World Neurosurg
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Thrombectomy increases the survival rate of acute ischemic stroke patients corresponding to large vessel occlusion. This study aimed to determine clinical predictors for good outcomes in patients subjected to tissue window guided thrombectomy. ⋯ A lower initial NIHSS score, smaller ischemic penumbra, and lack of hemorrhagic transformation are significant independent predictors for good outcomes after a tissue-window based thrombectomy.
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Artificial intelligence (AI) has the potential to disrupt how we diagnose and treat patients. Previous work by our group has demonstrated that the majority of patients and their relatives feel comfortable with the application of AI to augment surgical care. The aim of this study was to similarly evaluate the attitudes of surgeons and the wider surgical team toward the role of AI in neurosurgery. ⋯ This survey highlights that the majority of surgeons and the wider surgical team both agree and are comfortable with the application of AI within neurosurgery.
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Frailty is an increasingly studied tool for preoperative risk stratification, but its prognostic value for anterior cervical discectomy and fusion (ACDF) patients is unclear. We sought to evaluate the association of the 5-item modified Frailty Index (5i-mFI) with 30-day adverse outcomes following ACDF and its predictive performance compared with other common metrics. ⋯ The 5i-mFI was found to be significantly associated with 30-day adverse outcomes following ACDF but had similar or lesser predictive performance compared with more universally available and easily implemented metrics, such as ASA classification and age.
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Lumbar epidural lipomatosis is a rare condition defined as the excessive accumulation of epidural fat (EF). We herein investigated the indicators of the posterior compression factors, EF and yellow ligament, to identify the clinical features of lumbar epidural lipomatosis. ⋯ The EF/SC-L index is a simple and reliable indicator to quantitatively evaluate posterior compression in patients with LSS. As the accumulation of EF is associated with worse operative outcomes, the EF/SC-L index should be considered when planning lumbar decompression surgery for patients with LSS.
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Case Reports
AN EPIDERMOID CYST EXTENDING ALONG TRIGEMINAL NERVE PATHWAY WITH UNUSUAL IMGAGING FINDINGS.
Epidermoid cysts (ECs) are benign extraaxial tumors. They frequently occur at the cerebellopontine angle and parasellar regions. However, they rarely occur in the Meckel's cave. ⋯ Preoperative suspicion was trigeminal schwannoma with unusual radiologic features. Finally, the pathologic diagnosis was epidermoid cyst. Therefore to establish a proper preoperative diagnosis, one should be aware that ECs can occur in Meckel's cave and with unusual radiologic features, as occurred in the case described earlier.