World Neurosurg
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Multicenter Study Comparative Study
Comparison of grading scales regarding perioperative complications and clinical outcomes of brain arteriovenous malformations after endovascular therapy-a multicenter study.
Several scales have been proposed for risk assessment and outcome determination in brain arteriovenous malformations treated by endovascular therapy. We aim to validate and compare the efficacy of these scales in predicting perioperative complications and clinical outcomes. ⋯ The Puerto Rico score predicts complications and unfavorable outcomes better than the SM. The AVMES scale has medium efficacy in predicting complete obliteration.
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Surgery for patients with gunshot wound spinal cord injury (GSCI) remains controversial. Few recent studies provide standardized follow-up and detailed functional outcomes. To our knowledge, the research we present in this study is unique in that we are the first to incorporate Functional Independence Measure (FIM) scores as an outcomes measure for neurologic recovery in patients with GSCI. ⋯ Surgery for patients with GSCI is associated with increased LOS and is not associated with improved FIM scores for patients with either complete or incomplete spinal cord injuries.
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Foramen magnum meningiomas represent a challenge for neurosurgeons. These tumors require careful surgical manipulation as they are often located in proximity to critical neurovascular structures and the cranial nerves. The far lateral approach is considered the safest neurosurgical approach for excising foramen magnum lesions. ⋯ We describe key historical, epidemiological, genetic, epigenetic, clinical, and neurosurgical aspects of foramen magnum meningiomas. We emphasize the far lateral approach for lesions arising in the foramen magnum, as well as the most appropriate patient positioning for such approach. Caring for these aspects will be rewarded with the best perioperative neurosurgical outcomes.
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Primary cerebellar hemorrhage accounts for 10% of all intracranial hemorrhages. Given the confined space of the posterior fossa, cerebellar hemorrhage management sometimes necessitates suboccipital decompression and hematoma evacuation. In this study, we examine outcomes after surgery for primary cerebellar hemorrhage and identify risk factors associated with adverse outcomes. ⋯ Cerebellar hemorrhage is associated with significant risk of mortality and ventilator dependence. In patients who require surgery, 30-day mortality risk remains high (26.6%), with functional status and American Society of Anesthesiologists class predictive of death.
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Multicenter Study Observational Study
Stroke Burden in Rwanda; a multicenter study on stroke management and outcome.
Cerebrovascular accidents or stroke constitute the second leading cause of mortality worldwide. Low- and middle-income countries bear most of the stroke burden worldwide. The main objective of this study is to determine the burden of stroke in Rwanda. ⋯ Our results show that stroke is a significant public health concern in Rwanda. Risk factor awareness and control are still low and case fatality of stroke is significantly high. The significant delay in presentation to care and presentation with severe stroke are major contributors for the high mortality and severe disability rates.