Our case is a 72-year-old female with Fibromuscular Dysplasia (FMD) presented to the Emergency Department (ED) with acute coronary syndrome (ACS), more specifically NSTEMI. In ED, troponin levels were elevated and non...Our case is a 72-year-old female with Fibromuscular Dysplasia (FMD) presented to the Emergency Department (ED) with acute coronary syndrome (ACS), more specifically NSTEMI. In ED, troponin levels were elevated and non-ST segment elevation myocardial infarction (NSTEMI) was detected on electrocardiogram (ECG). Computed tomography (CT) scan showed Internal Carotid artery (ICA) pseudoaneurysm. Cardiac catheterization (CATH) was performed and revealed occlusion of the Left anterior descending (LAD) artery. Spontaneous coronary artery dissection (SCAD) was suspected due to the history of FMD without a history of hypertension, smoking or substance use.展开更多
Primary ventral hernias and ventral incisional hernias have been a challenge for surgeons throughout the ages. In the current era, incisional hernias have increased in prevalence due to the very high number of laparot...Primary ventral hernias and ventral incisional hernias have been a challenge for surgeons throughout the ages. In the current era, incisional hernias have increased in prevalence due to the very high number of laparotomies performed in the 20 th century. Even though minimally invasive surgery and hernia repair have evolved rapidly, general surgeons have yet to develop the ideal, standardized method that adequately decreases common postoperative complications, such as wound failure, hernia recurrence and pain. The evolution of laparoscopy and ventral hernia repair will be reviewed, from the rectoscopy of the 4th century to the advent of laparoscopy, from suture repair to the evolution of mesh reinforcement. The nuances of minimally invasive ventral and incisional hernia repair will be summarized, from preoperative considerations to variations in intraoperative practice. New techniques have become increasingly popular, such as primary defect closure, retrorectus mesh placement, and concomitant component separation. The advent of robotics has made some of these repairs more feasible, but only time and well-designed clinical studies will tell if this will be a durable modality for ventral and incisional hernia repair.展开更多
An estimated 285 million adults(aged 20-79 years)worldwide were diagnosed to have diabetes mellitus(DM)in 2010,and this number is projected to grow to 439million adults by the year 2030.Orthopaedic surgeons,regardless...An estimated 285 million adults(aged 20-79 years)worldwide were diagnosed to have diabetes mellitus(DM)in 2010,and this number is projected to grow to 439million adults by the year 2030.Orthopaedic surgeons,regardless of their subspecialty interest,will encounter patients with DM during their career since this epidemic involves both developed and emerging countries.Diabetes results in complications affecting multiple organ systems,potentially resulting in adverse outcomes afterorthopaedic surgery.The purpose of this review is to discuss the pathophysiology of DM and its potential for impacting orthopaedic surgery patients.Diabetes adversely affects the outcome of all orthopaedic surgery subspecialties including foot and ankle,upper extremity,adult reconstructive,pediatrics,spine surgery and sports medicine.Poorly controlled diabetes negatively impacts bone,soft tissue,ligament and tendon healing.It is the complications of diabetes such as neuropathy,peripheral artery disease,and end stage renal disease which contributes to adverse outcomes.Well controlled diabetic patients without comorbidities have similar outcomes to patients without diabetes.Orthopaedic surgeons should utilize consultants who will assist in inpatient glycemic management as well as optimizing long term glycemic control.展开更多
Objectives:The movement towards personalization of cochlear implantation has continued to generate interest about variabilities in cochlear size.In a recent metaanalysis,Atalay et al.(2022)examined organ of corti leng...Objectives:The movement towards personalization of cochlear implantation has continued to generate interest about variabilities in cochlear size.In a recent metaanalysis,Atalay et al.