World Neurosurg
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Assess the complications, clinical outcomes, and angiographic results of ruptured intracranial posterior circulation aneurysms in small arteries, and identify their risk factors. ⋯ Reconstructive endovascular treatment for ruptured intracranial posterior circulation small artery aneurysms is generally safe and effective. However, the risk of complications and unfavorable clinical outcomes persists. Early surgery within 72 hours post-rupture and external ventricular drainage are significant risk factors for in-hospital complications, whereas older age and higher WFNS grades are predictors of poor clinical outcomes.
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Surgery is the preferred option for lumbar spinal stenosis (LSS) when conservative methods cannot meet the needs. Recent advancements in surgical techniques have brought various new methods for treating LSS. ⋯ Endoscopic decompression can effectively improve short-term back VAS scores and reduce hospital stays, while IPSD is effective in reducing long-term back VAS scores with minimal surgical duration and blood loss.
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Trigeminal neuralgia (TN) has been described as one of the worst pains known to humankind. However, pain severity in TN has been measured using several different scales, resulting in difficulty comparing illness burden and response to TN surgery across studies. We examined the degree of concordance between standardized scales evaluating pain severity in a cohort of patients undergoing surgery for TN. ⋯ The degree of agreement across all three scores was moderate (ICC = 0.72). TN patients with residual mild-moderate pain after surgery are often discordantly classified by different pain measurement scales. These findings argue for a more standardized method of reporting port-operative pain outcomes in the TN literature.
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The application of the transorbital approach (TO) for vascular lesions has been scarcely explored. In this anatomical experience, we examine the carotid and middle cerebral arteries from the TO perspective and investigate the feasibility for vascular clipping in a pseudo-vascularised model. ⋯ The TO approach provides anatomical access to lateral and dorsal carotid siphon, complete posterior communicating and proximal middle cerebral artery. This preliminary experience suggests potential application in the elective treatment of paraclinoid and posterior communicating aneurysms.
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Patients with acute ischemic stroke (AIS) have limited evidence regarding the relationship between blood urea nitrogen and albumin (BUN/ALB). Aiming to investigate the relationship between the BUN/ALB ratio and poor outcomes in AIS patients at 3-months was the purpose of this study. ⋯ The BUN/ALB ratio and poor outcomes in AIS patients show a nonlinear correlation. For AIS patients, a BUN/ALB ratio of approximately 0.326 is associated with the lowest risk of adverse outcomes at 3 months. Specifically, for non-smoking AIS patients, a BUN/ALB ratio of approximately 0.295 is associated with the lowest risk of adverse outcomes at 3 months.