World Neurosurg
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Several studies have documented improved outcomes at high-volume hospitals for neurosurgery. However, the relationship between neurosurgical volume and costs remains poorly understood. ⋯ High-volume hospitals provide more cost-effective neurosurgical care. Centralization of care at high-volume neurosurgical institutions may be a promising strategy to delivering higher-value care, achieving better outcomes at lower costs.
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Hyperactive dysfunction syndrome (HDS) of the cranial nerves, such as trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN), is commonly managed by microsurgical treatment. However, certain patients may present a combination of these syndromes in the neurosurgery department. Here, we aimed to retrospectively assess patients with combined HDS from a single center. ⋯ Combined HDS involves a group of functional disturbance disorders affecting specific cranial nerves, and it may include TN, HFS, and GPN. In addition to gender and incidence of hypertension, age appeared to be a vital indicator for the development of combined HDS, although this finding was inconsistent in previous studies. MVD appears to be a safe and effective treatment for combined HDS, with a high rate of long-term success.
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The aims of this study were to evaluate the risk factors for muscle injury in patients undergoing posterior lumbar spinal surgery and the clearance of postoperative biochemical changes following lumbar fusion and secondarily to evaluate the timing for monitoring postoperative biochemical serum levels and potential clinical correlation. ⋯ The risk of RML increases with prolonged and invasive surgery with higher bleeding potential. Knowing the clearance of postoperative biochemical changes permits a standardized strategy with measurements in precise intervals, thereby avoiding unnecessary costs. The clinical significance is still undetermined.
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Primary central nervous system (pCNS) melanoma is an extremely rare malignant tumor. We explored the incidence, outcomes, and predictors of pCNS melanoma. ⋯ The overall age-adjusted incidence rate of pCNS melanoma is 0.52 per 10,000,000 person-years. Age ≤19 years and intracranial tumor location are independent risk factors of low survival rate, whereas gross total resection is associated with better survival rate.
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Acute anterior inferior cerebellar artery (AICA) occlusion is considered an acute ischemic stroke requiring medical treatment without mechanical thrombectomy (MT). There is a procedural risk of parent vessel rupture, but neurologic deficits are not generally severe. Here, we report a case of MT performed using partially deployed stent retrieval for acute AICA occlusion. ⋯ Our case suggests that MT can be performed in a highly selective manner in patients with the occlusion of a posterior circulation branch, such as the AICA, and yield a good clinical outcome.