Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2020
Keeping the team together: Transformation of an inpatient neurology service at an urban, multi-ethnic, safety net hospital in New York City during COVID-19.
The COVID-19 pandemic dramatically affected the operations of New York City hospitals during March and April of 2020. This article describes the transformation of a neurology division at a 450-bed tertiary care hospital in a multi-ethnic community in Brooklyn during this initial wave of COVID-19. In lieu of a mass redeployment of staff to internal medicine teams, we report a novel method for a neurology division to participate in a hospital's expansion of care for patients with COVID-19 while maintaining existing team structures and their inherent supervisory and interpersonal support mechanisms.
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Clin Neurol Neurosurg · Sep 2020
Risk factors of unplanned neurosurgery for scoliotic patients with Chiari malformation type I and syringomyelia after spinal deformity correction.
It remains unclear which subgroups of scoliotic patients with CMI and syringomyelia are more likely to undergo unplanned neurosurgery after spinal deformity correction. The purpose of this study is to explore risk factors of unplanned neurosurgery for scoliotic patients with CMI and syringomyelia after spinal deformity correction. ⋯ After spinal deformity correction, 78 % of the patients did not require later neurosurgery and those that needed it had a delay of more than nine months. Tonsil ectopia ≥ 10 mm and syrinx/cord area ratio ≥ 0.4 were independent risk factor of unplanned neurosurgery after spinal deformity correction. It is reasonable to perform spinal corrective surgery in patients with minimal symptoms and signs without the need for prior neurosurgical intervention.
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Clin Neurol Neurosurg · Sep 2020
Randomized Controlled Trial Comparative StudyThe treatment of V2 + V3 idiopathic trigeminal neuralgia using peripheral nerve radiofrequency thermocoagulation via the foramen rotundum and foramen ovale compared with semilunar ganglion radiofrequency thermocoagulation.
To compare the advantages and disadvantages of V2 + V3 idiopathic trigeminal neuralgia using peripheral nerve radiofrequency (RF) thermocoagulation (PRF) via the foramen rotundum (FR) and foramen ovale (FO) with those of semilunar ganglion RF thermocoagulation (GRF) under local anesthesia, for exploring a new and available surgical method for patients with V2 + V3 idiopathic trigeminal neuralgia. ⋯ The PRF surgery, like GRF, is another prospective treatment for V2 + V3 idiopathic trigeminal neuralgia by virtue of its excellent immediate effect, accurate positioning and high safety.
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Clin Neurol Neurosurg · Sep 2020
Observational StudyNon-invasive cerebral perfusion monitoring in cardiac arrest patients: a prospective cohort study.
To determine if non-invasive cerebral perfusion estimation provided by a new acousto-optic technology can be used as a reliable predictor of neurological outcome. ⋯ Cerebral perfusion monitoring using a c-FLOW device in survivors of cardiac arrest is feasible, but reliability of the information provided has yet to be demonstrated. In our cohort, we were unable to identify any association between the perfusion index and clinical outcomes at discharge. As such, clinical management of cardiac arrest patients based on non-invasive perfusion index is not supported and should be limited to research protocols. The trial was registered with ClinicalTrials.gov, number NCT02575196.