(2022)examined organ of corti length,cochlear lateral wall,and“A”value and found that most covariates,other than congenital sensorineural hearing loss,did not impact cochlear size via these measurements.However,no meta-analysis exists on how patient-specific variables could impact other cochlear size measurements,such as cochlear height(CH),and“B”value(defined as the distance between opposite lateral walls and perpendicular to“A”value).The purpose of this systematic review and meta-analysis is to examine how patient-specific variables impact additional cochlear size measurements to assist clinical decisionmaking.Databases reviewed:A systematic review for cochlear size measurements using PRISMA methodology was performed using PubMed,CINAHL,and MEDLINE from database inception to October 1st,2022.Methods:Search terms used included English,cochlea,size,histology,anatomy,and human.Inclusion criteria were measurements for human cochlea,full-text articles,and articles in English.Primary measurements were“B”value and CH,as these measurements differ from the recent meta-analysis on this topic.Cochlear duct length(CDL)was also included.A random-effects continuous model for meta-analysis was performed.Measurements were stratified by gender(male/female)and disease type(sensorineural hearing loss(SNHL)/conductive hearing loss(CHL)).Results:A total of 7 articles met final inclusion criteria from a total of 674 articles received on initial search,resulting in 2263 total human cochleae.There was a statistical difference between male CDL(n=681 cochlea)compared to female CDL(n=657)from four articles(p<0.001;Cohen’s d effect size(ES):0.421;95%confidence intervals(CI):0.171,0.671).The frequency weighted mean for male CDL was 33.5 mm±1.8 mm and the frequency weighted mean for female CDL was 32.4 mm±1.5 mm with an unstandardized mean difference of 0.854 mm.There was no statistical difference between male“B”value(n=329)and female“B”value(n=349)for cochlea from two studies(p=0.184;Cohen’s d ES:0.410;95%CI:0.194,1.014).The frequency weighted mean for male“B”value was 6.5 mm±0.1 mm and the frequency weighted mean for female“B”value was 6.4 mm±0.1 mm with an unstandardized mean difference of 0.126 mm.There was no statistical difference between CH for SNHL(n=282)and CHL(n=275)from two studies(p=0.486;ES:0.085;95%CI:0.323,0.153,F ig.3).The frequency weighted mean for SNHL CH was 4.6 mm±0.8 mm and the frequency weighted mean for CHL CH was 4.3 mm±0.8 mm with an unstandardized mean difference of 0.032 mm.Conclusion:Male CDL is statistically larger than female CDL.There is no statistically significant association between gender or hearing loss type and“B”value or CH.The effect size for all comparisons is small,indicating little practical significance between any existing differences.The results of this study provide two additional cochlear metrics and indicate similar findings to the study by Atalay and colleagues as patient-specific characteristics appear to have no statistically significantly impact on cochlear size.展开更多
Background: Identification of elevated intracranial pressure is important following traumatic brain injury. We assessed the feasibility of educating military trainees on accurately obtaining optic nerve sheath diamete...Background: Identification of elevated intracranial pressure is important following traumatic brain injury. We assessed the feasibility of educating military trainees on accurately obtaining optic nerve sheath diameter measurements using a brief didactic and hands-on training session. Optic nerve sheath diameter is a noninvasive surrogate marker for elevated intracranial pressure, and may be of value in remote military operations, where rapid triage decisions must be made without access to advanced medical equipment.Methods: Military trainees with minimal ultrasound experience were given a 5-min didactic presentation on optic nerve sheath diameter ultrasound. Trainees practiced optic nerve sheath diameter measurements guided by emergency physician ultrasound experts. Trainees then measured the optic nerve sheath diameter on normal volunteers. Following this, a trained physician measured the optic nerve sheath diameter on the same volunteer as a criterion standard. An average of three measurements was taken.Results: Twenty-three military trainees were enrolled. A mixed design ANOVA was used to compare measurements by trainees to those of physicians, with a mean difference of –0.6 mm(P=0.76). A Bland-Altman analysis showed that the degree of bias in optic nerve sheath diameter measures provided by trainees was very small: d=–0.004 for the right eye and d=–0.007 for the left eye.Conclusions: This study demonstrates that optic nerve sheath diameter measurement can be accurately performed by novice ultrasonographers after a brief training session. If validated, point-of-care optic nerve sheath diameter measurement could impact the triage of injured patients in remote areas.展开更多
