World Neurosurg
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Five billion people worldwide lack access to safe, timely, and affordable surgical and anesthesia care. This deficit is greatest in low- and middle-income countries, especially for specialty surgical services including neurosurgery, due to insufficient personnel, resources, and infrastructure. The southeastern European nation of the Republic of Moldova is one such middle-income country. ⋯ This article provides the first-ever description of the history and current state of neurosurgery in Moldova and presents key recommendations to guide the international neurosurgery community in developing neurosurgical care in countries with an unmet need.
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A male in his 70s presented with progressive vision loss in his right eye for 2 months. The conjunctival vessels in both eyes appeared dark red, excessively dilated, and tortuous. Macular Optical coherence tomography (OCT) revealed macular edema in the right eye. ⋯ The patient was diagnosed with macular edema and tortuous conjunctival vessels secondary to a carotid cavernous fistula (CCF). Subsequently, the patient underwent endovascular interventional embolization of the fistula, resulting in complete occlusion of the fistula. At the one-month follow-up, the patient reported that the redness in his eyes had disappeared and his vision had improved.
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To analyze the clinical efficacy of ultrasonic bone scalpel (UBS)-assisted unilateral biportal endoscopic lamina osteotomy replantation (ULOR) for treating lumbar infectious spondylitis (LIS). ⋯ The use of ULOR with assistance from UBS for the treatment of LIS has proven to be beneficial. It provides significant relief from symptoms and corrects lumbar deformity. This surgical procedure is both effective and safe.
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Deep venous thromboembolisms (DVT) increase morbidity in postoperative patients, and no current guidelines identify which patients undergoing endoscopic endonasal approach (EEA) to the skull base may be at increased risk. Postoperative care for these patients often includes a period of inactivity to prevent transient ICP shifts which may impact skull base reconstruction. We seek to characterize if postoperative bedrest puts EEA patients at increased risk of developing thromboembolic complications. ⋯ Short-term bedrest after EEA is not a risk factor for development of VTE in the immediate postoperative period.
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Pain is a complex sensory and emotional experience that significantly impacts individuals' well-being. Lumbar radicular pain (LRP) is a prevalent neuropathic pain affecting 9.9% to 25% of the population annually. Accurate identification of pain patterns in LRP is essential for diagnosis and management. Artificial intelligence has potential in health care but faces challenges in reliability and accuracy. This study aimed to investigate the accuracy and consistency of LRP patterns demonstrated by ChatGPT-4o. ⋯ ChatGPT currently lacks the capacity to accurately and consistently represent LRP patterns. AI tools in health care require further refinement, validation, and regulation to ensure reliability and safety. Future research should involve multiple AI platforms and broader medical conditions to enhance generalizability.