World Neurosurg
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Subarachnoid hemorrhage (SAH) is a severe neurologic event with high mortality. The choice of sedatives in SAH management may influence patient outcomes. This study aimed to investigate the association between sedatives and in-hospital mortality among patients with SAH. ⋯ Dexmedetomidine is associated with significantly lower in-hospital mortality in patients with SAH. These findings underscore the importance of sedative choice for patients with SAH, suggesting that dexmedetomidine could enhance patient outcomes.
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Ophthalmic artery (OphA) aneurysms, occurring at the junction of the internal carotid artery and the OphA orifice, present significant treatment challenges due to their location and complex anatomy. This systematic review and meta-analysis aimed to evaluate endovascular therapy and microsurgery in managing OphA aneurysms. ⋯ Our comparison of endovascular therapy and surgery for OphA aneurysms showed no significant difference in clinical outcomes. However, visual complications were more common with surgery, while mRS >2 was higher with endovascular therapy. Flow diversion reduced visual deficits compared to clipping and coiling, but further studies are needed.
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This study aims to elucidate the anatomical principles governing the surrounding venous structures (VS) of the horizontal part of the third segment of the vertebral artery (V3h) and develop a safe and bloodless surgical technique for exposing V3h. ⋯ The application of the PTRT effectively collapses the tent-like structure within the SOT, significantly reducing bleeding during V3h exposure in CVJ.
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This study was to evaluate the initial efficacy of lateral lumbar interbody fusion (LLIF) in treating degenerative lumbar spinal stenosis (DLSS), encompassing a spectrum of stenosis severity from minor to extreme cases. ⋯ Under certain indications, patients with varying degrees of DLSS, ranging from mild to extreme, can achieve favorable outcomes through LLIF, and preoperative imaging revealing severe or extreme stenosis does not automatically disqualify patients from undergoing indirect decompression surgery.
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To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy(CSM); and understand the process underlying loss of cervical lordosis. ⋯ The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.