Angiotensin-converting enzyme inhibitor induced angioedema (AIIA) can vary from mild to life-threatening. A vast majority of cases of AIIA occur within a month of starting an angiotensin-converting enzyme-inhibitor (A...Angiotensin-converting enzyme inhibitor induced angioedema (AIIA) can vary from mild to life-threatening. A vast majority of cases of AIIA occur within a month of starting an angiotensin-converting enzyme-inhibitor (ACE-I). We present a 48-year-old male who presented with respiratory failure secondary to AIIA, after being on lisinopril for over 8 years. He had no previous complications secondary to lisinopril and aside from smoking, carried no risk factors for AIIA. Despite conventional treatment for angioedema, he had a prolonged stay in the Medical Intensive Care Unit (MICU). Following discharge, there hasn’t been a recurrence of AIIA since the discontinuation of lisinopril. The case is intended to caution that AIIA remains possible even late into a chronic regimen of ACE-I. This is a risk that shouldn’t be neglected, even with sparse risk factors or longer duration of ACE-I use. Conventional treatment is not currently in line with proposed etiologies of AIIA. We advocate for more clinical trials involving pharmaceutical agents targeting bradykinin accumulation.展开更多
Mitochondrial encephalopathy,lactic acidosis,and stroke-like episodes(MELAS)syndrome is a complex mitochondrial disorder.[1]It exhibits a diverse range of clinical symptoms affecting multiple organ systems.[1]We are e...Mitochondrial encephalopathy,lactic acidosis,and stroke-like episodes(MELAS)syndrome is a complex mitochondrial disorder.[1]It exhibits a diverse range of clinical symptoms affecting multiple organ systems.[1]We are exploring the intriguing link between MELAS and an elevated risk of infections.The systemic consequences of mitochondrial dysfunction,disrupting vital energy production processes,extend beyond neurological representation.[1]We emphasize 2 key elements that lead to a higher risk of infection:overall immune system dysfunction and reduced antibody production.Mitochondrial dysfunction compromises immune cell function,making it difficult to build a strong defense against pathogens.展开更多
Background We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. Methods We identified patients undergoing percutaneous clos...Background We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. Methods We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project. Results 6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87,P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89,P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42,P < 0.001) were lower as compared to the 1st tertile of hospital volume. Conclusion Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.展开更多
Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ...Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.Methods We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke centres.Patients with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,codes.The 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May 2020.The prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal variation.Findings There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,p<0.0001).Embolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative drop.Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p<0.0001).A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this tertile.Interpretation There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic.These findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.展开更多
文摘Our case is a 72-year-old female with Fibromuscular Dysplasia (FMD) presented to the Emergency Department (ED) with acute coronary syndrome (ACS), more specifically NSTEMI. In ED, troponin levels were elevated and non-ST segment elevation myocardial infarction (NSTEMI) was detected on electrocardiogram (ECG). Computed tomography (CT) scan showed Internal Carotid artery (ICA) pseudoaneurysm. Cardiac catheterization (CATH) was performed and revealed occlusion of the Left anterior descending (LAD) artery. Spontaneous coronary artery dissection (SCAD) was suspected due to the history of FMD without a history of hypertension, smoking or substance use.
文摘Primary ventral hernias and ventral incisional hernias have been a challenge for surgeons throughout the ages. In the current era, incisional hernias have increased in prevalence due to the very high number of laparotomies performed in the 20 th century. Even though minimally invasive surgery and hernia repair have evolved rapidly, general surgeons have yet to develop the ideal, standardized method that adequately decreases common postoperative complications, such as wound failure, hernia recurrence and pain. The evolution of laparoscopy and ventral hernia repair will be reviewed, from the rectoscopy of the 4th century to the advent of laparoscopy, from suture repair to the evolution of mesh reinforcement. The nuances of minimally invasive ventral and incisional hernia repair will be summarized, from preoperative considerations to variations in intraoperative practice. New techniques have become increasingly popular, such as primary defect closure, retrorectus mesh placement, and concomitant component separation. The advent of robotics has made some of these repairs more feasible, but only time and well-designed clinical studies will tell if this will be a durable modality for ventral and incisional hernia repair.
