World Neurosurg
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Venous thromboembolism (VTE) represents a significant source of morbidity and mortality in the inpatient population and is considered a leading preventable cause of death among inpatients. Neurosurgical inpatients are of particular interest because of the greater rates of immobility, steroid use, and potential consequences of postoperative hemorrhage. A consensus protocol for VTE screening in this population has not yet been developed, and institutional protocols vary widely. ⋯ Our findings lend support to preoperative screening of high-risk patients and suggest that routine postoperative VDUS surveillance of asymptomatic patients is unnecessary.
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Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been performed as a minimally invasive surgery for lumbar degenerative disease, but previous MIS-TLIF methods have shown limitations by their own characters. In this study, we developed a newly interbody fusion technique of full-endoscopic posterior lumbar interbody fusion (FE-PLIF) via an interlaminar approach, presented its preliminary clinical results in comparison with MIS-TLIF procedure. ⋯ The FE-PLIF interlaminar approach is a safe and effective interbody fusion technique with less surgical trauma and similar outcomes compared to MIS-TLIF. However, this technique still requires technical advancements to improve efficiency and reduce technical complexity.
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To determine preoperative factors contributing to postoperative hemorrhage after stereotactic brain biopsy (STB), clinical implications of postoperative hemorrhage, and the role of postoperative imaging in clinical management. ⋯ Postbiopsy hemorrhage was associated with higher risk of immediate and delayed postoperative deficit and seizure. Postoperative computed tomography should be used to determine whether STB patients can be discharged same day or admitted for observation; clinical evaluation should determine return to OR for evacuation.
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Case Reports
Successful Relief of Abdominal Dystonia After Sequential GPi Pallidotomy with 2-Year Follow-Up.
Abdominal dystonia is very rare. To our knowledge, no clinical study has reported its specific treatment. Stereotactic therapy has been used to treat several movement disorders, including focal and general dystonia. We investigated the use of internal globus pallidum (GPi) pallidotomy for abdominal dystonia after failed oral medication. ⋯ GPi pallidotomy is feasible and effective for the treatment of abdominal dystonia that is resistant to standard medical therapy.
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The popularity of the ventriculoatrial shunt as a means for cerebrospinal fluid diversion was temporally limited, overcome by the success of the peritoneum as a site for distal drainage. Nevertheless, it remains an important tool for patients for whom ventriculoperitoneal shunting is not an option. ⋯ Recognizing the potential for atrial thrombus formation and using a team approach can help avoid a poor outcome.