World Neurosurg
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Surgery is the preferred option for lumbar spinal stenosis (LSS) when conservative methods cannot meet the needs. Recent advancements in surgical techniques have brought various new methods for treating LSS. ⋯ Endoscopic decompression can effectively improve short-term back VAS scores and reduce hospital stays, while IPSD is effective in reducing long-term back VAS scores with minimal surgical duration and blood loss.
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Trigeminal neuralgia (TN) has been described as one of the worst pains known to humankind. However, pain severity in TN has been measured using several different scales, resulting in difficulty comparing illness burden and response to TN surgery across studies. We examined the degree of concordance between standardized scales evaluating pain severity in a cohort of patients undergoing surgery for TN. ⋯ TN patients with residual mild-moderate pain after surgery are often discordantly classified by different pain measurement scales. These findings argue for a more standardized method of reporting postoperative pain outcomes in the TN literature.
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This study investigates the prognostic value of the apparent diffusion coefficient (ADC) in magnetic resonance imaging for patients with acute posterior circulation stroke (PCS) undergoing endovascular therapy (EVT). ⋯ High ADC values and unilateral infarction are independent predictive factors for the prognosis of patients with PCS after EVT. Combining these factors provides the highest predictive accuracy, aiding in clinical decision making for PCS treatment.
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Symptomatic intracranial hemorrhage (sICH) after mechanical thrombectomy (MT) is associated with worse outcomes. We sought to develop and internally validate a machine learning (ML) model to predict sICH prior to MT in patients with anterior circulation large vessel occlusion. ⋯ An ML model accurately predicted sICH prior to MT. It performed better than a standard statistical model and previously described clinical prediction models.
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Subdural drains are used to reduce recurrence after surgical evacuation of chronic subdural hematoma. There is a small risk of parenchymal injury. We hypothesize that using subgaleal drains with low active suction (-50 mm Hg to -100 mm Hg) may be a safer alternative and still maintain efficacy in preventing recurrence. ⋯ The use of subgaleal drains with low active suction led to significantly lower complication rates compared with the use of subdural drains and maintained its efficacy in preventing recurrence.