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) was significantly different between the low RPR group and the high RPR group (χ

=4.960, P=0.026).

Higher RPR, MHR, and NLR might be independent risk factors for predicting 3-month poor prognosis in patients with AIS who underwent MT.

Higher RPR, MHR, and NLR might be independent risk factors for predicting 3-month poor prognosis in patients with AIS who underwent MT.The goal of this study is to develop a model based on previously used prognostic predictors in traumatic brain injury (TBI) patients with polytrauma, which will facilitate the decision-making of whether to clear these patients for non-cranial surgery. Data of eligible patients was obtained from a trauma database at a Level I trauma and academic tertiary referral center in the United States. The number of days seen by the neurosurgical service prior to clearance, injury severity score (ISS), post-trauma day 0 (PTD 0) of Glasgow Coma Score (GCS), intracranial pressure (ICP) score and computed tomography (CT) score, as well as the changes in GCS, ICP score and CT score between PTD 0 and day of clearance were the variables used in developing the model. The Neurosurgical Clearance Model (NCM) was developed using data from 50 patients included in the study. Patients were cleared by neurosurgeons 1.6 days later than it would appear possible based on a retrospective review of the patients' clinical conditions. learn more A single model equation was developed, the ultimate result of which is a clearance probability value. The best cutoff clearance probability value was found to be 0.584 (or 58.4%) using Receiver Operator Characteristic curve analysis. Our data suggests that neurosurgeons are risk-averse in clearing polytrauma patients for non-cranial surgery. This pilot NCM, if reproduced and validated by other groups and in larger prospective studies, may become a useful tool to assist clinicians in this often-difficult decision-making process.Effective anticoagulation status may determine the recanalization and outcome of cerebral venous thrombosis (CVT). We report impact of anticoagulation status on recanalization and outcome of CVT. This is a retrospective study on 126 patients with CVT diagnosed on magnetic resonance venography (MRV). Their clinical features and risk factors were noted. The data were retrieved from a prospectively maintained registry, and international normalized ratio (INR) was noted after discharge till 3 months. All the patients were on acenocoumarol. Based on INR value, patients were categorized as Group A (effective anticoagulation INR within the therapeutic range or above) and Group B (ineffective anticoagulation INR > 50% below the therapeutic range). A repeat MRV at 3 months was done for recanalization. Outcome at 3 months was evaluated using modified Rankin Scale (mRS), and categorized as good (mRS ≤ 2) and poor (mRS 2 or more) 101(80.2%) patients were in group A and 25(19.8%) in group B. Their demographic, risk factors, magnetic resonance imaging (MRI) and MRV findings were comparable. On repeat MRV, recanalization occurred in 22/24(91.7%); 15(88%) in group A and 7(100%) in group B. Recanalization was independent of coagulation status. Seven (5.6%) patients died and 107(84.9%) had good outcome; 85(84.2%) in group A and 22(88%) in group B. Kaplan Meier analysis also did not reveal survival or good outcome benefits between the groups. In CVT, outcome and recanalization at 3 months are not dependent on coagulation status. Further prospective studies are needed regarding duration of anticoagulant and its impact on recanalization and outcome.Cerebral amyloid angiopathy (CAA) categorized as a cerebral small vessel disease can cause lobar intracerebral hemorrhage (ICH), convexity subarachnoid hemorrhage (SAH) and ischemic stroke (IS). The purpose of this study was to evaluate the differences in the diagnosis of CAA based on hospital characteristics and to assess the discharge outcomes of patients with CAA admitted for IS, ICH and SAH. Adult patients admitted with secondary diagnosis of CAA were identified in National Inpatient Sample in 2016 and 2017. Multivariable logistic regression analysis was performed to evaluate outcomes. A total of 16,040 patients had a secondary diagnosis of CAA. Among CAA patients, 1810 (11.3%) patients were admitted for IS, 4765 (29.7%) for ICH and 490 (3.1%) for SAH. Diagnosis of CAA was five-fold higher among patients admitted to urban teaching hospitals (aOR = 5.4;95% CI = 4.1-7.2) compared to rural hospitals and two-fold higher in large bed size hospitals (aOR = 2.3;95% CI = 2.0-2.7) compared to small bed size hospitals. Compared to non-CAA group, patients with history of CAA had lower odds of in-hospital mortality among patients admitted for ICH (10% vs 23%, aOR = 0.35; 95%CI = 0.27-0.44) and SAH (6% vs 19%, aOR = 0.24; 95%CI = 0.10-0.55); and higher odds of discharge to home among patients admitted for ICH (17% vs 18%, aOR = 1.27; 95%CI = 1.05-1.53). CAA diagnosis is less common in rural and small bed size hospitals compared to urban and large bedside hospitals, respectively. Patients with CAA admitted for ICH have better discharge outcomes compared to non-CAA patients admitted for ICH.

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity. The objective was to evaluate, whether specific morphological aneurysm characteristics could serve as predictive values for aSAH severity, disease-related complications and clinical outcome.

A total of 453 aSAH patients (mean age 54.9 ± 13.8 years, mean aneurysm size 7.5 ± 3.6 mm) treated at a single center were retrospectively included. A morphometric analysis was performed based on angiographic image sets, determining aneurysm location, aneurysm size, neck width, aneurysm size ratios, aneurysm morphology and vessel size. The following outcome measures were defined World Federation of Neurosurgical Societies (WFNS) grade 4 and 5, Fisher grade 4, vasospasm, cerebral infarction and unfavorable functional outcome.

Regarding morphology parameters, aneurysm neck width was an independent predictor for Fisher 4 hemorrhage (OR 1.1, 95%CI 1.0-1.3, p = 0.048), while dome width (OR 0.92, 95%CI 0.86-0.97, p = 0.005) and internal carotid artery location (OR 2.