Abstract Large vessel occlusions (LVOs), variably defined as blockages of the proximal intracranial anterior and posterior circulation, account for approximately 24% to 46% acute ischemic strokes. Commonly refractory intravenous tissue plasminogen activator (tPA), LVOs place large cerebral territories at risk cause high rates morbidity mortality without further treatment. Over past few years, an abundance high-quality data has demonstrated efficacy endovascular thrombectomy improving...

BACKGROUND Effective decompression, arthrodesis, and correction of spinal conditions frequently utilize operative approaches that expose both the anterior posterior column. Until now, circumferential column access often requires surgeon to reposition drape patient multiple times or a only approach has limited capability lateral-only complicates otherwise traditional surgical maneuvers. OBJECTIVE To describe technique utilizing single position enables minimally disruptive with simultaneous...

OBJECTIVE In vivo and in vitro studies have demonstrated histological evidence of iatrogenic endothelial injury after stent retriever thrombectomy. However, noncontrast vessel wall (VW)-MRI is insufficient to demonstrate injury. Authors this study prospectively evaluated damage thrombectomy humans by utilizing high-resolution contrast-enhanced VW-MRI. Characterization VW-MRI changes vessels subject mechanical from may allow better understanding the biological effects intervention. METHODS...

Background Intraoperative MRI has been shown to improve gross-total resection of high-grade glioma. However, the knowledge authors, cost-effectiveness intraoperative not established. Purpose To construct a clinical decision analysis model for assessing in treatment Materials and Methods An integrated five-state microsimulation was constructed follow patients with One-hundred-thousand treated were compared 100 000 who without from initial debulking until death (median age at resection, 55...

Background: Spine surgery training in the United States currently involves residency neurological or orthopaedic surgery. Because of different core surgical requirements, volume spine procedures may vary between 2 residencies. Methods: We reviewed Accreditation Council for Graduate Medical Education resident case logs both and exposure to graduating years 2009 2018. Results: The average number performed during that 10-year period was 433.8 neurosurgery residents 119.5 (p < 0.01). From 2018,...

Embolization of the middle meningeal artery (MMA) is a safe and effective adjunct in treatment chronic subdural hematoma. While prior authors describe use coils to assist embolization by preventing reflux through eloquent collaterals, we de- scribe further open MMA, allowing administration greater amounts embolisate for more robust embolization. The objective this study was demonstrate that helical can safely MMA following polyvinyl alcohol (PVA) particles. This allows be administered into...

The aim of this study was to investigate the impact US-Mexico border wall height extension on traumatic brain injuries (TBIs) and related costs.In retrospective cohort study, patients who presented UC San Diego Health Trauma Center for from falling at between 2016 2021 were considered. Patients in pre-height period (January 2016-May 2018) compared with those post-height 2020-December 2021). Demographic characteristics, clinical data, hospital charges analyzed.A total 383 identified: 51 (0...

To evaluate the cost-effectiveness of neuromuscular ultrasound (NMUS) for evaluation focal neuropathies.A prior prospective, randomized, double-blind controlled trial demonstrated that NMUS, when added to electrodiagnostic testing, resulted in improved clinical outcomes after 6 months follow-up. From this study, we abstracted quality-adjusted life-years (QALYs) from 36-item Short Form Health Survey and entered health-utility estimate into a mixed model-based analysis societal perspective....

Study Design. This is a retrospective analysis of national administrative hospital data. Objective. study examines trends in the surgical management lumbar spinal stenosis (LSS) patients with and without coexisting scoliosis between 2010 2014. The also revision rates for LSS procedures. Summary Background Data. There wide variability LSS, deformity. Methods. Data were obtained from Healthcare Cost Utilization Project's National Inpatient Sample Database. International Classification Diseases...

INTRODUCTION: The newest generation distal thrombectomy catheters are intended for use with larger wires in lieu of a microcatheter triaxial aspiration systems used the treatment LVO strokes. METHODS: stroke time cards and outcomes all patients from October 2022 to March 2023 April September at our institution were retrospectively reviewed. intervals question correspond thrombectomies performed prior after implementation Penumbra Red 43 catheter institution, respectively. Patients posterior...

To investigate the possibility of using coils as a standalone treatment for middle meningeal artery embolization. Four patients (3 females, 1 male, median age 77.5) with bilateral subdural hematomas were treated MMA One hematoma each patient was and PVA, other exclusively coils. New or resolved symptoms, radiographic imaging demonstrating change, complications recorded compared between two modalities. Minimum follow-up time three months. All demonstrated symptomatic improvement at month...

The disorder known as congenital scrotal agenesis is an extremely rare condition. In the literature, 11 cases of or absence have been reported thus far. Most them are bilateral and contain cryptorchidism. a case cryptorchidism, we report 36-day-old Afghan infant who presented to Maiwand Teaching Hospital with fever vomiting due infection agenesis. diagnosis these anomalies was made using clinical laboratory results, characteristics being recorded during sixth week life. After receiving...

Early case series suggest that the recently introduced Low-profile Visualized Intraluminal Support Junior (LVIS Jr.) device (MicroVention-Terumo, Inc., Tustin, CA) may be used to treat wide-necked aneurysms would otherwise require treatment with intrasaccular devices or open surgery. We report our single-center experience utilizing LVIS Jr. intracranial involving 1.8-2.5 mm parent arteries.We retrospectively reviewed records of patients treated for at a single center. A total 21 were in 18...

Introduction: Delays in door to groin puncture time (DGPT) for patients with ischemic stroke caused by acute large vessel occlusions (LVO) are associated worse clinical outcomes. We present the results of a quality improvement protocol endovascular treatment at University California, San Diego (UCSD) that aimed minimize DGPT. Materials and Methods: Our team implemented series measures decrease DGPT, target 90 minutes or less. Sixty-three treated our center were retrospectively divided into...

OBJECTIVE Preoperative embolization of meningiomas can facilitate their resection when they are difficult to remove. The optimal use and timing such a procedure remains controversial given the risk embolization-linked morbidity in select clinical settings. In this work, authors used large national database study impact immediate preoperative on outcomes meningioma resection. METHODS Meningioma patients who had undergone elective were identified National (Nationwide) Inpatient Sample (NIS)...

Safety-net hospitals deliver care to a substantial share of vulnerable patient populations and are disproportionately impacted by hospital payment reform policies. Complex elective procedures performed at safety-net facilities associated with worse outcomes higher costs. The effects burden on highly specialized, emergent, resource-intensive conditions poorly understood. authors examined the costs after emergent neurosurgical intervention for ruptured cerebral aneurysms.

Middle meningeal artery embolization (MMAe) has burgeoned as a treatment for chronic subdural hematoma (cSDH). This study evaluates the safety and short-term outcomes of MMAe patients relative to traditional approaches.

OBJECTIVE Rupture of large or giant intracranial aneurysms leads to significant morbidity, mortality, and health care costs. Both coiling the Pipeline embolization device (PED) have been shown be safe clinically effective for treatment unruptured aneurysms; however, relative cost-to-outcome ratio is unknown. The authors present first cost-effectiveness analysis compare economic impact PED compared with no endovascular management aneurysms. METHODS A Markov model was constructed simulate a...