure patient safety and the appropriate setup of the operating room, which must be fully established before the surgeon can initiate the first incision. Neurosurgical delay encompasses the time from anesthesia induction start to when the neurosurgeon makes the first incision. ⋯ Operational neurosurgical delays can be improved using sequential checklists by constraining the variability in each phase. The article provides a conceptual novel checklist that provides a modular approach and completion of all steps in a phase reduces the variability of error to the next phase. This approach eventually reduces the patient's time under anesthesia.