World Neurosurg
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Observational Study
Urban-rural inequalities in care and outcomes of severe traumatic brain injury: A nationwide inpatient database analysis in Japan.
This study aimed to investigate urban-rural inequalities in care and outcomes of severe traumatic brain injury (TBI). ⋯ There are significant urban-rural inequalities in TBI in Japan, and the gap in in-hospital mortality has not improved over the last 10 years. Improving TBI care in rural communities may be a target for reducing disparities in health care.
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Neurosurgery has a high barrier of educational access for medical students. The Medical Student Neurosurgery Training Center (MSNTC) is a novel online learning platform that provides on-site and virtual training opportunities and resources that aim to increase student access to neurosurgical education. The objective of this article was to describe student-reported utility of Medical Student Neurosurgery Training Center educational resources. ⋯ Medical Student Neurosurgery Training Center resources appear to have promising preliminary benefits for students. Increasing medical student awareness, continued development of these resources, and objectively assessing outcomes in neurosurgery education are warranted.
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Long-term durability and recurrence patterns after endovascular treatment for basilar tip aneurysms.
Treating recurrence after coil embolization of basilar tip aneurysm remains challenging even with the development of endovascular procedures. The present study evaluated long-term durability and recurrence patterns after endovascular treatment of basilar tip aneurysms. ⋯ Recurrence after coil embolization for basilar tip aneurysms is associated with large aneurysms and incomplete occlusion at initial embolization. Understanding the patterns of recurrence is useful for predicting recurrence and selecting treatment strategies.
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To propose a machine learning (ML) model predicting the favorable outcome of stereotactic radiosurgery (SRS) for residual brain arteriovenous malformation (bAVM) after partial embolization. ⋯ Dosimetric features are good predictors of prognosis for patients with partially embolized bAVM followed by SRS therapy. The use of ML models is an innovative method for predicting favorable outcomes of partially embolized bAVM followed by SRS therapy.
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Surgical site infections (SSIs) after spine surgery are a significant cause of morbidity. Surgeons often prescribe oral antibiotics in the postoperative setting for infected-appearing wounds to prevent reoperation for infection; however, the efficacy of this practice has not been well studied. ⋯ Wound infection remains a challenging problem in spine surgery and it is reasonable to perform early reoperation in patients with high clinical concerns for infection, because bacterial isolates are often resistant to common oral antibiotics. Patients with wounds with low clinical concerns for infection may undergo a trial of oral antibiotics; however, duration of treatment should not be prolonged.