Noninvasive brain stimulation during EEG improves machine learning classication in chronic stroke.

Background: In individuals with chronic stroke and hemiparesis, noninvasive brain stimulation (NIBS) may be used as an adjunct to therapy for improving motor recovery. Specific states of movement during motor recovery are more responsive to brain stimulation than others, thus a system that could auto-detect movement state would be useful in correctly identifying the most effective stimulation periods. The aim of this study was to compare the performance of different machine learning models in classifying movement periods during EEG recordings of hemiparetic individuals receiving noninvasive brain stimulation.

Infantile traumatic pericallosal aneurysm: illustrative case.

Background: Traumatic aneurysms are a rare sequela of nonaccidental head trauma in infants. The rate of nonaccidental trauma (NAT) in the pediatric population is increasing; therefore, traumatic aneurysms are an important consideration in the evaluation of pediatric patients with abusive head trauma.

Observations: A 24-day-old infant with no significant past medical or birth history presented with twitching and poor oral intake for 1 day.

Lateral versus prone robot-assisted percutaneous pedicle screw placement: a CT-based comparative assessment of accuracy.

Objective: Single-position lateral lumbar interbody fusion (SP-LLIF) has recently gained significant popularity due to increased operative efficiency, but it remains technically challenging. Robot-assisted percutaneous pedicle screw (RA-PPS) placement can facilitate screw placement in the lateral position. The authors have reported their initial experience with SP-LLIF with RA-PPS placement in the lateral position, and they have compared this accuracy with that of RA-PPS placement in the prone position.

Hemorrhage Rates After Implantation and Explantation of Stereotactic Electroencephalography: Reevaluating Patients' Risk.

Objective: Stereoelectroencephalography (sEEG), despite its established usefulness, has not been thoroughly evaluated for its adverse events profile. In this study, hemorrhage rates were evaluated both per patient and per lead placed not only in the immediate postoperative period, but also over the course of admission and after explantation when available.

Methods: This is a single-center retrospective study of pediatric and adult patients undergoing sEEG lead placement at a large urban hospital.

Increased Pulse Pressure Variability Within the First 24 Hours Leads to Poor Disposition in Subarachnoid Hemorrhage Patients.

Background: Aneurysmal subarachnoid hemorrhage (SAH) continues to be associated with significant morbidity and mortality despite treatment advancements. Although high blood pressure (BP) remains a significant risk factor in aneurysmal SAH and rerupture, the role of BP parameters and fluctuation in prognostication remains unclear. We sought to define how BP parameters and variability within 24 hours of hospitalization in acute-onset SAH affects patient discharge outcomes.

Relapsed granulomatosis with polyangiitis with panhypopituitarism.

A man in his early 60s with a medical history of granulomatosis with polyangiitis (GPA) in remission for two decades without maintenance therapy presented with non-specific complaints of profound fatigue and 40-pound weight loss. He was seronegative for antinuclear antibodies and cytoplasmic antineutrophilic antibodies, but erythrocyte sedimentation rate and C reactive protein levels were elevated. Endocrinological testing revealed adrenal insufficiency, hypogonadism, hypothyroidism and diabetes insipidus.

Embolic Agents and Microcatheters for Endovascular Treatment of Cerebral Arteriovenous Malformations.

Endovascular embolization of cerebral arteriovenous malformations (AVMs) originally entailed delivery of N-butyl cyanoacrylate glue to the nidus via a flow-directed microcatheter. Within the past decade, several new liquid embolic agents and novel microcatheter technologies have become available that have improved the ease of use and efficacy of endovascular therapies for AVMs. Nonadhesive copolymers, such as Onyx and Precipitating Hydrophobic Injectable Liquid, have largely replaced N-butyl cyanoacrylate given a lower risk of catheter entrapment.

Crossing the Cervicothoracic Junction During Posterior Cervical Decompression and Fusion: Is It Necessary?

Background: Posterior cervical fusion (PCF) is performed to treat cervical myelopathy, radiculopathy, and/or deformity. Constructs ending at the cervicothoracic junction (CTJ) may lead to higher rates of adjacent segment disease, and much debate exists regarding crossing the CTJ due to paucity of data in the literature.

Objective: To determine whether extension of PCF constructs across the CTJ decreases incidence of adjacent segment disease and need for revision surgery.

Interstitial Lung Disease in the Elderly.

Background: Despite the relationship between idiopathic pulmonary fibrosis (IPF) and advancing age, little is known about the epidemiology of interstitial lung disease (ILD) in the elderly. We describe the diagnoses, clinical characteristics, and outcomes of patients who were elderly at the time of ILD diagnosis.

Methods: Among subjects from a prospective cohort study of ILD, elderly was defined as age ≥ 70 years.