World Neurosurg
-
To investigate potential risk factors for cerebral hyperperfusion syndrome (CHS) after surgery in patients with moyamoya disease (MMD) using phase-contrast magnetic resonance imaging (MRI). ⋯ Patients with MMD and ischemic onset symptoms are more likely to develop CHS after surgery. Preoperative phase-contrast MRI analysis may be helpful to predict CHS in patients with MMD after surgery.
-
Iatrogenic spinal cord injury (iSCI) during spinal corrective surgery can result in devastating complications, such as paraplegia or paraparesis. Perioperatively, iSCI often occurs as a direct injury during spinal cord instrumentation placement. Currently, treatment of iSCI remains limited to posttraumatic hypothermia, which has demonstrated some value in recent clinical trials. Here we report the outcomes of preinjury hypothermia initiated preprocedurally and maintained for a considerable time after iSCI. ⋯ The use of prophylactic hypothermia before iSCI was significantly associated with an increased survival rate, higher BBB scores, and improved neurophysiological measures.
-
Calcification of intervertebral disc is a common impairment, which has been considered as the degenerative condition of the spine. In clinical practice, we note that the onset of intervertebral disc calcification (IDC) and ossification of the posterior longitudinal ligament (OPLL) can exist simultaneously in some cases, especially in younger children. However, only 8 cases have been reported in detail previously. In addition, controversy remains in terms of the best way to treat this condition. ⋯ Pediatric IDC accompanied with OPLL is much less frequent, but we must be aware of this disease. Since the distribution of this disease is age-specific and sex-specific, further research is necessary. Treatment for IDC combined with OPLL needs to follow the treatment principles as described in the text.
-
We analyzed the effect of specific optimization steps to reduce treatment delays in a nonacademic stroke hospital setting. ⋯ For acute reperfusion therapies, significant reductions in workflow intervals can be achieved after simple optimization methods in a nonacademic community-based hospital.
-
An appropriate time (5-7 days) of discontinuation of low-dose acetylsalicylic acid (ASA) in patients undergoing surgery for chronic subdural hematoma (CSDH) is recommended. However, patient clinical deterioration often does not allow to wait the recommended time for surgery. Clear guidelines regarding the perioperative management of patients with ASA therapy are still lacking. The aim of this study is to compare the surgical outcome, complications, and mortality of patients suffering from CSDHs who underwent urgent surgery or before and after 5 days of discontinuation of low-dose ASA. ⋯ Our data showed that the time of discontinuation of ASA does not influence outcome.