World Neurosurg
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Observational Study
Digital Subtraction Angiography May Reduce the Rate of Radiographic Hemorrhage in Stereo-Electroencephalography.
To study the effect of preoperative digital subtractive angiography (DSA) for planning stereoelectroencephalography (sEEG) electrode trajectories on the rate of postoperative radiographic hemorrhage. ⋯ Analysis of our sEEG series reveals a substantially lower rate of postimplant hemorrhage when compared with the recent cohort studies. Our data indicate that preoperative DSA may be efficacious in reducing the incidence of sEEG postimplant hemorrhages.
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Reports of a duplicated or fenestrated inferior petrosal sinus (IPS) are scarce or not found in the literature, respectively. To our knowledge, there are no cadaveric reports of the latter. ⋯ Unfamiliarity with a duplicated or fenestrated IPS could increase risk of iatrogenic injury and misinterpretation of imaging. Further radiological imaging studies are required to substantiate more accurately the mechanisms by which a duplicated or fenestrated IPS affects clinical outcomes. Nonetheless, anatomical awareness of such lesser known variations of the IPS is crucial for promoting safe and effective interventional approaches at the skull base.
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The objective of the study was to determine home program matching percentage (staying in a program affiliated with one's medical school) for each neurosurgical residency program in the United States. Secondarily, it was to elucidate both program-level and resident characteristics associated with home program matching. ⋯ The results of this study delineate home program matching patterns on a program-by-program level for U.S. neurosurgical residency programs.
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We evaluated the frequency of nasal pathologies and the significance of surgical access to the sellar region in patients who underwent an operation for sellar mass using the endonasal and microscopic transsphenoidal approaches. ⋯ The preoperative evaluation of patients undergoing endonasal transsphenoidal surgery by an ear, nose, and throat surgeon allows for the detection and treatment of nasal pathologies that may lead to serious perioperative and postoperative complications. Evaluating patients with septum deviation using our classification will help determine the necessity of preoperative or perioperative septum surgery, depending on the preferred pituitary surgical method.
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The aims of this study were to determine the time trend of demographics, complications, and outcomes for patients undergoing posterior lumbar interbody fusion/transforaminal lumbar interbody fusion (PLIF/TLIF) or anterior lumbar interbody fusion/lateral lumbar interbody fusion (ALIF/LLIF) and to compare the differences in the time trends between both procedures. ⋯ Time trends for PLIF/TLIF and ALIF/LIIF showed a significant increase in the number of older patients with complex medical status undergoing surgery. Despite these trends, there were decreases in overall postoperative morbidity, incidence of blood transfusion, and length of stay, without increasing readmission. These results suggest general improvement in surgical and perioperative management of lumbar fusion over time with greater gains found in ALIF/LLIF-specific care than in PLIF/TLIF.