Neurosurgery
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Observational Study
Quality of British and American Nationwide Quality of Care and Patient Safety Benchmarking Programs: Case Neurosurgery.
Multiple nationwide outcome registries are utilized for quality benchmarking between institutions and individual surgeons. ⋯ The implemented benchmarking programs in the United Kingdom and United States fail to identify a considerable number of complications in a high-volume center. Health care policy makers should be cautious as outcome comparisons between most centers and individual surgeons are questionable if based on the programs.
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Review Meta Analysis
A Meta-Analysis of Risk Factors for the Formation of de novo Intracranial Aneurysms.
Understanding the risk factors for the formation of de novo intracranial aneurysms (IAs) is important for patients who have ever suffered a cerebral aneurysm. ⋯ Observational evidence identified multiple clinical and anatomic risk factors for the formation of de novo IAs, including female sex, age <40 yr, family history, smoking history, multiple sIAs at first diagnosis, and IC as the initial site. More aggressive long-term angiographic follow-up with digital subtraction angiography, computed tomography angiography, or magnetic resonance angiography is recommended for these patients.
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Drain insertion following chronic subdural hematoma (CSDH) evacuation improves patient outcomes. ⋯ Drain insertion after CSDH drainage is important, but position (subgaleal or subdural) and duration did not appear to influence recurrence rate or clinical outcomes. Similarly, drain location did not influence recurrence rate nor outcomes where both parietal and frontal burr holes were made. Further prospective cohort studies or randomized controlled trials could provide further clarification.