World Neurosurg
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Limited information is available about the hospital types to which patients with intracerebral hemorrhage (ICH) are admitted and treated. This could be important because some effective therapeutic measures can only be administered at comprehensive stroke centers (CSCs). ⋯ Despite a considerable proportion of ICH patients remaining at a non-CSC for their entire hospitalization, the short- and long-term mortality were comparable between the 2 hospital types. More studies are required to determine whether outcomes other than mortality might be related to the admitting hospital type and whether the routing protocols for ICH patients should be modified.
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The treatment of high-grade arteriovenous malformations (AVMs) remains challenging. Microsurgery provides a rapid and complete occlusion compared with other options but is associated with undesirable morbidity and mortality. The aim of this study was to compare the occlusion rates, incidence of unfavorable outcomes, and cost-effectiveness of embolization and stereotactic radiosurgery (SRS) as a curative treatment for high-grade AVMs. ⋯ Both techniques achieved similar occlusion rates, but SRS carried a lower risk of complications. Staged embolization may be associated with a greater risk of hemorrhage, whereas SRS was shown to have a better cost-effectiveness ratio. These results support SRS as a better treatment option for high-grade AVMs.
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Based on the positron emission tomography (PET) computed tomography (CT) image segmentation algorithm, this article explores the application of PET/CT in the recurrence and metastasis of thyroid cancer after differentiated thyroid cancer (DTC). ⋯ PET/CT and 131I scans are similar in the diagnosis of residual thyroid and lymph node metastasis, but PET/CT has more advantages than does the 131I scan in the diagnosis of bone metastasis and lung metastasis. PET/CT can still find other benign and malignant lesions, which is of great value in the restaging of DTC. The imaging effect of WBS lung lesions in older patients is not good. The presence of stripe, calcification, and patch shadows in the lungs is not conducive to the imaging of WBS lung metastases. Lung strips and calcification affect the WBS lung main factors for imaging of metastases.
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Case Reports
Minimally Invasive Microsurgical Technique for Evacuation of Deep Intracerebral Hematomas.
Despite the lack of conclusive outcome data, surgical evacuation of large, symptomatic intracerebral hematomas (ICH) may be offered to patients on a case-by-case basis, aiming to prevent brain herniation, control intracranial pressure, relieve symptoms, and possibly facilitate or accelerate recovery.1-3 For deep ICH, minimally invasive techniques, which limit operative damage to healthy brain tissue, are generally preferred. Although new tube and endoscope-based techniques are currently being studied,4-7 those elaborate techniques are not widely available and often require special equipment and/or expensive disposable material. ⋯ We acknowledge that this technique or a modification thereof may currently be in use by other neurosurgeons in their practice.8 However, to the best of our knowledge, a step-by-step microsurgical video illustration of this technique has not been previously published. Although this technique can be broadly used by neurosurgeons, irrespective of the hospital setting, it would be particularly valuable in settings where expensive cutting-edge technology is not readily available.
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Post-traumatic hydrocephalus (PTH) is a common complication of craniocerebral injury. If not diagnosed in time, PTH can lead to clinical deterioration and a poor prognosis. The early diagnosis of PTH can lead to success with early treatment. However, PTH can be easily ignored during rehabilitation. The main purpose of the present study was to investigate whether plasma S100B protein levels can be used as a biochemical predictive index of PTH. We also explored the correlation among S100B protein levels, intracranial pressure, and PTH severity. ⋯ Measurements of serum S100B can be used to predict for PTH. We found a positive correlation between S100B levels and intracranial pressure but no correlation with the severity of PTH. Thus, serum S100B could have important clinical significance for the early detection and evaluation of PTH.