IEEE transactions on bio-medical engineering
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IEEE Trans Biomed Eng · Apr 2013
Noninvasive intracranial hypertension detection utilizing semisupervised learning.
Intracranial pressure (ICP) monitoring is an established clinical practice in managing patients with risk of acute ICP elevation although the clinically accepted way of measuring ICP remains invasive. However, the invasive nature of ICP measurement obviates its application in many clinical circumstances such as diagnosis of idiopathic intracranial hypertension (IH). We propose a noninvasive diagnostic tool for IH based on the morphological analysis of cerebral blood flow velocity waveforms. ⋯ Although the predictive accuracy is a widely used accuracy measurement, it does not consider clinical consequences of necessary and unnecessary treatments. For this reason, we have adopted the decision curve analysis to address this issue. The decision curve analysis results show that the semisupervised IH detection method is not only more accurate, but also clinically more useful than the supervised IH detection method or the PI-based IH detection method.
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Despite the potential increase in precision and accuracy, laser technology is not widely used in neurological surgery. This in part relates to challenges associated with the early introduction of lasers into neurosurgery. Considerable advances in laser technology have occurred, which together with robotic technology could create an ideal platform for neurosurgical application. ⋯ In preclinical studies, the laser improved microsurgical performance and reduced thermal damage, while neuroArm decreased intra- and intersurgeon variability. Clinical studies demonstrate dutility in meningioma resection (n = 4). Together, laser and robotic technology offered a more consistent, expedient, and precise tool for microsurgery.