World Neurosurg
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To develop and validate a risk-scoring model for predicting recurrent hypertensive cerebral hemorrhage (RHCH) occurring within 1 year after initial hypertensive cerebral hemorrhage and to facilitate preemptive clinical intervention for the prevention of secondary hemorrhage. ⋯ This model will help identify high-risk groups for RHCH in order to facilitate and improve preemptive clinical intervention.
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In the management of meningiomas invading the major venous sinuses, balance between tumor control and complication prevention is desirable. The aim of this study was to describe an institutional experience in management of meningiomas involving major venous sinuses. ⋯ Management of meningiomas involving major venous sinus with microsurgical techniques and adjuvant Gamma Knife radiosurgery achieves a good tumor control rate with an acceptable complication rate.
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Diagnosis of idiopathic normal pressure hydrocephalus is based in clinical data, radiologic variables, and invasive cerebrospinal fluid (CSF) testing, such as the lumbar infusion test. Several neuroimaging findings are inconclusively related to improvement after CSF shunt surgery. CSF tests are invasive and have complications. The aim of this study was to select radiologic variables related to a positive lumbar infusion test so as to avoid this test in patients. ⋯ Owing to high positive predictive values of matched radiological variables, the lumbar infusion test could be avoided in the diagnosis of idiopathic normal pressure hydrocephalus. However, when 1 or 2 of the variables are negative, this invasive test should be performed.
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Mechanical thrombectomy (MT) became a standard of care for stroke patients after the positive results of 5 randomized trials in 2015. However, elderly patients >65 were excluded from those trials. Recent studies and clinical trials examining the efficacy of MT in patients older than the age of 85 have shown that good outcomes can be achieved with careful patient selection. ⋯ We believe that MT in centennials is technically safe and effective and should be considered. In this age group a careful assessment of existing medical condition and a thorough discussion with the family about goals of care is of paramount importance to optimize clinical outcomes.
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The middle cluneal nerves (MCNs) are stated to arise from the sacral dorsal rami of S1 to S3 and supply the gluteal skin, but their detailed anatomy is unclear and often variably depicted and described. Therefore, the goal of this study was to revisit the anatomy of the MCNs and provide a clearer picture of their morphology. ⋯ We clarified the anatomy and variations of the MCNs and revisited its current nomenclature. Such knowledge might improve diagnoses and invasive procedure outcomes in patients with pathology in the region of the MCNs.