World Neurosurg
-
Observational Study
Same-Year Repeat Concussions in the National Football League: Trends from 2015 through 2019.
Sport-related concussion (SRC) prevention and management is a focus of the National Football League (NFL). While most prior reports evaluated sport-related concussion incidence, few have studied same-year repeat concussions. This study aimed to evaluate the frequency of same-year repeat concussions in the NFL. ⋯ The risk of a repeat concussion was similar to the risk of sustaining a single concussion among NFL players. More time was missed following a same-year repeat concussion compared with single or initial concussions. Further research is needed to maximize player safety and minimize same-year repeat concussions.
-
Observational Study
Statistical Approaches for Quantifying the Quality of Neurosurgical Care.
Quantifying quality of health care can provide valuable information to patients, providers, and policy makers. However, the observational nature of measuring quality complicates assessments. ⋯ By combining multiple quality measures using item response theory models, a composite measure can be estimated that has more statistical power to detect differences among subjects than the observed mean per subject.
-
Malignant ischemic stroke (MIS) occurs in a subgroup of patients with cerebrovascular accident who sustain massive or significant cerebral infarction. It is characterized by neurological deterioration owing to progressive edema, raised intracranial pressure, and cerebral herniation. Decompressive craniectomy (DC) is a surgical technique that can be used to treat select cases of this condition in the presence of medically refractory intracranial hypertension. This study aimed to identify prognostic factors associated with clinical outcome, including timing of the procedure, and postoperative mortality. ⋯ Patients in whom more time passed from presentation to the neurosurgical procedure, owing to living in a distant city or taking more time to be seen by a specialist, tended to have a worse prognosis. The timing of procedure, surgical side, and hospitalization length were independent predictors in determining the prognosis of patients who underwent DC after an MIS.
-
Medical research is increasing in complexity with every year. The breadth of possibilities is expanding with every new methodologic and statistical innovation. ⋯ Lately, owing to serious improvements made to study design quality, the neurosurgical evidence base is growing. The special section on neurosurgical study design highlights the most important methodologic concepts to date and illustrates the most important methodologic advancements, which will shape the future of neurosurgical study design.
-
To evaluate demographics, treatment options, and outcomes of traumatic brachial plexus injuries in pediatric patients. ⋯ Pediatric traumatic brachial plexus injuries are often high-energy injuries resulting in nerve root avulsions. Most patients were able to regain antigravity elbow flexion or stronger after brachial plexus reconstruction, and more than half had similar improvement in shoulder function. Treatment should be directed with goals of elbow flexion, shoulder stability/external rotation, and rudimentary grasp.