World Neurosurg
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Review Meta Analysis
Predictive modeling of early neurological deterioration in patients with Acute Ischemic Stroke.
Ischaemic stroke is the leading cause of death worldwide, and early neurological deterioration(END) occurs in 20%-40% of patients, which is the main cause of severe neurological deficits and disability, and even increased mortality. The occurrence of END is closely related to the poor prognosis of the patients, so it is important to identify the risk factors for the occurrence of END in patients with AIS and target intervention at an early stage factors and targeted intervention is of great significance. ⋯ Clinical practitioners should closely monitor high-frequency predictors of END in patients. However, the varying quality of current models necessitates the selection of models that balance performance with operational simplicity in clinical practice.
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While early diagnosis of brain tumors is essential for improving prognoses, several challenges prevent early diagnosis of these illnesses in low- and middle-income countries (LMICs). The objective of this systematic review is to identify and evaluate the barriers and challenges to early detection of brain tumors in LMICs, as well as to propose potential solutions. ⋯ Significant barriers to early detection persist in LMICs. Collaboration between stakeholders, legislators, health ministries, and governmental organizations is essential for developing and implementing focused interventions, such as establishment of referral pathways and specialized centers, adapting guidelines to local cultural contexts and raising public and professional awareness.
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Meta Analysis Comparative Study
Comparative Analysis of Somatosensory-evoked Potentials and Transcranial Doppler Ultrasound for Cerebral Ischemia Detection in Carotid Endarterectomy: Insights from Network Meta-Analysis and Clinical Data.
This study aims to compare the diagnostic efficacy of somatosensory-evoked potentials (SEPs) and transcranial Doppler sonography (TCD) for monitoring cerebral tissue ischemia during carotid endarterectomy (CEA) using network meta-analysis and retrospective analysis of clinical data. ⋯ During CEA, SEP appears to provide a slightly more reliable indication of the ischemic condition in cerebral tissues compared to TCD.
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Biomechanical resistance and surgical morbidity of spinal posterior pedicle screw fixation depend on the intraosseous position of the implants. Upper thoracic pedicle screws are particularly demanding given their convergence and thin character. We present our experience as military surgeons of freehand placement of upper thoracic pedicle screws supported solely by anteroposterior, i.e., frontal x-ray fluoroscopy. ⋯ Clinically, placement of upper thoracic pedicle screws supported solely by anteroposterior fluoroscopy appears to be safe. The surgical technique is simple enough to be used in settings with limited resources, such as a mobile field surgical team.
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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.