World Neurosurg
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Randomized Controlled Trial Observational Study
Extracranial Complications in Monitored and Non-Monitored Patients with Traumatic Brain Injury in the BEST TRIP Trial and a Companion Observational Cohort.
Extracranial complications occur commonly in patients with traumatic brain injury (TBI) and can have implications for patient outcome. Patient-specific risk factors for developing these complications are not well studied, particularly in low and middle-income countries (LMIC). The study objective was to determine patient-specific risk factors for development of extracranial complications in TBI. ⋯ Extracranial complications are common following TBI. ICP monitoring and treatment are related to extra-cranial complications. This supports the need for reassessing the risk-benefit balance of our current management approaches in the interest of improving outcome.
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This study evaluates the impact of L4-L5 minimally invasive surgery (MIS)- transforaminal lumbar interbody fusion (TLIF) on adjacent-level parameters. ⋯ L4-L5 MIS-TLIF had a more consistent effect on L3-L4 than L5-S1. Although adjacent-level SL and DA decreased over time, their association with ASDeg appears limited, suggesting a multifactorial etiology. L4-L5 MIS-TLIF provides demonstrable clinical benefits with lasting PRO improvements and low adjacent-level reoperations.
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Comparative Study
Anatomical Differences In Sphenoid Sinus During Endoscopic Trans-Sphenoidal Surgery: Comparison Between Non-Functioning PiTNET And GH-Secreting PiTNET.
In surgical practice during endoscopic endonasal approach, growth hormone-secreting pituitary neuroendocrine tumor (GH-secreting PitNET) patients show morphologic differences in the nasal cavities and sinuses, leading to a narrower surgical field and a carotid prominence and potentially increasing the complexity of the surgical and the risk of complications. The aim of the study is to evaluate the anatomical differences of the sphenoid sinus between patients with GH-secreting PitNETs and patients with nonfunctioning pituitary neuroendocrine tumor (NF-PitNET) who underwent endoscopic endonasal approach. ⋯ Intercarotid distance, DSS, and VCD resulted smaller in acromegalic patients, confirming that patients with GH-secreting PitNETs have a narrower surgical field. A meticulous anatomical preoperative planning and neuronavigation are important to recognize the sphenoid anatomical landmarks in order to reduce the risk of complications, especially in acromegalic patients.
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The present study compares postoperative outcomes between patients with and without sickle cell disease (SCD) undergoing 1-to 3-level lumbar spinal fusion for degenerative pathologies. ⋯ Patients with SCD undergoing lumbar spinal fusion demonstrate higher risks for coagulopathic, ischemic, and infectious-related complications, as well as long-term postoperative opioid use. Awareness of the unique complication profile in SCD patients may help guide surgeons in refining perioperative management strategies to optimize outcomes in patients with SCD.
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Epidermoid cysts are prevalent noncancerous cutaneous lesions known to exhibit unusually extended periods of growth. In this study, we present a remarkable case of an epidermoid cyst located on the scalp, which exhibited a growth period of 76 years, the longest growth time documented in the literature to date. ⋯ This case highlights the ability of epidermoid cysts to manifest as slow-growing entities over an exceptionally prolonged timeframe. Furthermore, instances of rapid growth may be attributed to a combination of mass rupture and inflammatory processes.