Neurosurgery
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Multicenter Study
Early Multicenter Experience With the Neuroform Atlas Stent: Feasibility, Safety, and Efficacy.
The Neuroform Atlas stent™ (by Stryker, Fremont, California) represents the most recent widely available upgrade to intracranial stenting, providing a laser cut open cell stent with a diameter of 3.0 to 4.5 mm that is delivered through an 0.017-inch microcatheter. ⋯ Our series demonstrates the safety, feasibility, and efficacy of the Atlas stent. The low complication rate and the high obliteration rate managing complex aneurysms, even in an acute ruptured setting, are notable.
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Optimal postoperative pain control is critical after spinal fusion surgery. There remains significant variability in the use of postoperative intravenous opioid patient-controlled analgesia (PCA) and few data evaluating its utility compared with nurse-controlled analgesia (NCA) among patients with lumbar fusion. ⋯ Postoperative PCA is associated with significantly more opioid consumption in the first 72 h after surgery and equal or worse postoperative pain scores compared with NCA after lumbar spinal fusion surgery.
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Stereotactic radiosurgery (SRS) is a safe and effective treatment for acromegaly. ⋯ IGF-1i is a reliable predictor of biochemical remission after SRS. BED appears to predict biochemical outcome more reliably than radiation dose, but confirmatory study is needed.
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Observational Study
Sensitivity and Specificity of On-Field Visible Signs of Concussion in the National Football League.
On-field visible signs (VS) are used to help identify sport-related concussion (SRC) in the National Football League (NFL). However, the predictive utility of a VS checklist for SRC is unknown. ⋯ In the NFL, the diagnosis of concussion cannot be made from on-field VS alone. The VS checklist is one part of the comprehensive sideline/acute evaluation of concussion, and the diagnosis remains a multimodal clinical decision.
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High school (HS) sport-related concussions (SRCs) remain a public health concern in the United States. ⋯ Headache was the most commonly reported symptom. Notable group differences in the prevalence of amnesia, loss of consciousness, and SRT may be associated with more severe SRCs, warranting further attention.