World Neurosurg
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Multicenter Study
Neurosurgical Infection Rates and Risk Factors: A NSQIP Analysis of 132,000 Patients, 2006-2014.
The existing body of literature on postoperative neurosurgical infections lacks large multicenter reports on postoperative neurosurgical infections. This is the largest study to date of postoperative neurosurgical infections rates, time to event, and risk factors. ⋯ The overall ACS-NSQIP reported rate of postoperative infections was 5.3% from 2006 to 2014. Multivariable analysis demonstrated several predictive factors for postoperative infections.
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Brain surgery to promote behavioral or affective changes in humans remains one of the most controversial topics at the interface of medicine, psychiatry, neuroscience, and bioethics. Rapid expansion of neuropsychiatric deep brain stimulation has recently revived the field and careful appraisal of its 2 sides is warranted: namely, the promise to help severely devastated patients on the one hand and the dangers of premature application without appropriate justification on the other. ⋯ This goal is accomplished by a detailed reassessment of numerous case reports and small-scale open or controlled trials in their historical and social context. The different surgical approaches, their rationale, and their scientific merit are discussed in a manner comprehensible to readers lacking extensive knowledge of neurosurgery or psychiatry, yet with sufficient documentation to provide a useful resource for practitioners in the field and those wishing to pursue the topic further.
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Comparative Study
Healthcare costs of spontaneous aneurysmal subarachnoid hemorrhage for rehabilitation, home care and in-hospital treatment for the first year.
Given the young age of onset and high probability of long-term disability after subarachnoid hemorrhage (SAH), the financial impact is expected to be substantial. Our primary objective was to highlight subsequent treatment costs after the acute in-hospital stay, including rehabilitation and home care, compared with costs for ischemic stroke. ⋯ Aneurysmal SAH prevalently affects working individuals with long-term occupational disability necessitating long-term medical rehabilitation for most patients and subsequent nursing care in one third of survivors. Overall, SAH treatment generates far higher costs than reported for ischemic stroke.
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Radiation-induced meningioma (RIM) is an uncommon late risk of cranial irradiation. We conducted an exhaustive review of individual patient data to characterize RIM. ⋯ For patients treated with cranial radiotherapy, the risk of secondary meningioma warrants a longer follow-up period beyond the standard time frame typically designated for determining the risk of primary tumor relapse.
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Clinical Trial
Angiographic characteristics and endovascular treatment of anterior cerebral artery A1 segment aneurysms.
This report aimed to review the angiographic characteristics and evaluate the safety and feasibility of endovascular treatment of A1 aneurysms. ⋯ Endovascular treatment is technically feasible and safe for A1 aneurysms.