World Neurosurg
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Comparative Study
Inertial measurement unit-assisted implantation of thoracic, lumbar, and sacral pedicle screws improves precision of a freehand technique.
A method applying inertial measurement units (IMUs) was developed to implant pedicle screws in the thoracic and lumbosacral spine. This was compared with a freehand technique. ⋯ IMU-assisted implantation of pedicle screws may enhance the performance of a freehand technique in the thoracic and lumbosacral spine.
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Comparative Study
Long Term Outcome After Conservative Treatment and Direct Bypass Surgery of Moyamoya Disease at Late Suzuki Stage.
To investigate the long-term outcomes after conservative and direct surgical treatment for patients with moyamoya disease (MMD) at late Suzuki stage. ⋯ Although direct bypass surgery was shown to effectively improve the cerebral perfusion in patients with MMD at late Suzuki stage, compared with conservative treatment, it did not reduce the risk of recurrent stroke. Further study is needed to determine whether direct bypass surgery is effective in patients with MMD at late Suzuki stage.
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Environmental and Clinical Risk Factors for Delirium in a Neurosurgical Center: A Prospective Study.
Few reports of delirium-related risk factors have focused on environmental risk factors and clinical risk factors, such as white matter signal abnormalities on magnetic resonance imaging fluid attenuated inversion recovery images. ⋯ WMLs in patients and the surrounding environment are risk factors for delirium in a neurosurgical center. To prevent delirium, clinicians must recognize risk factors, such as high-grade WMLs, and manage environmental factors.
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Cerebral cavernous malformations (CCM) can cause intracerebral hemorrhage. The lesions themselves are frequently associated with perifocal hemosiderin deposits caused by repetitive microhemorrhages. Main indications for a surgical treatment are recurrent symptomatic hemorrhages or cavernoma-related epilepsy. After surgical resection, follow-up magnetic resonance imaging (MRI) is usually performed to confirm 1) the complete resection of the CCM and, especially in cases of cavernoma-related epilepsy, 2) the complete resection of the hemosiderin deposits. ⋯ Our data suggest that early postoperative MRI after CCM surgery is often hampered by imaging artifacts creating false-positive results and therefore ineligible for a resection control. However, reliability of a negative result on early postoperative T2-weighted MRI is relatively high regarding both CCM and hemosiderin remnants.
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Typical recurrence of glioblastoma occurs locally, usually within 2 cm from the original lesion. With improvement of surgical techniques, more aggressive surgical strategies have become feasible, resulting in a significantly increased rate of complete resection. We investigated whether these improvements are also reflected by tumor recurrence pattern. ⋯ Despite complete resection of contrast-enhancing tumor, most recurrences occurred locally. Patients with distant tumor recurrence demonstrated increased progression-free survival. Therefore, to gain local control, we may need to shift toward a more aggressive supramarginal resection, using extensive intraoperative monitoring to avoid permanent deficits.