World Neurosurg
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We sought to measure the coronal alignment of the lumbar spine of patients in the right lateral decubitus position on a hinged Jackson operating table with the following 3 table positions: neutral and right and left 20-degree flexion. ⋯ The coronal alignment of the lumbar spine of patients in the right lateral decubitus position on a flat operating table (neutral position) was convex. The right 20-degree flexion position of the hinged operating table yielded less coronal plane lumbar spine deformity, with greater deformity in women.
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Microvascular decompression (MVD) is considered the only etiological treatment for drug-resistant trigeminal neuralgia (TN). Nonetheless, despite the recent technological advances, the risks associated with MVD remain non-negligible. The aim of this study was to evaluate the impact of using neuronavigation on the surgical outcomes of patients with TN submitted for MVD. ⋯ Neuronavigation is a useful tool that significantly reduced craniotomy size, surgical duration, and CSF leak incidence in patients with TN submitted for MVD. We advise to routinely implement neuronavigation in this type of surgery.
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Observational Study
Neurologic factors in patients with vascular mild cognitive impairment based on fMRI.
This study focused on the application of functional magnetic resonance imaging and neuropsychology in diagnosis of vascular mild cognitive impairment (MCI) and the exploration of its relevant factors. The study enrolled 28 patients with vascular MCI in an observation group and 30 healthy individuals in a control group. All patients underwent magnetic resonance imaging. ⋯ Heart disease, such as myocardial infarction and atrial fibrillation, is a high risk factor for vascular MCI. Functional magnetic resonance imaging combined with an automatic segmentation algorithm can noninvasively observe the changes of a patient's brain tissue, which can be used in the recognition of vascular MCI. The global network attributes of patients with depression tend to be more randomized and have stronger resilience under targeted attacks.
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This study aims to examine the risk factors that can cause intraoperative rupture (IOR), and especially, the role of surgical experience. To our knowledge, this is the first study to analyze the effect of the surgeon's experience on the IOR rate in 2 different perspectives. ⋯ Increased surgical experience reduces the IOR rate from 10%-11% to 4%-5% after an average of 250 aneurysm operations. However, this rate does not decrease further with more experience. To our knowledge, a learning curve regarding IOR is presented for the first time in the literature.
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To evaluate outcomes of thrombectomy in patients with a basilar artery occlusion (BAO) and mild symptoms, defined by an initial National Institutes of Health Stroke Scale (NIHSS) score ≤6. ⋯ Thrombectomy seems to be safer and more effective for mild BAO strokes with NIHSS score ≤6 than for more severe patients. Even although thrombectomy showed high rates of recanalization, a substantial proportion (32%) nevertheless had a poor long-term clinical outcome. The number of passes, patient's age, and stroke cause seem to be predictors of clinical outcome.