World Neurosurg
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Despite the importance of adverse drug reactions (ADRs), little is known about their role in perioperative neurosurgery. This study aimed to determine the prevalence of ADRs in perioperative neurosurgery and clarify the characteristics, severity, preventability, and risk factors of ADRs. ⋯ The frequency of suspected and severe ADRs was higher than expected. Polypharmacy and older age were independent risk factors for ADRs in perioperative neurosurgery. To decrease ADRs during perioperative neurosurgery, polypharmacy must be discouraged, especially among older adult patients.
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Hematoma expansion (H-Ex) in small-/medium-sized acute epidural hematoma (AEDH) cases upon emergency admission is critical. Predicting H-Ex can lead to early surgical interventions, improving outcomes, and eliminating the need to check for expansion via computed tomography (CT). This study aimed to identify the most reliable predictors of AEDH expansion. ⋯ LS can predict H-Ex in patients with pure AEDH for whom emergency surgery is unnecessary at admission. The time from injury and platelet counts must also be considered.
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The Pfirrmann scoring system classifies lumbosacral disc degeneration based on magnetic resonance imaging signal intensity. The relationship between pre-existing disc degeneration and patient-reported outcome measures (PROMs) after one-level lumbar fusion is not well documented. The purpose of this study was to investigate the relationship between the severity of preoperative intervertebral disc degeneration and preoperative and postoperative PROMs in patients undergoing one-level lumbar fusion. ⋯ In patients undergoing one-level lumbar fusion, higher Pfirmann scores were associated with increased preoperative leg pain and greater 1-year postoperative improvement in back pain. Further studies into the relationship of preoperative disc degeneration and their impact on postoperative outcomes may help guide clinical decision-making and patient expectations.
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Case Reports
Nonaneurysmal Perimesencephalic Subarachnoid Hemorrhage Associated with an Anomalous Anastomotic Cisternal Vein.
A 54-year-old woman with no relevant medical history presented with severe headache, nausea, and vomiting for 8 days. Imaging examination revealed a subarachnoid hemorrhage in the left interpeduncular cistern without aneurysms. ⋯ In the primitive pattern, the basal vein of Rosenthal drains into the lateral mesencephalic vein and to the petrosal sinus. This anomalous flow may predispose to subarachnoid hemorrhage, emphasizing the association between nonaneurysmal perimesencephalic hemorrhage and venous anomalies.
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The aim of this study was to evaluate the occurrence and factors predisposing to delirium following brain tumor resection. ⋯ Many factors were associated with the occurrence of delirium after brain tumor resection. Therefore, clinicians should identify high-risk patients prone to delirium in a timely manner and take effective management measures to reduce adverse outcomes.