World Neurosurg
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The prognostic value of admission serum glucose for early hematoma growth in patients with intracranial hemorrhage remains controversial. Island sign is a novel imaging predictor for early hematoma growth, implying multifocal active bleeding. The aim of this study is to investigate the potential associations between hyperglycemia and early hematoma expansion in patients with intracranial hemorrhage with or without island sign. ⋯ Admission serum glucose is associated with hematoma growth and prevalence of island sign, respectively. These results indicated that elevated blood glucose level plays a pathological role in active bleeding. Further studies concerning exact molecular signal pathway are urgently required.
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To determine role of lordosis in cervical spine injuries using a novel competing risk analysis model. ⋯ Increased risk of bony injuries in a preflexed spine and ligament injuries in a lordotic spine may have implications for military personnel, as continuous use of helmets in the line of duty affects the natural curvature; astronauts, as curvatures are less lordotic after missions; and civilian patients with spondylotic myelopathy who use head protective devices, as curvatures may change over time in addition to the natural aging process.
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Spine surgery is entering a new era of evolution, with minimally invasive spine surgery to decompress the neural structures without affecting the stability of the spine. However, complications may occur. The surgeon must have these in mind in order to prevent them. We report on the main intraoperative and postoperative complications of endospine surgery of lumbar disc herniation. ⋯ Twenty-two years of follow-up on endospine treatment for lumbar disc herniation showed a low complication rate. An early and efficient management will nevertheless allow a good outcome in the majority of patients operated.
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Acute subdural hematomas are frequently seen in brain trauma-injured patients. However, spontaneous subdural hematomas are uncommon, especially those localized in the posterior fossa, where fewer than 10 case reports have been described in the medical literature. ⋯ The patient had a great outcome, with no neurologic deficits at hospital discharge and the 1-year follow-up.
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In percutaneous endoscopic transforaminal discectomy (PETD), surgeons are exposed to intraoperative radiographic radiation over a long-term career, which may be correlated with high risk of iatrogenic radiation hazards. The purpose of this prospective cohort study was to assess the impact of concentric stereotactic technique on radiation exposure to surgeons in PETD. ⋯ The concentric stereotactic technique can effectively reduce radiation exposure to surgeons by about 40%.