Identifying risk factors of intracerebral hemorrhage stability using explainable attention model.

Segmentation of intracerebral hemorrhage (ICH) helps improve the quality of diagnosis, draft the desired treatment methods, and clinically observe the variations with healthy patients. The clinical utilization of various ICH progression scoring systems has limitations due to the systems' modest predictive value. This paper proposes a single pipeline of a multi-task model for end-to-end hemorrhage segmentation and risk estimation.

Longitudinal medication profile and cost savings in Parkinson's disease patients after bilateral subthalamic nucleus deep brain stimulation.

Introduction: Deep brain stimulation of the subthalamic nucleus (STN DBS) has been shown to reduce antiparkinsonian medication in Parkinson's disease. We aimed to investigate the changes in long-term medication profile with STN DBS.

Methods: Antiparkinsonian medication data for 56 patients were collected from as early as 3 years before STN DBS up to 10 years after.

Incidence of biomarkers in high-grade gliomas and their impact on survival in a diverse SouthEast Asian cohort - a population-based study.

Background: Gliomas consist of a heterogeneous group of tumors. This study aimed to report the incidences of O-methylguanine-DNA-methyltransferase (MGMT) promoter methylation, 1p19q co-deletion, isocitrate dehydrogenase (IDH) gene mutations, and inactivating mutations of alpha-thalassemia/mental retardation syndrome X-linked (ATRX) in high-grade gliomas in an ethnically diverse population.

Methods: Records of patients who underwent surgery for high-grade gliomas from January 2013 to March 2017 at our institution were obtained.

Survey on Willingness to Pay for Life-Saving Treatment, Functional Recovery, and Cosmesis in a Neuroscience Outpatient Clinic Setting in Singapore.

Background: Neurologic disorders impose a heavy burden on healthcare in Singapore. To date, no data on the willingness to pay (WTP) for neurologic treatments has been reported in the local population.

Objectives: We aimed to quantify the value of various health domains to neuroscience patients and their caregivers by comparing their WTP for different types of treatments.

Effects of anticoagulant and antiplatelet agents in severe traumatic brain injury in an asian population - A matched case-control study.

The use of anticoagulation and antiplatelet agents (ACAP) has steadily increased over recent years. However, the effects of ACAP on traumatic brain injuries (TBI) are not well investigated. The aim of this study was to investigate the effects of pre-injury ACAP use on clinical outcome and mortality in severe TBI.

Effects of surgery on neurocognitive function in patients with glioma: a meta-analysis of immediate post-operative and long-term follow-up neurocognitive outcomes.

Purpose: This study aims to identify the neuropsychological tests commonly used for assessment in each neurocognitive domain, and quantify the post-operative changes in neurocognitive function in the immediate post-operation and follow-up.

Methods: With the use of the PubMed, a comprehensive search of the English literature was performed following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. There were 1021 publications identified for screening.

External Validation of Hematoma Expansion Scores in Spontaneous Intracerebral Hemorrhage in an Asian Patient Cohort.

Background: Hematoma expansion (HE) occurs in approximately one-third of patients with intracerebral hemorrhage (ICH) and is known to be a strong predictor of neurological deterioration as well as poor functional outcome. This study aims to externally validate three risk prediction models of HE (PREDICT, 9-point, and BRAIN scores) in an Asian population.

Methods: A prospective cohort of 123 spontaneous ICH patients admitted to a tertiary hospital (certified stroke center) in Singapore was recruited.

A review on microelectrode recording selection of features for machine learning in deep brain stimulation surgery for Parkinson's disease.

Objective: This study seeks to systematically review the selection of features and algorithms for machine learning and automation in deep brain stimulation surgery (DBS) for Parkinson's disease. This will assist in consolidating current knowledge and accuracy levels to allow greater understanding and research to be performed in automating this process, which could lead to improved clinical outcomes.

Methods: A systematic literature review search was conducted for all studies that utilized machine learning and DBS in Parkinson's disease.

Long-term recovery profile of patients with severe disability or in vegetative states following severe primary intracerebral hemorrhage.

Purpose: We conducted a single-center retrospective review to investigate the long-term recovery of patients who were severely disabled or vegetative secondary to primary intracerebral hemorrhage upon discharge from hospital from January 2009 to November 2013.

