World Neurosurg
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Randomized Controlled Trial
Prediction of Objectively Measured Physical Activity and Self-Reported Disability Following Lumbar Fusion Surgery.
To investigate the predictive value of preoperative fear-avoidance factors (self-efficacy for exercise, pain catastrophizing, kinesiophobia, and depression), walking capacity, and traditional predictor variables for predicting postoperative changes in physical activity level and disability 6 months after lumbar fusion surgery in patients with chronic low back pain (LBP). ⋯ Patients with low levels of preoperative physical activity were more likely to increase their level of physical activity after lumbar fusion surgery, especially when their self-efficacy for exercise was high. However, most of these patients still had low levels of physical activity after surgery, and they may therefore need extra support in increasing their postoperative physical activity levels.
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Multicenter Study Observational Study
Cranioplasty with porous hydroxyapatite custom-made bone flap: results from a multi-centre study enrolling 149 patients over 15 years.
Despite the mixed evidence regarding the effect of decompressive craniectomy in terms of outcome, a tremendous increase in related reports has been observed in the last years. Cranioplasty plays a key role in restoring function and anatomy of the cranial vault. Considering that cranioplasty is not exempt from risks, the identification of the safest technique becomes crucial to achieve better patients' recovery. Porous hydroxyapatite (PHA) has received growing attention for its potential in bony integration. Here we report a multicenter prospective follow-up analysis of 149 patients who underwent cranioplasty with PHA prostheses. In particular, we focus on the incidence of adverse events and implant removal. ⋯ Hydroxyapatite for cranial implants is fully comparable to other heterologous materials. It has a biologic potential of bony integration. The risk of explants seems to be significantly higher in second-line patients, data not shown in previous studies.
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We sought to identify potential risk factors for the development of shunt-dependent chronic hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH) and external ventricular drain (EVD) insertion. In particular, the role of inflammatory markers within the cerebrospinal fluid (CSF) was assessed. ⋯ The time course of selected inflammatory markers in CSF may support management considerations in the early phase after SAH and critical impairment of CSF circulation.
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This meta-analysis aimed to evaluate the risk of shunt-dependent hydrocephalus among patients with ruptured intracranial aneurysms treated with either coil placement or clipping. ⋯ Microsurgical clipping and endovascular coiling of ruptured cerebral aneurysms are associated with similar incidences of ventricular shunt placement for hydrocephalus. The risk of shunt-dependent hydrocephalus is not higher after coiling than after clipping of ruptured intracranial aneurysms.
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Multicenter Study Controlled Clinical Trial
Association of Cardioembolism and Intracranial Arterial Stenosis with Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke.
To estimate the association of different etiologies of cardioembolism (CE), intracranial arterial stenosis (ICAS), or the combination of these conditions with outcomes of mechanical thrombectomy in acute ischemic stroke. ⋯ The presence of both CE and ICAS was associated with poor outcome in patients with anterior circulation large-vessel occlusion treated with endovascular thrombectomy. Future studies are warranted to further explore this association.