World Neurosurg
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Patients with moderate traumatic brain injury (mTBI) are under the threat of intracranial hypertension (IHT). However, it is unclear which mTBI patient will develop IHT and should receive intracranial pressure (ICP)-lowering treatment or invasive ICP monitoring after admission. The purpose of the present study was to develop and validate a prediction model that estimates the risk of IHT in mTBI patients. ⋯ A prediction model based on baseline parameters was found to be highly sensitive in distinguishing mTBI patients with GCS score of 9-11 who would suffer IHT. The high discriminative ability of the prediction model supports its use in identifying mTBI patients with GCS score of 9-11 who need ICP-lowering therapy or invasive ICP monitoring.
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Historical Article
Mildred Codding (1902-1991): Neurosurgery Medical Illustrator at Harvard Medical School, Peter Bent Brigham Hospital, and Boston's Children Hospital.
This historical account reviews the life and times of Mildred Codding (1902-1991) in neurosurgery and medical illustration. ⋯ This article provides glimpses into the personality and marked influence of Mildred Codding on neurosurgery and medical education and adds to the growing literature on her person.
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Chiari malformation type I (CM-1) is a complex disorder in which tonsillar herniation through the foramen magnum (FM) manifests with a spectrum of clinical symptoms. This work analyzes morphometric and volumetric characteristics of CM-1 patients. ⋯ Our findings suggest that the amount of tissue at the FM correlates with CM-1 patients who underwent decompressive surgery, more so than tonsillar length. Additionally, the combination of neural tissue at the FM, CBL, and fourth ventricular volumes led to a great degree of correlation with syrinx formation. Together, these findings suggest that a global compressive phenomenon within the posterior fossa leads to CM-1 symptomatology and syrinx formation.
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The aim of this study is to evaluate the efficacy of cerebral revascularization for Moyamoya disease (MMD) with extracranial internal carotid artery occlusion (ICAO). ⋯ Cerebral revascularization can prevent recurrent ischemic and hemorrhagic stroke events for MMD patients with extracranial ICAO. There was no difference on long-term clinical outcomes after combined bypass, direct bypass, and indirect bypass surgery. The cerebral revascularization has similar effect on the MMD patients with extracranial ICAO and MMD patients without extracranial ICAO.
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This study aimed to evaluate preoperative and perioperative predictors associated with persistent low back pain (LBP) following lumbar fusion in patients aged >75 years. ⋯ This study showed that a relatively younger age, history of preoperative lumbar decompression, and greater preoperative VAS score for LBP were preoperative predictors of postoperative persistent LBP following lumbar fusion in elderly patients. In contrast, preoperative spinopelvic sagittal parameters were not associated with persistent postoperative LBP. Although lumbar fusion is expected to improve LBP, surgeons should pay attention to age, surgical history, and preoperative back pain intensity.