World Neurosurg
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Cerebral arteriovenous malformations (AVMs) can lead to significant morbidity and are particularly challenging to manage in resource-limited settings where endovascular treatment modalities are unaffordable for most patients. ⋯ Good clinicoradiologic outcomes can be achieved through microsurgery in a setting where endovascular treatment is inaccessible to patients due to limited resources.
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How maximal safe resection of glioblastoma (GBM) is implemented in the clinical setting remains understudied. Here, we utilized a survey-based approach to understand physician perspectives on this matter. ⋯ Our results suggest that while maximal safe resection remains a guiding principle for GBM resection, physician preference in terms of the extent of resection varies significantly as a function of tumor location and personal values.
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Redundant nerve roots (RNRs) seen in conjunction with lumbar spinal stenosis (LSS) are well-described radiographic findings. Several studies suggest their presence may be a negative prognostic indicator of postoperative outcome. Our hypothesis was that severe RNR (informally known as the spaghetti sign [SS]) can serve as a reliable marker of LSS that would benefit from surgical decompression. We sought to evaluate a grading scale for RNR, characterize the association with stenosis, and investigate the clinical implications of RNR. ⋯ The study demonstrated that there is a significant association between SS and severe LSS and that presence of RNR is not a negative prognostic indicator for postoperative outcomes.
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To investigate the improvement of spinopelvic parameters and therapeutic efficacy in the treatment of complex degenerative lumbar spondylolisthesis (CDLS) after oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF). ⋯ In the therapy of CDLS, OLIF can better reduce pelvic tilt, L1 axis S1 distance, and sagittal vertical axis, and increase lumbar lordosis angle and sacral slope, showing advantages over TLIF in improving and maintaining spinopelvic parameters. Although there was no difference in complication rates between OLIF and TLIF, OLIF was more minimally invasive, had less tissue damage, had faster recovery, and had better long-term outcomes.
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Accurate volumetric assessment of spontaneous aneurysmal subarachnoid hemorrhage (aSAH) is a labor-intensive task performed with current manual and semiautomatic methods that might be relevant for its clinical and prognostic implications. In the present research, we sought to develop and validate an artificial intelligence-driven, fully automated blood segmentation tool for subarachnoid hemorrhage (SAH) patients via noncontrast computed tomography (NCCT) scans employing a transformer-based Swin-UNETR architecture. ⋯ Our Swin UNETR-based model offers significant advances in the automated segmentation of blood in SAH patients on NCCT images. Despite the computational demands, the model operates effectively on standard hardware with a user-friendly interface, facilitating broader clinical adoption. Further validation across diverse datasets is warranted to confirm its clinical reliability.