World Neurosurg
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Comparative Study
Early vs. Delayed Surgical Management of Ruptured Arteriovenous Brain Malformations in a Tertiary Referral Center in Colombia, South America.
Surgical timing after rupture of brain arteriovenous malformations (AVMs) is controversial. There is scarce literature on AVM surgical outcomes from developing countries. This study aims to determine if there is a difference between early and delayed surgical resection for patients with ruptured brain AVMs. ⋯ In this case series of 31 patients from a developing country, there were no differences in clinical outcomes at the final follow-up between acute and delayed surgical interventions for ruptured AVMs. The most important factor associated with the final outcomes was the initial Glasgow Coma Scale.
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To objectively correlate distortions of optic apparatus morphology in patients with pituitary adenomas undergoing trans-sphenoidal surgery. ⋯ Anatomic realignment of the optic apparatus 3 months following trans-sphenoidal surgery predicts VF scores, but not VA or TV scores at 1-year follow-up. Patients with preoperative ONKA values of more than 139.3° have a 76% chance of achieving normal TV scores 1 year after surgery. Postoperative chiasm sag appears to be clinically irrelevant at short-term follow-up.
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This study aimed to investigate the incidence and risk factors for sacral fractures following lumbosacral fusion. ⋯ The overall incidence of sacral fracture was 10.8%. In our study, advanced age, low BMD, long fusion levels, and preoperative compensatory pelvic retroversion and excessive correction of it were risk factors for sacral fractures.
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Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke, and most favorable treatments to improve patients' neurologic outcomes are not clear. Invasive intracranial pressure (ICP) monitoring is a common treatment of ICH, but whether patients with ICH could benefit from ICP monitoring is controversial. ICP variability (IPV) has been shown to correlate with poor outcomes in patients with subarachnoid hemorrhage and traumatic brain injury, but this association has not been clearly elucidated in patients with ICH. We hypothesized that 72-hour IPV from time of ICP probe implantation is associated with outcomes in patients with ICH. ⋯ IPV during the first 72 hours after ICP implantation in patients with ICH was independently associated with poor functional outcome at 3 months. Stabilization of IPV during hyperacute and acute periods may be a potential therapeutic target to improve functional outcomes of these patients.
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Razorback deformity with stiff thoracic scoliosis creates a complex three-dimensional deformity. Posterior spinal fusion (PSF) and thoracoplasty can correct rib hump deformity and improve patient satisfaction. However, conventional thoracoplasty may impair pulmonary function and increase complications. We present a modified thoracoplasty (MTP) technique for addressing rib hump deformity in stiff thoracic scoliosis patients, emphasizing its clinical efficacy and safety. ⋯ MTP provides enhanced correction of thoracic curve and rib hump deformity without significantly increasing pulmonary function impairment or complication rates. It also improves patients' self-image, making it a valuable addition to PSF in treating stiff thoracic scoliosis with rib hump deformity.