Neurosurgery
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Review Meta Analysis
Association of Hemodynamic Factors With Intracranial Aneurysm Formation and Rupture: Systematic Review and Meta-analysis.
Recent evidence suggests a link between the magnitude and distribution of hemodynamic factors and the formation and rupture of intracranial aneurysms. However, there are many conflicting results. ⋯ Pooled analyses of computational fluid dynamics models suggest that an increase in WSS and gradient oscillatory number may contribute to aneurysm formation, whereas low WSS is associated with ruptured aneurysms. The location of the aneurysm at the bifurcation or sidewall may influence the correlation of these hemodynamic factors.
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Targeting hyperoxemia is common practice in neurocritical care settings, but the safety of hyperoxemia has been questioned. ⋯ Early moderate hyperoxemia may not increase or decrease the risk of a poor outcome in mechanically ventilated aneurysmal SAH patients.
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Comparative Study
Comparison of Outcome Between Surgical and Conservative Management of Symptomatic Spinal Cord Cavernous Malformations.
Intramedullary cavernous malformations (CMs) are rare lesions with unclear natural history. ⋯ Surgical resection of intramedullary CMs eliminates the risk of subsequent hemorrhagic and may achieve satisfactory outcome when patients are carefully selected. Although conservative management is recommended in patients at high surgical risk, they should be closely monitored because of persistent hemorrhagic risk.