Deep Learning-Based Knee MRI Classification for Common Peroneal Nerve Palsy with Foot Drop.

Foot drop can have a variety of causes, including the common peroneal nerve (CPN) injuries, and is often difficult to diagnose. We aimed to develop a deep learning-based algorithm that can classify foot drop with CPN injury in patients with knee MRI axial images only. In this retrospective study, we included 945 MR image data from foot drop patients confirmed with CPN injury in electrophysiologic tests ( = 42), and 1341 MR image data with non-traumatic knee pain ( = 107).

Diagnostic Roots Radiofrequency Sensory Stimulation Looking for Symptomatic Injured Roots in Multiple Lumbar Stenosis.

Objective: We present how to perform radiofrequency sensory stimulation (RFSS) and whether RFSS could be helpful in identifying symptomatic injured roots in multilevel lumbar stenosis.

Methods: Consecutive patients who underwent RFSS from 2010 to 2012 were enrolled. To identify pathologic lesions, RFSS was performed for suspicious roots, as determined using lumbar magnetic resonance imaging (MRI).

The Influence of High Blood Pressure on Developing Symptomatic Lumbar Epidural Hematoma after Posterior Lumbar Spinal Fusion Surgery: Clinical Data Warehouse Analysis.

Background: Determining the risk factors for symptomatic lumbar epidural hematoma (SLEH) is important for preventing postoperative SLEH. However, the relationship between blood pressure and SLEH is still debatable. The purpose of our study was to determine the risk factors for postoperative SLEH, to assess the influence of high blood pressure on developing SLEH after posterior lumbar spinal fusion surgery, and to evaluate the usefulness of big data analysis utilizing a clinical data warehouse (CDW).

Preoperative Inflammatory Markers and the Risk of Postoperative Delirium in Patients Undergoing Lumbar Spinal Fusion Surgery.

We investigated the possible associations between postoperative delirium (POD) and routinely available preoperative inflammatory markers in patients undergoing lumbar spinal fusion surgery (LSFS) to explore the role of neuroinflammation and oxidative stress as risk factors for POD. We analyzed 11 years’ worth of data from the Smart Clinical Data Warehouse. We evaluated whether preoperative inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), and the CRP-to-albumin ratio (CAR), affected the development of POD in patients undergoing LSFS.

Removal of malformation in cerebral proliferative angiopathy: illustrative case.

Background: Cerebral proliferative angiopathy (CPA) is a rare vascular disorder distinct from arteriovenous malformation. Because of the disorder's rarity, there is still a controversy on the most promising treatment method for CPA. However, several meta-analysis articles suggest indirect vascularization such as encephalo-duro-arterio-synangiosis as an effective way of treating symptoms that are medically uncontrolled.

Clinical Efficacy of Pulsed Radiofrequency Treatment Targeting the Mid-cervical Medial Branches for Intractable Cervicogenic Headache.

Objective: Cervicogenic headache has been known to originate from the convergence of the upper 3 cervical and trigeminal afferents. The administration of conservative treatments, interventional procedures, and more recently, pulsed radiofrequency, has been used to relieve cervicogenic headache. In this study, the authors evaluated the clinical efficacy and safety of pulsed radiofrequency targeting the mid-cervical medial branches.

A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy.

Objective: Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively.

Seizure incidence of angiogram-negative subarachnoid hemorrhage: An updated meta-analysis.

Background: To provide updated information on seizure events and patterns in patients with angiogram-negative subarachnoid hemorrhage based on the initial hemorrhage patterns: perimesencephalic subarachnoid hemorrhage (PMH) vs non-PMH.

Methods: A review of online database literature from January 1990 to November 2017 was systematically performed. In case of heterogeneity <50%, a fixed effect model was used.

Association of Endothelin Receptor Type A with Intracranial Aneurysm in 20,609 East Asians: An Updated Meta-Analysis.

Introduction: Genome-wide association studies have reported an association between the EDNRA gene and intracranial aneurysm (IA) in European and Japanese populations; however, there is no study on this polymorphism in other Asian populations. Therefore, we performed an extensive large-scale meta-analysis for association of the rs6841581 variant of EDNRA with IA susceptibility in East Asian population.

Methods: We conducted a systemic review via electronic search for papers published between January 2002 and February 2019.

Correlation Between Altered DNA Methylation of Intergenic Regions of ITPR3 and Development of Delayed Cerebral Ischemia in Patients with Subarachnoid Hemorrhage.

Background: Delayed cerebral ischemia (DCI) is related to the major causes of morbidity and mortality in patients following subarachnoid hemorrhage (SAH); however, little is known about the role of epigenetics in the pathogenesis of DCI. We investigated the specific DNA methylation profile that may affect the expression of inositol 1-,4-,5-trisphosphate receptor (ITPR3) responsible for cerebral vasospasm following SAH.

Methods: We prospectively studied patients with SAH between March 2015 and October 2018.

Retrospective Chronologic Computed Tomography Analysis of Bone Flap Fusion and Resorption After Craniotomy and Autologous Cryopreserved Cranioplasty.

Background: In open brain surgery, fixation of the bone flap is the final procedure. The bone flaps then fuse naturally. The objective of this study was to investigate the chronological process of bone fusion after craniotomy and autologous cranioplasty.

Genomic Variations in Susceptibility to Intracranial Aneurysm in the Korean Population.

Genome-wide association studies found genetic variations with modulatory effects for intracranial aneurysm (IA) formations in European and Japanese populations. We aimed to identify the susceptibility of single nucleotide polymorphisms (SNPs) to IA in a Korean population consisting of 250 patients, and 294 controls using the Asian-specific Axiom Precision Medicine Research Array. Twenty-nine SNPs reached a genome-wide significance threshold (5 × 10).

