J Neurosurg Sci
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Early hyperglycemia is a feature of traumatic brain injured (TBI) patients. The aim of our study was to analyze the impact of early hyperglycemia on in-ICU mortality in isolated TBI and its correlations with other factors responsible for secondary injury. ⋯ Early hyperglycemia is a major predictor of mortality and correlates with other factors responsible for secondary injury. Early hyperglycemia seems to be a marker of inflammatory reaction responsible for early cardiovascular and respiratory impairment.
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The purported advantages of minimally invasive spine surgery over open microsurgical alternatives for lumbar decompression and fusion are attractive to patients, surgeons, and hospital administrators. Shorter hospital length of stay, less blood loss, shorter operating times, decreased use of postoperative narcotic analgesics, and a more rapid return to work have all been touted as advantages. ⋯ Key learning tasks for the introduction of each technique into practice are highlighted. The current quality of evidence for each approach is also critically evaluated.
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Case Reports
Non-infected carotid artery pseudoaneurysm 29 years after endarterectomy, endovascular management with covered stent.
Pseudoaneurysm formation is a rare complication following carotid endarterectomy (CEA). Arterial pseudoaneurysms lack all three layers of the arterial wall that include the intima, media and adventitia. Pseudoaneurysms are most commonly seen after injuries to the artery in the form of blunt trauma and puncture, and are less common after surgeries such as carotid endarterectomy. ⋯ This case demonstrates that pseudoaneurysm formation can occur as a long term complication after carotid endarterectomy. It may present as a rapidly expandable, pulsatile, vascular lesion in the absence of clinical and sub-clinical infection. Placement of an endovascular stent graft may be a safe and effective option for treatment of infected and non-infected carotid pseudoaneurysm.