World Neurosurg
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Cranial deformation, including deformational plagiocephaly, brachycephaly, and craniosynostosis, is a condition that affects a large number of infants. Despite its prevalence, there are no standards for the systematic evaluation of the cranial deformation. Usually, the deformation is measured manually by the use of calipers. Experts, however, do not agree on the suitability of these measurements to correctly represent the deformation. Other methodologies for evaluation include 3-dimensional (3D) photography and radiologic scanners. These techniques require either patient's sedation and ionizing radiation or high investment. The aim of this study is to develop a novel, low-cost, and minimally invasive methodology to correctly evaluate the cranial deformation using 3D imagery. ⋯ Smartphone-based photogrammetry is a low-cost, highly useful methodology to evaluate cranial deformation. This technique provides a much larger quantity of information than linear measurements with a similar accuracy as far as head marks exist. In addition, a new approach for the evaluation is pointed out: the comparison between the head 3D model and an ideal head, represented by a 3-axis ellipsoid.
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Mechanical endovascular embolectomy using stent retrievers has gained popularity for treatment of large vessel occlusion in acute ischemic stroke. Use of open embolectomy as a direct surgical treatment has been limited, likely owing to the technical difficulty, therapeutic time window, and time-consuming procedure. ⋯ Open embolectomy resulted in a high complete recanalization rate with an acceptable safety profile. Open embolectomy is a safe and durable method of cerebral recanalization in patients with embolic stroke and can be considered as a potential treatment if endovascular embolectomy cannot be performed. The details of the occluded arteries presented here will be useful for endovascular surgeons to prevent complications.
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Observational Study
Mortality Associated Characteristics of Traumatic Brain Injury Patients at the University Teaching Hospital of Kigali, Rwanda.
Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with TBI in low and middle-income countries have worse outcomes than patients in high-income countries. We evaluated important clinical indicators associated with mortality for patients with TBI at University Teaching Hospital of Kigali, Kigali, Rwanda. ⋯ GCS score <13, hypoxia, bradycardia, tachycardia, and age >50 years were associated with mortality. These findings inform future research that may guide clinicians in prioritizing care for patients at highest risk of mortality.
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To evaluate the association of perioperative hemoglobin A1c (HbA1c) level in patients with diabetes with the incidence of infection after anterior cervical discectomy and fusion requiring operative intervention, in addition to determining if a threshold level of HbA1c above which the risk of infection increases significantly exists. ⋯ The risk of deep postoperative infection in patients with diabetes mellitus increases as the perioperative HbA1c level increases. ROC analysis determined that a perioperative HbA1c level higher than 7.5 mg/dL could serve as a threshold for a significantly increased risk of infection.
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This study aimed to assess the clinical and radiologic outcomes after neurosurgical treatment of large and giant aneurysms of the middle cerebral artery (MCA). In addition, we aimed to identify risk factors for unfavorable outcomes. ⋯ Neurosurgical management should be considered a priority for large and giant MCA aneurysms because of the high rupture rate and clinical symptoms. However, treatment outcomes remain unsatisfactory. Therefore, tailored management with consideration of risk factors for unfavorable outcomes should be implemented.