World Neurosurg
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With vertebral compression fractures (VCF), height loss has been associated with kyphotic deformity and intractable pain, 2 indications for potential surgical intervention. Consequently, assessment of factors associated with continual height loss can provide insights regarding management. Computed tomography (CT) Hounsfield units (HU), a measure of radiodensity, have been implicated for the assessment of bone quality. No studies have assessed the relationship between CT HU and traumatic VCF. Consequently, the objective of this study was to evaluate this relationship. ⋯ Age, BMI, and CT HU values are independent predictors of worsening VCF. These factors can help determine appropriate clinical follow-up and need for surgical intervention.
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Case Reports
The Long-term Effect of Flow Diversion on Large and Giant Aneurysms: An MRI-DSA-Clinical Correlation Study.
The long-term effect of flow diversion (FD) on aneurysms has not been well studied. ⋯ Most aneurysms treated with Pipeline decreased in size, correlating with clinical improvement. Some aneurysms remained unchanged on MRI until a later time point despite early DSA occlusion. It may be reasonable to eliminate early postprocedural imaging and start follow-up only as late as 1 year after FD treatment in clinically stable, asymptomatic patients.
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The study aimed to investigate optimal surgical timing, methods, and clinical efficacy of bifrontal decompression craniotomy (BDC) on traumatic bifrontal contusions (TBC). ⋯ TBC progressed gradually and deteriorated rapidly; this should be strictly and dynamically observed, and patients should be operated on in a timely manner. Changing the operation-timing score is the gold standard for surgery. Amended BDC can significantly improve the prognosis of patients.
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Comparative Study
Biomechanical Study of Three Atlantoaxial Proactive Vertebral Artery Injury Prevention Fixation Combinations.
To evaluate the biomechanical stability of 3 atlantoaxial proactive vertebral artery injury prevention fixation combinations. ⋯ The combination of C1LH and C2ILS supplemented with contralateral TAS or C1LH and TAS or C1LH and C2ILS was superior to bilateral TAS fixation with regard to biomechanics and vertebral artery safety.
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Mild traumatic brain injury (mTBI), defined as blunt trauma to the head resulting in witnessed loss of consciousness, definite amnesia, or witnessed disorientation with a Glasgow Coma Scale (GCS) score of 14 or 15 is a common occurrence in the emergency department. In mTBI, oral anticoagulation is known to be an important risk factor for hemorrhage. Clinical guidelines recommend baseline computed tomographic (CT) scan and observation for 24 hours plus a CT scan before discharge. ⋯ Patients with a GCS score of 15 who are taking long-term anticoagulation therapy and who present with mTBI have a risk of cranial hemorrhage that is likely to be similar to that of non-anticoagulated patients. It may be reasonable to envision a protocol including only one CT scan and an appropriate observation period.