Saskatoon Medical Imaging

Background: Subdural hematoma (SDH) is a serious complication of shunt surgery for normal pressure hydrocephalus (NPH). Since the introduction of adjustable valves, management strategy has changed significantly. Methods: A retrospective review of NPH patients treated in the Hydrocephalus and CSF Disorders Clinic over the past five years was conducted. A review of clinical materials and imaging identified 32 patients who developed SDH following shunt surgery for NPH. Results: Twenty-seven patients were male and five were female. Mean age was 74. All patients received programmable valves. Nineteen patients were diagnosed with SDH within six months of shunt insertion, with a mean duration to diagnosis of 48 days. Five required surgery. The remaining 14 patients were treated successfully with shunt adjustment. All patients returned to their clinical baseline. Thirteen of the 32 patients developed SDH after a period of six months, with a mean duration to diagnosis of 43 months. None required surgical intervention. Ten patients were treated with shunt adjustment. The remainder were observed. Conclusions: Close surveillance following shunt insertion, particularly within the first six months post-op, is essential to prevent significant clinical sequelae secondary to SDH. Programmable valves can play an important role in early SDH management.

Background: Ischemic stroke is a major cause of morbidity and mortality in Canada. Since 2015, mechanical thrombectomy has been the standard of care for eligible large vessel occlusions (LVOs), though anesthetic strategies remain variable. Methods: We conducted a single-center retrospective review of patients undergoing mechanical thrombectomy for anterior circulation LVOs between 2021 and 2023. Patients were categorized by anesthetic strategy (general anesthesia vs. conscious sedation), and outcomes, including time to recanalization, angiographic results (mTICI), and 90-day functional status (mRS), were compared. Statistical analyses included Student’s t-test, Mann-Whitney U-test, and Fisher’s exact test. Results: Among 226 patients, 177 (78%) received general anesthesia and 49 (22%) underwent conscious sedation. Baseline characteristics including sex, age, NIHSS, ASPECTS, collaterals, and laterality were similar between groups. Conscious sedation was associated with a statistically significant shorter time from arrival to the angiography suite to groin puncture (p=0.007), but no differences in time to recanalization (p=0.893), angiographic outcomes (p=0.987), or 90-day functional status (p=0.795) were observed. Conclusions: Conscious sedation led to faster procedural initiation, though no difference in clinical or radiographic outcome was observed. Anesthetic choice should be individualized based on patient and physician factors in acute mechanical thrombectomy.

W artykule przedstawiono wyniki analizy literatury przedmiotu nt inteligentnych metadanych rejestrowanej w wybranych bazach danych (LISTA, Scopus, Web of Science). W ramach dyskusji terminologicznej zdefiniowano termin „smart metadata” oraz wyjaśniono przyjętą metodologię badań literaturowych. Przedstawiono wyniki badań ilościowych i jakościowych oraz wnioski wynikające z analizy literatury przedmiotu. Zwrócono szczególną uwagę na rolę inteligentnych metadanych w sztucznej inteligencji oraz praktyczne zastosowania inteligentnych metadanych w archiwach, bibliotekach i muzeach (ALM). W zakończeniu wskazano luki badawcze w badaniach nad inteligentnymi metadanymi używanymi w polskich instytucjach kultury.