World Neurosurg
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Colloid cysts, although benign, may occasionally cause obstructive hydrocephalus and sudden death. Reliable prognostic factors for symptomatic progression have been sought, with heterogenous results. ⋯ Only a few asymptomatic colloid cysts showed progression requiring surgery, with no acute deterioration or fatal events, whereas the rest remained stable over time, thus supporting a more conservative approach for this group of patients. Higher risk for developing symptomatic colloid cyst was defined by a risk score that included T1-weighted magnetic resonance imaging appearance, risk zone, and colloid cyst volume, aiding the detection of patients at risk of clinical deterioration.
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Deep venous thrombosis (DVT) is considered the most common cause of preventable death among hospitalized patients. A few studies have investigated the risk of venous thromboembolic events in patients undergoing elective spine surgery and reported varying incidences. We aim to assess the incidence of preoperative lower limb DVT in patients with lumbar degenerative disease undergoing elective surgery. ⋯ Patients with LST or SPL with higher preoperative disability scores were at higher risk to have preoperative DVT. Further research is needed to evaluate the feasibility and value of preoperative LLVD to detect DVT in patients planned for lumbar degenerative surgery.
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The flow diversion technique is increasingly used for reconstructive endovascular treatment of fusiform cerebral aneurysms. Double stenting with the Low-profile Visualized Intraluminal Support (LVIS) Blue stent is one of the flow diversion techniques. The aim of this study was to analyze the clinical and angiographic outcomes of LVIS Blue double stenting for fusiform cerebral aneurysms. ⋯ Double stenting using LVIS Blue stents for the treatment of fusiform cerebral aneurysms is effective and safe.
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American College of Surgeons National Surgical Quality Improvement Program Participant Use File data from 2014 through 2019 were used to compare 1- and 2-level anterior cervical discectomy and fusion (ACDF) and cervical total disc replacement (cTDR) with respect to: patient demographics, comorbidities, adverse events, and 30-day morbidity rates. ⋯ Adjusting for demographics and comorbidities; ACDF has a higher average risk of adverse event. When ACDF and cTDR are equipoise, consideration for cTDR may be indicated in populations with higher rates of comorbid conditions.
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Cavernous sinus dural arteriovenous fistula (DAVF) was a special type of intracranial vascular malformation, and endovascular treatment was usually the first choice. However, sometimes it might fail for patients without the proper approach. Video 1 illustrates the case of a patient who presented with left exophthalmos and conjunctival hyperemia caused by cavernous sinus DAVF. ⋯ Endovascular treatment remained the optimal choice for cavernous sinus DAVF. However, for practical cases without accessible pathways, combined microsurgical and endovascular management in a hybrid neurovascular operating room was feasible, although challenging. The patient gave informed consent for the procedure and video production.