文摘An estimated 285 million adults(aged 20-79 years)worldwide were diagnosed to have diabetes mellitus(DM)in 2010,and this number is projected to grow to 439million adults by the year 2030.Orthopaedic surgeons,regardless of their subspecialty interest,will encounter patients with DM during their career since this epidemic involves both developed and emerging countries.Diabetes results in complications affecting multiple organ systems,potentially resulting in adverse outcomes afterorthopaedic surgery.The purpose of this review is to discuss the pathophysiology of DM and its potential for impacting orthopaedic surgery patients.Diabetes adversely affects the outcome of all orthopaedic surgery subspecialties including foot and ankle,upper extremity,adult reconstructive,pediatrics,spine surgery and sports medicine.Poorly controlled diabetes negatively impacts bone,soft tissue,ligament and tendon healing.It is the complications of diabetes such as neuropathy,peripheral artery disease,and end stage renal disease which contributes to adverse outcomes.Well controlled diabetic patients without comorbidities have similar outcomes to patients without diabetes.Orthopaedic surgeons should utilize consultants who will assist in inpatient glycemic management as well as optimizing long term glycemic control.
文摘Objectives:The movement towards personalization of cochlear implantation has continued to generate interest about variabilities in cochlear size.In a recent metaanalysis,Atalay et al.(2022)examined organ of corti length,cochlear lateral wall,and“A”value and found that most covariates,other than congenital sensorineural hearing loss,did not impact cochlear size via these measurements.However,no meta-analysis exists on how patient-specific variables could impact other cochlear size measurements,such as cochlear height(CH),and“B”value(defined as the distance between opposite lateral walls and perpendicular to“A”value).The purpose of this systematic review and meta-analysis is to examine how patient-specific variables impact additional cochlear size measurements to assist clinical decisionmaking.Databases reviewed:A systematic review for cochlear size measurements using PRISMA methodology was performed using PubMed,CINAHL,and MEDLINE from database inception to October 1st,2022.Methods:Search terms used included English,cochlea,size,histology,anatomy,and human.Inclusion criteria were measurements for human cochlea,full-text articles,and articles in English.Primary measurements were“B”value and CH,as these measurements differ from the recent meta-analysis on this topic.Cochlear duct length(CDL)was also included.A random-effects continuous model for meta-analysis was performed.Measurements were stratified by gender(male/female)and disease type(sensorineural hearing loss(SNHL)/conductive hearing loss(CHL)).Results:A total of 7 articles met final inclusion criteria from a total of 674 articles received on initial search,resulting in 2263 total human cochleae.There was a statistical difference between male CDL(n=681 cochlea)compared to female CDL(n=657)from four articles(p<0.001;Cohen’s d effect size(ES):0.421;95%confidence intervals(CI):0.171,0.671).The frequency weighted mean for male CDL was 33.5 mm±1.8 mm and the frequency weighted mean for female CDL was 32.4 mm±1.5 mm with an unstandardized mean difference of 0.854 mm.There was no statistical difference between male“B”value(n=329)and female“B”value(n=349)for cochlea from two studies(p=0.184;Cohen’s d ES:0.410;95%CI:0.194,1.014).The frequency weighted mean for male“B”value was 6.5 mm±0.1 mm and the frequency weighted mean for female“B”value was 6.4 mm±0.1 mm with an unstandardized mean difference of 0.126 mm.There was no statistical difference between CH for SNHL(n=282)and CHL(n=275)from two studies(p=0.486;ES:0.085;95%CI:0.323,0.153,F ig.3).The frequency weighted mean for SNHL CH was 4.6 mm±0.8 mm and the frequency weighted mean for CHL CH was 4.3 mm±0.8 mm with an unstandardized mean difference of 0.032 mm.Conclusion:Male CDL is statistically larger than female CDL.There is no statistically significant association between gender or hearing loss type and“B”value or CH.The effect size for all comparisons is small,indicating little practical significance between any existing differences.The results of this study provide two additional cochlear metrics and indicate similar findings to the study by Atalay and colleagues as patient-specific characteristics appear to have no statistically significantly impact on cochlear size.
