Neurosurgery
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The value of neuron-specific enolase (NSE) in predicting clinical outcomes has been investigated in a variety of neurological disorders. ⋯ We found a significant association between higher NSE levels and poorer clinical presentations and worse outcomes. Although it is still early for any relevant clinical conclusions, our results suggest that NSE holds promise as a tool for screening patients at increased risk of poor outcomes after SAH.
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The history of false localizing signs is intimately linked to the birth of modern neurology and the unraveling of the mysteries of localization through neurological examination at the end of the 19th century. This phenomenon has attracted much attention but has not been properly explained, even in the authoritative handbooks such as that by Oppenheim. ⋯ In another article published 2 years earlier in 1927, Groeneveld and Schaltenbrand provided a pathophysiological and anatomical explanation of the phenomenon, described in detail. Although Kernohan and Woltman themselves refer to that previous article, it was this article that provided the first logical, clear, indubitable explanation of the phenomenon that we today refer to as the Kernohan notch.
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Direct cost comparisons between minimally invasive spine surgeries and the open options are rare. ⋯ AUC, area under the curveBP, back painEQ-5D, EuroQol-5DHTI, Health Transition IndexICER, incremental cost-effectiveness ratioLLIF, lateral lumbar interbody fusionLP, leg painMCED, minimum cost-effective differenceMCID, minimum clinically important differenceMCS, mental component summaryODI, Oswestry Disability IndexPCS, physical component summaryPRO, patient-reported outcomeQALY, quality-adjusted life-yearSF-36, Short Form-36TLIF, transforaminal lumbar interbody fusionVAS, visual analog scale.
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Glioblastoma is an aggressive and highly infiltrative brain cancer. Standard surgical resection is guided by enhancement on postcontrast T1-weighted (T1) magnetic resonance imaging, which is insufficient for delineating surrounding infiltrating tumor. ⋯ Visually imperceptible imaging patterns discovered via multiparametric pattern analysis methods were found to estimate the extent of infiltration and location of future tumor recurrence, paving the way for improved targeted treatment.
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Stereotactic radiosurgery (SRS) has been performed on patients with cerebral arteriovenous malformations (AVMs) for over 40 years. ⋯ Advances in SRS procedures over the past 20 years have resulted in a lower risk of RIC, but fewer patients had AVM obliteration. Increasing the prescription dose for patients with medium- and large-volume AVMs by using current conformal dose-planning techniques may improve the obliteration rate while maintaining a low risk of RICs.