World Neurosurg
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Because of the health care initiative on quality improvement projects in academic medicine, this study explores the impact of different postgraduate years (PGYs) on unexpected re-operation rates. ⋯ Resident participation in neurosurgical cases does not affect 30-day unplanned re-operation rates, which were affected by frailty index, functional subspecialty, and wound class.
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We aimed to examine the effect of preinjury antithrombotic medication on clinical and radiologic neuroworsening in traumatic brain injury (TBI) and study the effect on outcome. ⋯ In this study of patients with moderate and severe TBI, preinjury platelet inhibitors did not cause neuroworsening or predict higher mortality or worse outcome. In contrast, preinjury warfarin caused neuroworsening and was an independent risk factor for mortality and worse outcome at 6 months. Hence, fall prevention and liberal use of computed tomography examinations is important in this patient group.
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The retrotransverse foramen is a nonmetric variant of C1 that consists of an abnormal accessory foramen on the posterior root of the transverse process. ⋯ Neurosurgeons should be aware of the possible presence of the "conventional" retrotransverse foramen and the "exceptional" double retrotransverse foramen so that they can safely plan to prevent surgical complications. This will thus ensure better patient management by neurosurgeons.
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Vessel wall magnetic resonance imaging (MRI) has been suggested as a potential in vivo method to detect inflammation of aneurysm wall and identify unruptured intracranial aneurysm (UIA) at high risk for rupture. This study aims to investigate the correlation between aneurysm wall enhancement (AWE) on vessel wall MRI and rupture-related morphological parameters in patients with multiple UIAs. ⋯ The presence of AWE on vessel wall MRI was significantly correlated with conventional morphological rupture risk factors in patients with multiple UIAs, which might indicate AWE as a potential radiologic predictor for UIAs with high rupture risk.