Neurosurgery
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Observational Study
Post-treatment Antiplatelet Therapy Reduces Risk for Delayed Cerebral Ischemia due to Aneurysmal Subarachnoid Hemorrhage.
Delayed cerebral ischemia (DCI) has a strong impact on outcome of patients with aneurysmal subarachnoid hemorrhage (SAH). Positive effect of antiplatelet therapy on DCI rates has been supposed upon smaller SAH series. ⋯ Regular administration of aspirin might have a positive impact on DCI risk and outcome of SAH patients, without increasing the risk for clinically relevant bleeding events. In our SAH cohort, dual antiplatelet therapy showed no additional benefit on DCI risk, but increased the likelihood of major bleeding events.
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Intraneural ganglion (IG) cysts have been considered curiosities and their pathogenesis remains controversial. ⋯ A unifying articular theory is responsible for the pathogenesis of IG of UNE and disconnection of the CAB would prevent recurrence. The long-term outcome is good after surgical treatment of IG of UNE.
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Postoperative stereotactic body radiotherapy (pSBRT) is an emerging indication for spinal metastases (SM). ⋯ pSBRT is an effective and safe treatment. The association between downgrading preoperative ED and better local control following pSBRT is confirmed and supports the concept of separation surgery.
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Dysthyroid optic neuropathy (DON) is a devastating complication of thyroid eye disease. Corticosteroids are the primary medical treatment for DON, but some refractory patients may require surgical management. ⋯ Endoscopic endonasal decompression of the orbital apex significantly improves visual parameters. As a result, multidisciplinary screening for patients is crucial to ensure prompt surgical decompression.
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Observational Study
Regionalization of Spine Trauma Care in an Urban Trauma System in the United States: Decreased Time to Surgery and Hospital Length of Stay.
The effect of regionalized trauma care (RT) on hospital-based outcomes for traumatic spine injury (TSI) in the United States is unknown. ⋯ RT is associated with increased surgical rates, earlier time to surgery, and decreased ICU LOS for patients with TSI.