World Neurosurg
-
Opioids are often prescribed for patients who eventually undergo lumbar decompression. Given the potential for opioid-related morbidity and mortality, postoperative weaning is often a goal of surgery. The purpose of this study was to examine the relationship between preoperative opioid use and postoperative complete opioid weaning among lumbar decompression patients. ⋯ Patients who used opioids for longer preoperatively were less likely to completely wean following surgery. Among patients with >180 days of preoperative use, those with lower preoperative doses were more likely to wean. Weaning was also associated with several clinical and demographic factors. These findings may help shape expectations regarding opioid use following lumbar decompression.
-
Review Case Reports
Cerebral Myiasis, an unexpected intraoperative finding - A Case Report and Systematic Review.
Postoperative complications, exemplified by surgical site infections, are commonplace in the realm of daily surgical interventions. Conversely, certain infectious entities, such as cerebral myiasis (CM), are distinctly rare. ⋯ This case report underscores the critical significance of prompt identification, precise diagnostic elucidation, and comprehensive multidisciplinary management to optimize patient outcomes in instances of CM. Furthermore, a systematic literature review on CM supplements this report, contributing to the understanding of this infrequent complication.
-
Multicenter Study
CSF SHUNT REINFECTION AND MALFUNCTION IN ECUADORIAN CHILDREN WITH DIFFERENT RESHUNTING CRITERIA AFTER INFECTION. "IS JUST A SHUNT AFTER ANOTHER?
There is no firm evidence regarding cerebrospinal fluid (CSF) shunt reimplantation after infection in the pediatric population. The purpose of this study was to compare different criteria and analyze new shunt failure. ⋯ G2 reimplantation criteria were related to improved pleocytosis, CSF proteins, and blood neutrophils compared with G1. Mechanical and infectious dysfunction of the new shunt was 3 times more prevalent in G1 than in G2, considering the differences between the groups at diagnosis. Increased parameters of infection at diagnosis were associated with future malfunction more than parameters before reimplantation in both groups.
-
To investigate predictive factors and outcomes in those admitted to post-acute rehabilitation (PAR) versus those that discharged home following multi-level spinal decompression and fusion surgery. ⋯ Female sex and presence of a mood disorder increase the likelihood to PAR discharge following multi-level spinal decompression surgery.
-
Giant meningiomas may show special features in terms of biological behavior and management. We aimed to research recurrence and mortality of giant meningiomas. ⋯ Giant intracranial meningiomas are challenging because of surgical experience, tumor size, peritumoral edema, blood supply, anatomical changes, and limited visibility. They have a high risk of recurrence and mortality.