Rapid Healing and Remodeling Process of Pediatric Seat-Belt Fracture without Surgical Treatment.

Pediatric seat-belt fracture is a rare condition, and its management has not been well defined. The authors report a case of pediatric Chance fracture that was managed conservatively and that demonstrated rapid bone healing. A 7-year-old boy presented with back pain after a motor vehicle accident.

Factors Associated With Longer Postoperative Outpatient Follow-up Duration in Patients With Single Lumbar Disc Herniation: A Noncomplicated Patient Cohort Study.

Objective: Many reports have described the outcomes of surgical treatment of lumbar disc herniation (LDH). However, few reports have investigated the treatment period after lumbar disc surgery. If no complications occur, how long should an ordinary patient be treated? Which factors are associated with the outpatient follow-up period (OFP)? To answer these questions, we reviewed the medical records of patients who underwent lumbar disc surgery, calculated their average OFP, and sought to identify factors associated with the OFP.

Correlation of optic nerve sheath diameter with directly measured intracranial pressure in Korean adults using bedside ultrasonography.

Objectives: The correlation of optic nerve sheath diameter (ONSD) as seen on ultrasonography (US) and directly measured intracranial pressure (ICP) has been well described. Nevertheless, differences in ethnicity and type of ICP monitor used are obstacles to the interpretation. Therefore, we investigated the direct correlation between ONSD and ventricular ICP and defined an optimal cut-off point for identifying increased ICP (IICP) in Korean adults with brain lesions.

A Novel Association between Lysyl Oxidase Gene Polymorphism and Intracranial Aneurysm in Koreans.

Purpose: Lysyl oxidase (LOX) controls the cross-linking and maturation of elastin and collagen fibers. In this study, we investigated the association between LOX gene polymorphisms and intracranial aneurysm (IA) formation in a homogeneous Korean population.

Materials And Methods: This cross-sectional study involved 80 age-sex matched patients with IA and controls.

Osteoblast and Bacterial Culture from Cryopreserved Skull Flap after Craniectomy: Laboratory Study.

Objective: Cranioplasty using a cryopreserved skull flap is a wide spread practice. The most well-known complications of cranioplasty are postoperative surgical infections and bone flap resorption. In order to find biological evidence of cryopreserved cranioplasty, we investigated microorganism contamination of cryopreserved skulls and cultured osteoblasts from cryopreserved skulls.

Delayed Consecutive Contralateral Thalamic Hemorrhage after Spontaneous Thalamic Hemorrhage.

Simultaneous or subsequent bilateral thalamic hemorrhagic events have ranged from 12 to 19 in prior reports, with a time lag between bilateral thalamic hemorrhage of up to two days. Herein, we report the first case of delayed (17 days) consecutive contralateral thalamic hemorrhage after spontaneous first thalamic hemorrhage. A 65-year-old female initially presented with a drowsy mentality with a left-side motor weakness (grade II/III).

Clinical Efficacy of Pulsed Radiofrequency Neuromodulation for Intractable Meralgia Paresthetica.

Background: Meralgia paresthetica (MP) is a neurologic disorder of the lateral femoral cutaneous nerve (LFCN), which is characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. In most patients with MP, symptoms can be successfully managed with conservative treatment. However, in a small group of MP patients who are refractory to medical treatment, more aggressive low-risk treatment should be considered.

Dynamic Radiographic Results of Different Semi-Rigid Fusion Devices for Degenerative Lumbar Spondylolisthesis: "Dynamic Rod" vs. "Dynamic Screw Head".

Aim: To assess the clinical outcomes and compare the segmental range of motion (ROM) at the implanted L4-L5 level, the cranial and caudal adjacent levels, and the ROM of the whole lumbar spine after semi-rigid lumbar fusion with 2 different devices.

Material And Methods: Patients with neurogenic claudication, due to grade 1 spondylolisthesis and spinal stenosis at levels L4-L5, were treated either Bio-flex® (n = 28) and Cosmic® (n = 23); discectomy was not performed at any level. The clinical outcomes were compared between the 2 groups.

Neuralgic Amyotrophy Manifesting as Mimicking Posterior Interosseous Nerve Palsy.

The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy.

Radiologic Determination of Corpus Callosum Injury in Patients with Mild Traumatic Brain Injury and Associated Clinical Characteristics.

Objective: To investigate the incidence of corpus callosum injury (CCI) in patients with mild traumatic brain injury (TBI) using brain MRI. We also performed a review of the clinical characteristics associated with this injury.

Methods: A total of 356 patients in the study were diagnosed with TBI, with 94 patients classified as having mild TBI.

Coil embolization in ruptured inferior thyroid artery aneurysm with active bleeding.

We present a unique experience of urgent parent arterial embolization for treatment of an aneurysm of the inferior thyroid artery (ITA) that bled during tracheostomy. The event happened to a 69-year-old female patient with subarachnoid hemorrhage and hospital-acquired pneumonia that required tracheostomy. Abrupt and massive bleeding developed during the procedure, and the source could not be identified.

Acute myelopathy caused by a cervical synovial cyst.

Synovial cysts of the cervical spine, although they occur infrequently, may cause acute radiculopathy or myelopathy. Here, we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching. A 68-year-old man presented with gait disturbance, decreased touch senses, and increased sensitivity to pain below T12 level.

Sensory complications in patients after scalp mass excision and its anatomical considerations.

Objective: To evaluate the incidence of postsurgical sensory complications in patients with scalp masses and classify the locations of them from a surgical standpoint according to anatomical considerations.

Methods: A total of 121 patients who underwent surgery for scalp mass were included in this study. The authors reviewed medical records and preoperative radiologic images.