World Neurosurg
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Intraoperative ultrasounds for surgery of cranial traumatic acute subdural hematoma: Technical note.
Intraoperative ultrasonography (IOUS) in traumatic brain injury is a fast, easy, and low-cost technique that has been poorly investigated so far even though it could potentially answer many of the intraoperative needs of the surgeon. The aim of this study was to investigate the role of IOUS in patients undergoing surgery for traumatic acute subdural hematoma (aSDH), focusing on its influence on intraoperative surgical strategy, particularly regarding the management of intracerebral contusions (ICCs) associated with aSDH. ⋯ Our study suggests that IOUS in patients undergoing surgery for traumatic aSDH can promptly identify possible evolution of a primary head injury, leading to early and effective treatment.
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We aimed to describe the initial experience of mechanical thrombectomy using tandem double stent retrievers combined with intermediate catheter aspiration to treat refractory severe hemorrhagic (SH)-cerebral venous sinus thrombosis (CVST). ⋯ MT-TDSA for refractory SH-CVST might improve clot-capturing ability and remove blood clots from cerebral venous sinuses effectively and safely, achieving good clinical outcomes.
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Laparoscopic ventriculoperitoneal shunt surgery has been reported to have several advantages in selected patients. However, the prognostic factors have been understudied specifically for this surgery. We sought to investigate the factors influencing the complications after the laparoscopic ventriculoperitoneal shunt placement. ⋯ Ventriculoperitoneal shunt surgery provided benefits with little complication rate, whereas patients treated with nonprogrammable shunts and obese patients had less favorable outcome. A positive correlation between the vertical distance from the distal tip to the bottom of peritoneal cavity and pressure adjustments inferred to the advantage of the laparoscopic method.
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To compare perioperative characteristics and patient-reported outcome measures (PROMs) in workers' compensation (WC) patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in either the inpatient/outpatient setting. ⋯ Despite more comorbidities and worse perioperative measures, the IC showed improved PROMs from preoperative to ≥1 follow-up visit, whereas the OC had improvement with only VAS back and leg. The IC showed multiple MCID achievements, whereas the OC showed MCID in only SF-12 PCS. These findings may help guide a surgeon's decision making between inpatient/outpatient lumbar surgery in the WC population.
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Although pituitary adenomas and intracranial aneurysms often coexist,1 the locations of these lesions rarely affect surgical planning. In such cases, however, a simultaneous (rather than staged) approach avoids multiple procedures or delays in treating the dominant pathology. Building on limited prior reports of transnasal aneurysm clipping,2-6 we describe simultaneous transnasal treatment of an adrenocorticotropic hormone-secreting adenoma and a paraclinoid aneurysm in a 35-year-old woman (Video 1). ⋯ Postoperatively, the patient developed transient diabetes insipidus and hydrocortisone dependence but was neurologically intact and eupituitary on follow-up. With sufficient transnasal and vascular surgical experience, transnasal clipping of aneurysms can be safely performed in very selected cases. The patient consented to the procedures and publication.