World Neurosurg
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Intraoperative use of positive end-expiratory pressure (PEEP) has a protective effect in patients with acute lung injury and is recommended during anesthesia to minimize postoperative pulmonary complications. However, high levels of pressure might also cause harm to the lung because of overdistension. This retrospective study was designed to compare the effect of low and high levels of PEEP on the risk of postoperative pulmonary complications in patients with normal lung function who were undergoing an elective craniotomy. ⋯ Low and high levels of PEEP show similar incidences of postoperative pneumonia and requirement of postoperative NIV or invasive MV in patients with normal function of the lungs undergoing elective craniotomy.
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In the treatment of acute ischemic stroke (AIS), patients need to be selected for mechanical thrombectomy (MT) in the acute phase. Selection criteria vary, however, depending on the patient's situation. This study investigated the effectiveness of a noncontrast computed tomography and symptom-based protocol for selecting patients for MT. ⋯ Noncontrast computed tomography and symptom-based selection of MT to treat AIS can be useful for achieving better neurologic recovery in a subgroup of patients. This approach could broaden the use of MT.
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To investigate clinical and radiologic results of anterior cervical discectomy and fusion for cervical spondylotic myelopathy in elderly patients with T2-weighted increased signal intensity (ISI), focusing specifically on the quantitative analysis of ISI. ⋯ Compared with young patients with ISI, the elderly patients had a lower preoperative JOA score, a greater preoperative SCR, and a longer preoperative ISI length, indicating poor surgical outcomes.
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Cortical ependymomas (CEs), supratentorial ependymomas that selectively involve the cerebral cortex, are relatively rare neoplasms that have not been extensively described. The purpose of our study was to identify the clinical features, radiologic characteristics, and treatment of a series of such tumors. ⋯ CEs are a rare subset of supratentorial ependymomas that selectively involve the cerebral cortex. Most CEs are low grade and present with seizures. Anaplastic CEs show a greater recurrence rate and a relatively poor prognosis. Gross total resection with or without adjuvant radiotherapy is currently the optimal treatment for CEs. CEs seem to have a more favorable prognosis than other supratentorial ependymomas.
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To evaluate short-term efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in treatment of symptomatic adjacent segment disease (ASD) after lumbar fusion in elderly patients >65 years old. ⋯ PTED demonstrated satisfactory short-term efficacy and safety in management of ASD after lumbar fusion in patients >65 years old. PTED may be an alternative choice for elderly patients with ASD after lumbar fusion.