Neurosurgery
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Pre- and postoperative cognitive deficits have repeatedly been demonstrated in patients with glioblastoma (GBM). ⋯ We demonstrated preoperative cognitive risk factors that enable the identification of GBM patients who are at risk for cognitive impairment 3 mo after surgery. This information can help to inform patients and clinicians at an early stage, and emphasizes the importance of recognizing, assessing, and actively dealing with cognitive functioning in the clinical management of GBM patients.
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Wide-necked cerebral aneurysms in the setting of acute subarachnoid hemorrhage (SAH) remain difficult to treat with endovascular methods despite recent progress in the neuroendovascular field. ⋯ Comaneci-assisted embolization of wide-necked intracranial aneurysms in patients presenting with acute SAH is associated with high procedural safety and adequate occlusion rates. Furthermore, dual antiplatelet therapy can be safely avoided in this patient group.
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Occipital arteriovenous malformations (AVMs) carry a high risk of postoperative morbidity because of their anatomic relation to the visual cortex and optic radiations. Data regarding endovascular management of these lesions are scant. ⋯ EVT of occipital AVM carries a non-negligible rate of complications, especially regarding visual functions.
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Opioid use in the management of pain secondary to spinal disorders has grown significantly in the United States. However, preoperative opioid use may complicate recovery in patients undergoing surgical procedures. ⋯ Following LLIF, patients prescribed preoperative opioids had increased postoperative lumbar pain, disability, and subjective pain.
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We have previously reported a method and device capable of manipulating ICP pulsatility while minimally effecting mean ICP. ⋯ Cardiac-gated manipulation of ICP pulsatility allows the study of intracranial pulsatile dynamics and provides a potential means of altering CBF.