Neurosurgery
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Natural history of hemorrhage in brain arteriovenous malformations (bAVM) is reported at 2%-4% per year. Published studies using survival analysis fail to account for recurrent hemorrhagic events. In this study, we present a large, single institution series to elucidate the natural history of bAVM using multivariable Poisson regression. ⋯ Hemorrhage after bAVM detection occurs in 8.41% of all patients, and the rate averages 2.81% per year. However, this risk varies from 0.00% to 10.81% per year depending on various risk factor combinations. Efforts should be made to stratify bAVM hemorrhage rate by risk factors for more precise estimation of bleeding risk if left untreated.
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Greater thecal sac volumes are associated with an increased risk of spinal anesthesia (SA) failure. The thecal sac cross-sectional area accurately predicts thecal sac volume. The thecal sac area may be used to adjust the dose and prevent anesthetic failure. We aim to assess the rate of SA failure in a prospective cohort of lumbar surgery patients who receive an individualized dose of bupivacaine based on preoperative measurement of their thecal sac area. ⋯ Adjusting the dose of SA according to thecal sac area significantly reduces the rate of SA failure in patients undergoing lumbar spine surgery.