World Neurosurg
-
Pituitary neoplasms account for 15% of all intracranial neoplasms and affect 20% of the population. Disparities in treatment and outcomes may exist across racial, socioeconomic, and insurance groups, warranting further investigation. ⋯ Despite advancements in endoscopic endonasal pituitary surgery, disparities in access and outcomes persist across racial, socioeconomic, and insurance groups. These findings underscore the need for targeted interventions to address these inequalities and ensure equitable access to quality care.
-
The prognosis of adult patients with tuberculous meningitis undergoing ventriculoperitoneal (VP) surgery is not well known. Prognostic models developed to predict the prognosis might help clinicians immensely. ⋯ About 39% of adult patients with tuberculous meningitis die or remain disabled after VP shunt surgery. Medical Research Council grade III illness, papilledema, seizures, and size of hydrocephalus are the most important baseline predictors that can help in prognostication. The nomograms developed may help the treating physician with prognostication.
-
Radiographic evaluation of the presumed lower instrumented vertebrae (LIV) is crucial for determining the optimal fusion level for adolescent idiopathic scoliosis (AIS) with main thoracolumbar/lumbar curves. However, few studies have examined its variations intraoperatively. This study aims to investigate the radiographic variations of the presumed LIV during fluoroscopic positioning to aid surgeons in decision-making. ⋯ This study firstly reports the radiographic variations of the presumed LIV using intraoperative positioning fluoroscopy for Lenke 5/6 AIS and establishes the correlation with baseline measurements. This information may assist surgeons in selecting the optimal LIV, but long-term follow-up is needed to evaluate its outcomes.
-
Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma. The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE. ⋯ The published literature suggests that MMAE is a generally well-tolerated procedure with a low risk of significant complications.
-
Traumatic brain injury (TBI) is a major cause of disability and mortality worldwide. Acute traumatic subdural hematoma (TSDH) accounts for a large proportion of all TBI cases. However, factors to predict postoperative prognosis in patients with acute TSDH are limited. Recently, it has been reported that inflammatory markers increase the accuracy of prognosis in various diseases. The neutrophil-to-lymphocyte ratio (NLR) is a marker for inflammation, which is easy to test, inexpensive and can be performed quickly. However, the prognostic value of NLR in patients with acute TSDH remains controversial. This study therefore aimed to assess the predictive value of the admission and postoperative NLR in patients with acute TSDH who underwent surgical treatment. ⋯ Initial NLR was not strongly associated with 1-month mortality in patients with acute TSDH who underwent surgery. However, the postoperative 48-hour NLR was associated with 1 month mortality.