World Neurosurg
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Traumatic brain injuries (TBIs) are largely underdiagnosed and may have persistent refractory consequences. Current assessments for acute TBI are limited to physical examination and imaging. Biomarkers such as glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and S100 calcium-binding protein B (S100B) have shown predictive value as indicators of TBI and potential screening tools. ⋯ GFAP, UCH-L1, and S100B demonstrated utility for rapid prediction of a CT-positive TBI within 0-8 hours of injury. GFAP exhibited the greatest predictive power at 12-32 hours. Furthermore, these results suggest that GFAP alone has greater utility for predicting a positive CT of the head than UCH-L1, S100B, or any combination of the 3.
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Metastasis from melanoma carries poor prognosis and survival. Average life expectancy is estimated 4 to 6 months after diagnosis of skeletal metastasis. Comprehensive treatment, along with newer immunotherapies, has shown promising results. ⋯ Our report emphasizes the importance of regular and critical surveillance of the disease and aggressive surgical and medical management in melanoma.
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Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for patients with Parkinson disease. One adverse event is the development of postoperative confusion. The aim of this study was to report the incidence and associated factors of postoperative confusion after STN DBS surgery. ⋯ The incidence of postoperative confusion in this cohort was 26.5%. After analysis of confounding factors, the Charlson comorbidity index was significantly associated with postoperative confusion.
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Case Reports
Rare hereditary Klippel-Feil syndrome and Arnold-chiani Malformation caused by cervical spondylotic myelopathy.
A rare case of familial genetic disorder Klippel-Feil syndrome and Arnold-Chiari malformation caused by cervical spondylotic myelopathy was reported here. ⋯ Although the disease genetic characteristics have been studied, operation is necessary when it leads to abnormal neurologic symptoms and the surgery of surgery can have a beneficial outcome.
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Case Reports
Double-barrel STA on proximal MCA bypass to treat complex intracranial aneurysms: a reliable high blood flow bypass.
The superficial temporal artery (STA) to proximal middle cerebral artery bypass has been reported before. However, the flow supply capacity of the double-barrel STA to proximal MCA bypass in treating complex intracranial aneurysms has not been well documented. ⋯ When anastomosed to proximal branches, a double-barrel STA to MCA bypass can reliably provide a high blood flow of >100 mL/minute. Combined with aneurysm trapping or parent artery occlusion, this bypass algorithm could be an alternative treatment for complex intracranial aneurysms.