World Neurosurg
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Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain. ⋯ Postoperative psychological symptoms clearly correlated with their corresponding preoperative symptoms. Thus, mental health was not negatively affected by the AC experience in our series. Intraoperative fear and pain were not related to the preoperative psychological condition. However, preoperative fear and anxiety were positively related with pain and its interference with daily activity in the immediate postoperative period.
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The transvenous approach via the inferior petrosal sinus (IPS) is the most commonly used route to access cavernous sinus dural arteriovenous fistulas (CSDAVF). The facial (FV) or superficial temporal vein (STV) are alternatives in cases with IPS occlusion. However, navigation through the ophthalmic vein via FV or STV is difficult because of its specific anatomical features, such as abrupt angulations and tortuous course. Herein, we introduce a microwire looping method to overcome these obstacles, thus enabling access to cavernous sinus. ⋯ Making a microguidewire loop to pass through abruptly angulated or tortuous head and neck veins might be an effective and safe alternative for when catheterization is not feasible by the traditional method.
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Granulocyte-colony stimulating factor (G-CSF) has been observed to have direct protective effects on neurons after stroke in experimental models and in humans. In the present study, the antiapoptotic effects of G-CSF on spinal α-motoneurons after inducement of peripheral sciatic nerve lesions were evaluated in a rat model. ⋯ The results indicated that G-CSF has neuroprotective properties in spinal α-motoneurons and contributes to antiapoptotic effects after peripheral nerve lesions. The relevance of G-CSF, its precise mode of action, and the effect of these findings in clinical situations remains to be elucidated and require examination in further studies.
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The present study examined the differences in outcomes of cervical spinal surgery for patients with and without a major psychiatric comorbidity using the Healthcare Cost and Utilization Project National Inpatient Sample database. ⋯ Psychiatric comorbidity was associated with an increased risk of non-home discharge and a longer length of stay for patients undergoing surgical intervention for cervical myelopathy. However, we did not find an associated increased risk of in-hospital mortality, complications, or total hospital charges. Psychiatric comorbidity should not be weighed against patients who require surgical treatment for cervical spondylotic myelopathy, and special attention should be given to postoperative care and discharge planning for this unique patient population.
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The adoption of endovascular techniques for treatment of pericallosal artery aneurysms (PAAs) has been comparatively gradual due to anatomic and technological factors. We conducted a retrospective cohort study to evaluate the outcomes of PAA treatment with coiling and flow diversion at our institution. ⋯ Our study demonstrates that endovascular coiling for PAAs is associated with a definite rate of recurrence, which has to be monitored with timely angiography. We also demonstrate the excellent effectiveness of flow diversion for PAAs with either presentation.