Development and Internal Validation of Machine Learning Models to Predict Mortality and Disability After Mechanical Thrombectomy for Acute Anterior Circulation Large Vessel Occlusion.

Objective: Mechanical thrombectomy (MT) improves outcomes in patients with LVO but many still experience mortality or severe disability. We sought to develop machine learning (ML) models that predict 90-day outcomes after MT for LVO.

Methods: Consecutive patients who underwent MT for LVO between 2015-2021 at a Comprehensive Stroke Center were reviewed.

The Influence of Body Mass Index on Outcomes in Patients Undergoing Mechanical Thrombectomy for Anterior Circulation Large Vessel Occlusion: Institutional Experience and Meta-analysis.

Background: An obesity paradox, whereby patients with higher body mass index (BMI) experience improved outcomes, has been described for ischemic stroke. It is unclear whether this applies to patients undergoing mechanical thrombectomy (MT) for large vessel occlusion (LVO).

Methods: Mechanical thrombectomies for anterior circulation LVO between 2015 and 2021 at a single institution were reviewed.

The influence of pre-reperfusion blood pressure on outcomes following mechanical thrombectomy for anterior circulation large vessel occlusion.

Background: We evaluated how systolic blood pressure (SBP) and mean arterial pressure (MAP) parameters between presentation and reperfusion influence functional status and intracranial hemorrhage (ICH).

Methods: All patients who underwent MT for LVO at a single institution were reviewed. Independent variables included SBP and MAP measurements obtained on presentation, between presentation and reperfusion (pre-reperfusion), and between groin puncture and reperfusion (thrombectomy).

Machine learning prediction of malignant middle cerebral artery infarction after mechanical thrombectomy for anterior circulation large vessel occlusion.

Objective: Prediction of malignant middle cerebral artery infarction (MMI) could identify patients for early intervention. We trained and internally validated a ML model that predicts MMI following mechanical thrombectomy (MT) for ACLVO.

Methods: All patients who underwent MT for ACLVO between 2015 - 2021 at a single institution were reviewed.

Embolization of a Dural Arteriovenous Fistula Using Transcranial Middle Meningeal Artery Access: 2-Dimensional Operative Video.

The transcranial approach for direct middle meningeal artery (MMA) access to embolize dural arteriovenous fistulas (dAVF) has been described, but limited information regarding the setup, equipment, and technique is available. We present the details of this hybrid approach in the setting of a ruptured Cognard grade IV tentorial dAVF (Video 1). The patient was an adult female who presented with nausea, vomiting, and dizziness and was found to have a cerebellar hemorrhage.

Outcomes after endovascular embolization for the treatment of nasal and oropharyngeal hemorrhage: safety, efficacy, and rebleeding.

Background: Intractable nasal and oropharyngeal hemorrhage may be treated with endovascular embolization, but limited data are available. We sought to evaluate the efficacy, safety, and factors associated with rebleeding.

Methods: A retrospective analysis of consecutive embolizations for nasal and oropharyngeal hemorrhage over a 10-year period at a single institution was performed.

Management of chronic subdural hematoma with the subdural evacuating port system: Systematic review and meta-analysis.

The subdural evacuating port system (SEPS) is a minimally invasive option for treating chronic subdural hematoma (cSDH). Individual case series have shown it to be safe and effective, but outcomes have not been systematically reviewed. We sought to review the literature in order to determine the safety and efficacy of SEPS as a first line treatment for cSDH.

Prediction of mortality after evacuation of supratentorial intracerebral hemorrhage using NSQIP data.

Spontaneous intracerebral hemorrhage (sICH) is associated with high rates of morbidity and mortality. Neurosurgical clot evacuation is controversial but often a life saving maneuver in the setting of severe mass effect and cerebral herniation. Outcomes from large multicenter databases are sparsely reported.

A Propensity Score-Matched Comparison of Readmission Rates Associated With Microsurgical Clipping and Endovascular Treatment of Ruptured Intracranial Aneurysms.

Background: In the treatment of aneurysmal subarachnoid hemorrhage (aSAH), microsurgical clipping, and endovascular therapy (EVT) with coiling are modalities for securing the ruptured aneurysm. Little data is available regarding associated readmission rates. We sought to determine whether readmission rates differed according to treatment modality for ruptured intracranial aneurysms.

Annual incidences and predictors of 30-day readmissions following spontaneous intracerebral hemorrhage from 2010 to 2014 in the United States: A retrospective Nationwide analysis.

Objective: 30-day readmission rate is a quality metric often employed to represent hospital and provider performance. Currently, little is known regarding 30-day readmissions (30dRA) following spontaneous intracerebral hemorrhage (sICH). The purpose of this study was to use a national database to identify risk factors and trends in 30dRAs following sICH.

The risk factors, outcomes, and costs associated with venous thromboembolism after traumatic brain injury: a nationwide analysis.

: We sought to identify risk factors for VTE following traumatic brain injury (TBI) and determine how venous thromboembolism (VTE) affects outcomes and costs using a national database.: The Nationwide Inpatient Sample (NIS) was used to identify patients with TBI between 2002 and 2014. VTE was identified as any occurrence of deep venous thrombosis or pulmonary embolism.

Costs and predictors of 30-day readmissions after craniotomy for traumatic brain injury: a nationwide analysis.

Objective: There is increasing interest in the use of 30-day readmission (30dRA) as a quality metric to represent hospital and provider performance. Data regarding the incidence and risk factors for 30dRA after traumatic brain injury (TBI) are sparse. The authors sought to characterize these variables using a national database.

The Obesity Paradox in Spontaneous Intracerebral Hemorrhage: Results from a Retrospective Analysis of the Nationwide Inpatient Sample.

Background/objective: Mild obesity is associated with a survival benefit in cardiovascular and cerebrovascular disease. Only a few studies have analyzed the effect of obesity on outcomes after spontaneous intracerebral hemorrhage (ICH), and none have used a national US database. We sought to determine whether or not obesity was associated with outcomes and in-hospital complications following ICH.

Comparison of Cortical Bone Trajectory Screw Placement Using the Midline Lumbar Fusion Technique to Traditional Pedicle Screws: A Case-Control Study.

Background: Cortical bone trajectory (CBT) screws are an alternative to traditional pedicle screws (PS) for lumbar fixation. The proposed benefits of CBT screws include decreased approach-related morbidity and greater cortical bone contact to prevent screw pullout. Relatively little data is published on this technique.

The Incidence of Meningitis in Patients with Traumatic Brain Injury Undergoing External Ventricular Drain Placement: A Nationwide Inpatient Sample Analysis.

Background/objective: Infection is the most common complication of external ventricular drain (EVD) placement. National trends in the annual incidence of meningitis among patients with traumatic brain injury (TBI) who have undergone EVD placement have not been reported.

Methods: The Nationwide Inpatient Sample was used to select adults with a primary diagnosis of TBI who underwent EVD placement between 2002 and 2011.

Effect of Hypernatremia on Outcomes After severe Traumatic Brain Injury: A Nationwide Inpatient Sample analysis.

Objective: Induced hypernatremia is frequently used to reduce intracranial pressure in patients with severe traumatic brain injury (TBI). This technique is controversial, and some studies have independently associated hypernatremia with worse outcomes after TBI. We sought to investigate this potential association in a large healthcare database.