World Neurosurg
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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.
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To assess factors which may influence surgical success following brachial plexus reconstruction for obstetric brachial plexus injury (OBPI). ⋯ Brachial plexus reconstruction is an effective treatment modality for patients without spontaneous recovery of upper extremity function following OBPI, although identifying the optimal age-range for surgery remains elusive. Patients with intraoperative findings consistent with a more severe injury may be less likely to benefit from surgery.
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Volatile anesthetics have shown neuroprotective effects in preclinical studies, but clinical data on their use after aneurysmal subarachnoid hemorrhage (aSAH) are limited. This study aimed to analyze whether the use of volatile anesthetics for neurocritical care sedation affects the incidence of delayed cerebral ischemia (DCI), cerebral vasospasm (CVS), DCI-related infarction, or functional outcome. ⋯ Volatile sedation in aSAH patients is not associated with the incidence of DCI, CVS, DCI-related infarction, or functional outcome. Although we could not demonstrate neuroprotective effects of volatile anesthetics, our results suggest that volatile sedation after aSAH has no negative effect on the patient's outcome.
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Cerebral arteriovenous malformations (AVMs) pose significant management challenges, with treatment options such as stereotactic radiosurgery (SRS) and surgical resection (SR) often debated. This meta-analysis seeks to compare the efficacy and safety of SRS versus SR in treating cerebral AVMs. ⋯ SRS appears to offer several advantages over SR, including lower rates of embolization, hemorrhage, shorter operative times, and fewer neurologic deficits post-treatment. These findings suggest SRS may be a preferable treatment modality for cerebral AVMs, particularly for lesions located in eloquent brain regions or in patients where traditional surgery presents significant risks.
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Dr. Samuel Frank Clarendon Ghouralal emerged not only as a pioneer in neurosurgery but as a community leader in Trinidad and Tobago, contributing significantly to a region where neurosurgical care was scarce. This historical account aims to shed light on the remarkable life and career of Dr. Ghouralal, emphasizing the critical role he played in establishing and advancing neurosurgery in Trinidad and Tobago. ⋯ Dr. Ghouralal's life and achievements stand as a testament and inspiration to the transformative impact dedicated individuals can have on the advancement of neurosurgery throughout the world.