Methods: Patients were categorized into two groups based on their Glasgow outcome scale (GOS) scores at discharge, namely vegetative state (GOS 2; n = 91) and severely disabled (GOS 3; n = 278). Long-term outcomes at three years post discharge were defined as death, stable, deterioration and improvement from discharge to follow-up.

Awake Craniotomy for Resection of Brain Metastases: A Systematic Review.

Background: Surgery for brain metastases aims to reduce mass effect and achieve local control through maximizing resection. There is increasing recognition that awake craniotomy (AC) is especially relevant for resection of brain metastases in eloquent areas. This study seeks to examine the neurologic outcomes of using AC for brain metastases resection.

Validation of Prognostic Models to Predict Early Mortality in Spontaneous Intracerebral Hemorrhage: A Cross-Sectional Evaluation of a Singapore Stroke Database.

Objective: Numerous scores have been developed for prognostication of outcomes in intracerebral hemorrhage (ICH). Prediction models must be validated internally and externally before they are considered widely applicable. We aim to independently externally validate and compare 3 prediction models (ICH score, ICH grading scale [ICH-GS], and simplified ICH [sICH]) in our population, which has not been previously done.

Improving Surgical Outcome Using Diffusion Tensor Imaging Techniques in Deep Brain Stimulation.

Introduction: Recent advances in surgical imaging include the use of diffusion tensor imaging (DTI) in deep brain stimulation (DBS) and provide a detailed view of the white matter tracts and their connections which are not seen with conventional magnetic resonance imaging. Given that the efficacy of DBS depends on the precise and accurate targeting of these circuits, better surgical planning using information obtained from DTI may lead to improved surgical outcome. We aim to review the available literature to evaluate the efficacy of such a strategy.

Models of Mortality and Morbidity in Severe Traumatic Brain Injury: An Analysis of a Singapore Neurotrauma Database.

Objective: Current prognostic models for traumatic brain injury (TBI) are developed from diverse historical data sets. We aimed to construct a prognostication tool for patients with severe TBI, as this group would benefit most from an accurate model.

Methods: Model development was based on a cohort of 300 patients with severe TBI (Glasgow Coma Scale score ≤8) consecutively admitted to a neurosurgical intensive care unit at the National Neuroscience Institute (NNI), Singapore, between February 2006 and December 2009.

Characterization of Pyramidal Tract Shift in High-Grade Glioma Resection.

Objective: This study aimed to characterize pyramidal tract shift in different regions of the brain during glioma resection and its association with head position and tumor location.

Methods: From 2008-2013, 14 patients presenting at the National Neuroscience Institute with high-grade glioma (World Health Organization III or IV) underwent preoperative and intraoperative diffusion tensor imaging. A novel method of placing landmarks along the preoperative and intraoperative tracts, with anterior commissure as the origin, was used to determine pyramidal tract shift.

Decompressive Craniectomy in Spontaneous Intracerebral Hemorrhage: A Case-Control Study.

Background: Decompressive craniectomy is performed to relieve intracranial pressure as an emergency procedure. There is no large study to systematically evaluate the benefit of decompressive craniectomy versus best medical therapy. This study evaluates the survival and long-term functional outcomes of decompressive craniectomy for spontaneous intracranial hemorrhage.

Incidence of Recurrent Intracerebral Hemorrhages in a Multiethnic South Asian Population.

Introduction: Spontaneous primary intracerebral hemorrhage (ICH) accounts for approximately 25% of all strokes in Singapore. Incidence of recurrent ICH is not well studied, and previous studies have reported inconsistent findings in the rate and risk factors associated with ICH recurrences. We aimed to study the incidence of recurrent ICHs in Singapore and to identify the associated risk factors as well as pattern of ICH recurrence.

Prevalence of Asymptomatic Unruptured Intracranial Aneurysms in a Southeast Asian Population.

Background: The prevalence of asymptomatic unruptured intracranial aneurysms (AUIA) in a Southeast Asian population has not been previously studied. Knowing the disease burden and population at risk can assist us in making informed decisions when managing AUIAs. We aimed to determine if the local prevalence of AUIAs differed from other populations in the published literature.

Effect of prior statin use on outcome after severe traumatic brain injury in a South-East Asian population.

Introduction: Traumatic brain injury (TBI) is a global concern associated with high mortality and morbidity. Costs to individuals and society are extensive due to poor recovery, long-term disability and the young age group affected. Statins have emerged as potential therapeutic agents in TBI.