World Neurosurg
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Assess the complications, clinical outcomes, and angiographic results of endovascular treatment (EVT) for ruptured intracranial posterior circulation aneurysms in small arteries, and identify their risk factors. ⋯ Reconstructive EVT for ruptured intracranial posterior circulation small artery aneurysms was generally safe and effective. However, the risk of complications and unfavorable clinical outcomes persisted. External ventricular drainage was a significant risk factor for in-hospital complications, whereas older age and higher World Federation of Neurosurgical Societies grades were predictors of unfavorable clinical outcomes.
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The management of multiple intracranial aneurysms poses a significant clinical challenge.1 Various factors, including the patient's neurologic status, age, risk factors, aneurysm morphology, location, ruptured or unruptured status, availability of equipment, the surgeon's surgical abilities, and patient preferences, influence the choice of treatment modality.2 It has been observed that there is a higher risk of rupture during the perioperative period when surgical intervention is performed to treat a ruptured aneurysm.3 Additionally, it is suggested that patients with multiple aneurysms located in both the anterior and posterior circulation are less likely to be treated with a single procedure.4 This surgical strategy should be applied in the setting of multiple aneurysms in the anterior and posterior circulation that would, on the other hand, demand multiple interventions.5 In an experienced scenario, microsurgery could be a viable option. We present the case of a 58-year-old patient who presented with chronic headaches, a medical history of hypertension, and tobacco use. The patient had no neurologic deficits. ⋯ The patient consented to the procedure and publication of her image. No institutional research ethics board approval was required because only intraoperative footage was shown. No identifiable data are displayed except for 2 photographs of the patient's head without the face, which was appropriately consented to.
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The purpose of this study was to investigate whether the preservation of the anterior edge of the vertebral body affects the cage subsidence and clinical outcomes after anterior cervical discectomy and fusion (ACDF) using zero-profile cages. ⋯ For patients who undergo ACDF with zero-profile cages, especially those with a higher surgical segment, bone protection at the anterior edge of the vertebral body can effectively reduce the risk of zero-profile cage subsidence, but there is no difference in the final clinical effect.
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To investigate the treatment effect and prognosis of posterior fossa epidural hematoma in children by different surgical methods. ⋯ The effect of minimally invasive skull trepanation and drainage in the treatment of posterior fossa epidural hematoma in children is similar to that of craniotomy hematoma removal, but the operation is simpler, less trauma, less intraoperative bleeding, and short operation time, which is worthy of clinical application.
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Subarachnoid hemorrhage (SAH) is a severe neurological event with high mortality. The choice of sedatives in SAH management may influence patient outcomes. This study aimed to investigate the association between sedatives and in-hospital mortality among SAH patients. ⋯ Dexmedetomidine is associated with significantly lower in-hospital mortality in SAH patients. These findings underscore the importance of sedative choice for SAH patients, suggesting that dexmedetomidine could enhance patient outcomes.