World Neurosurg
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Hematoma expansion (HE) is closely related to poor outcome in spontaneous intracerebral hemorrhage (sICH). Island sign (IS) is a novel HE predictor based on noncontrast computed tomography (NCCT). This study is aimed to confirm the accuracy of IS for predicting HE and compare it to the spot sign (SS) on computed tomography angiography (CTA). ⋯ IS is independently associated with HE. Although the accuracy of IS for predicting HE is lower than SS, it can be an alternative predictor if CTA cannot be performed.
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To report a single-center experience with endovascular treatment of ruptured proximal posterior inferior cerebellar artery (PICA) aneurysms. ⋯ Ruptured proximal PICA aneurysms may be effectively treated with endovascular coil embolization. A variety of coil embolization techniques are required to obliterate an aneurysm without parent artery occlusion. Given that recurrence is possible, follow-up is required. Surgical clipping can be performed for recurrence with a relatively low risk of complications, because the aneurysm is unruptured. Coil embolization of a proximal PICA aneurysm in the acute phase can be a good treatment modality with good patient outcomes.
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To investigate the effects of atorvastatin on the surgical treatment of patients with chronic subdural hematoma (CSDH). ⋯ Our findings demonstrate that the administration of atorvastatin perioperatively is associated with a lower risk of CSDH recurrence rate. The use of atorvastatin perioperatively was not associated with higher rates of morbidity or mortality.
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Comparative Study
Racial Differences in the Anatomy of the Posterior Fossa: Neurosurgical Considerations.
Racial differences in anatomy of the cranium exist but have not been specifically considered in neurosurgical access planning. We sought to find differences in the anatomy of the posterior fossa in a cohort study consisting of Asian, African American, and Caucasian patients. ⋯ Significant differences in anatomy have practical implications in the retrosigmoid approach to the cerebellopontine angle. Based on our findings, the junction of the transverse sinus with the sigmoid sinus can differ up to 0.5 cm in the craniocaudal axis depending on race. As neuronavigation is not standard to the approach to the cerebellopontine angle, the study aimed to provide the neurosurgeon operating in the retrosigmoid area additional knowledge to avoid sinus injury with subsequent complications, such as blood loss, sinus occlusion, or air embolism.
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To compare the efficacy of long and short segment instrumentation after pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis caused by ankylosing spondylitis (AS). ⋯ Both approaches were able to maintain sustained surgical outcomes. Short segment instrumentation is recommended for AS patients with bridging syndesmophytes. Long constructs are better indicated for patients without fully ossified anterior longitudinal ligaments. Nevertheless, extension of the length of instrumentation might not prevent complications such as proximal junctional kyphosis or rod fracture in patients without fully ossified vertebrae.