文摘Background: Identification of elevated intracranial pressure is important following traumatic brain injury. We assessed the feasibility of educating military trainees on accurately obtaining optic nerve sheath diameter measurements using a brief didactic and hands-on training session. Optic nerve sheath diameter is a noninvasive surrogate marker for elevated intracranial pressure, and may be of value in remote military operations, where rapid triage decisions must be made without access to advanced medical equipment.Methods: Military trainees with minimal ultrasound experience were given a 5-min didactic presentation on optic nerve sheath diameter ultrasound. Trainees practiced optic nerve sheath diameter measurements guided by emergency physician ultrasound experts. Trainees then measured the optic nerve sheath diameter on normal volunteers. Following this, a trained physician measured the optic nerve sheath diameter on the same volunteer as a criterion standard. An average of three measurements was taken.Results: Twenty-three military trainees were enrolled. A mixed design ANOVA was used to compare measurements by trainees to those of physicians, with a mean difference of –0.6 mm(P=0.76). A Bland-Altman analysis showed that the degree of bias in optic nerve sheath diameter measures provided by trainees was very small: d=–0.004 for the right eye and d=–0.007 for the left eye.Conclusions: This study demonstrates that optic nerve sheath diameter measurement can be accurately performed by novice ultrasonographers after a brief training session. If validated, point-of-care optic nerve sheath diameter measurement could impact the triage of injured patients in remote areas.
文摘Angiotensin-converting enzyme inhibitor induced angioedema (AIIA) can vary from mild to life-threatening. A vast majority of cases of AIIA occur within a month of starting an angiotensin-converting enzyme-inhibitor (ACE-I). We present a 48-year-old male who presented with respiratory failure secondary to AIIA, after being on lisinopril for over 8 years. He had no previous complications secondary to lisinopril and aside from smoking, carried no risk factors for AIIA. Despite conventional treatment for angioedema, he had a prolonged stay in the Medical Intensive Care Unit (MICU). Following discharge, there hasn’t been a recurrence of AIIA since the discontinuation of lisinopril. The case is intended to caution that AIIA remains possible even late into a chronic regimen of ACE-I. This is a risk that shouldn’t be neglected, even with sparse risk factors or longer duration of ACE-I use. Conventional treatment is not currently in line with proposed etiologies of AIIA. We advocate for more clinical trials involving pharmaceutical agents targeting bradykinin accumulation.
文摘Mitochondrial encephalopathy,lactic acidosis,and stroke-like episodes(MELAS)syndrome is a complex mitochondrial disorder.[1]It exhibits a diverse range of clinical symptoms affecting multiple organ systems.[1]We are exploring the intriguing link between MELAS and an elevated risk of infections.The systemic consequences of mitochondrial dysfunction,disrupting vital energy production processes,extend beyond neurological representation.[1]We emphasize 2 key elements that lead to a higher risk of infection:overall immune system dysfunction and reduced antibody production.Mitochondrial dysfunction compromises immune cell function,making it difficult to build a strong defense against pathogens.
文摘Background We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. Methods We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project. Results 6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87,P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89,P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42,P < 0.001) were lower as compared to the 1st tertile of hospital volume. Conclusion Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.
文摘Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.Methods We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke centres.Patients with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,codes.The 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May 2020.The prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal variation.Findings There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,p<0.0001).Embolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative drop.Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p<0.0001).A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this tertile.Interpretation There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic.These findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction.
