World Neurosurg
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This study aimed to assess the diagnostic accuracy of a novel marker, the combined lactate glucose ratio (CLGR), in identifying cerebrospinal fluid (CSF) bacterial infection (CBI) in neurosurgical patients. Additionally, it seeks to establish cutoff values for CLGR and evaluate the reliability of measurement using blood gas analyzer (BGA). ⋯ CLac levels ≥6.0 mmol/L and CLGR ≥20.0 accurately identified CBI in neurosurgical patients, with CLGR exhibiting superior efficacy. The potential for instant BGA measurement suggests promise for point-of-care testing.
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Craniocerebral trauma is one of the main causes of death and disability worldwide. Decompressive craniectomy is a common emergency measure in the treatment of craniocerebral trauma, aimed at relieving intracranial pressure. However, cranial bone reconstruction (CP) following this surgery is crucial for the patient's long-term recovery. Despite this, research on complications and prognostic factors after ultra-early cranioplasty remains limited. Therefore, this study aims to explore the complications of ultra-early cranioplasty with titanium mesh and its impact on prognosis. ⋯ Ultra-early CP can promote the recovery of neurological function, reduce the disturbance of consciousness, improve daily living ability, and improve cognitive function in patients with craniocerebral trauma, but there is a high risk of postoperative complications. In addition, age and postoperative NIHSS score are related factors affecting the poor prognosis of ultra-early CP patients.
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Although pedicle screw and rod instrumentation remains the gold standard method of posterior rod fixation, it is associated with complications, including pedicle breach and facet joint violation. There is current interest in facet joint stabilization with the potential to create a less invasive, natural arch of fixation that may avoid the complications associated with pedicle screw and rod instrumentation. This study examined the stabilizing potential of a novel facet joint fixation device for single-level (L4-L5) fixation in a human cadaveric model. ⋯ Bilateral lumbar facet fixation with and without supplemental transfacet screw fixation provided significant stability. Cranial and caudal adjacent-level ROM was not influenced by facet fixation except for a slight increase in cranial segment motion during extension. Facet fixation did not alter the lordotic intervertebral disc angle at the instrumented level.
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Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke, and most favorable treatments to improve patients' neurologic outcomes are not clear. Invasive intracranial pressure (ICP) monitoring is a common treatment of ICH, but whether patients with ICH could benefit from ICP monitoring is controversial. ICP variability (IPV) has been shown to correlate with poor outcomes in patients with subarachnoid hemorrhage and traumatic brain injury, but this association has not been clearly elucidated in patients with ICH. We hypothesized that 72-hour IPV from time of ICP probe implantation is associated with outcomes in patients with ICH. ⋯ IPV during the first 72 hours after ICP implantation in patients with ICH was independently associated with poor functional outcome at 3 months. Stabilization of IPV during hyperacute and acute periods may be a potential therapeutic target to improve functional outcomes of these patients.
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Review Case Reports
"Clinical and Radiologic Follow-up in Ecchordosis Physaliphora: A Case Series and Literature Review".
This study endeavors to assess the clinical and radiologic findings of ecchordosis physaliphora (EP) in patients under long-term observation at our clinic as well as in cases reviewed from the existing literature. ⋯ Utilizing a combination of imaging modalities, ensuring a clear radiological distinction between EP and chordoma, can offer substantial advantages in this context. Given that EP might be incidentally discovered and nonresistant symptoms may resolve on their own, considering conservative treatment before surgery may be a viable option in all cases.