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Aim: Aesthetic plastic surgery allows for the reshaping of the human body. Most research on aesthetic surgery has focused primarily on improving self-confidence. In this study, we aimed to assess the visual perception, body appreciation, body image quality of life, and satisfaction with life among aesthetic surgery patients, and compare these outcomes with those of healthy controls., Methods: A total of 57 aesthetic surgery patients and 56 healthy controls, with no history of psychiatric disorders, were included in the study. All participants completed the Motor-Free Visual Perception Test (3rd Edition), the Body Appreciation Scale (BAS), the Body Image Quality of Life Inventory (BIQLI), and the Satisfaction with Life Scale (SWLS). Participants with a history of psychiatric disorders and the surgeon's own revision patients were excluded., Results: MVPT-3 scores were significantly lower in aesthetic surgery patients compared to healthy controls. Additionally, as the number of operations increased, MVPT-3 scores decreased. A similar trend was observed between MVPT-3 and BIQLI/BAS scores, where lower body image quality and appreciation were associated with reduced visual perception scores. Interestingly, satisfaction with life was not significantly affected., Conclusion: Evaluating visual perception in patients seeking multiple surgeries may help prevent negative outcomes and contribute to more positive surgical experiences., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., Competing Interests: Declarations. Conflict of interest: The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Background and Objectives: Rebleeding of ruptured intracranial aneurysms (RIA) is associated with poor outcomes. Although immediate treatment of RIAs is preferred, optimal treatment timing is multifactorial and may be a complicating factor for achieving the best outcomes. The objective of this study was to compare outcomes for patients with RIAs as a function of treatment time of day. To the best of our knowledge, this is the first study that examines how treatment time of day influences treatment outcomes., Methods: This retrospective single-center study included all patients who were treated, either surgically or endovascularly, for RIAs within 24 hours after admission. Exclusion criteria were blister, mycotic or giant aneurysms, or incomplete records. The modified Rankin Scale was used to evaluate treatment outcomes using multivariate analysis. Nighttime treatment was defined when greater than 50% of the procedure was performed between 10 pm and 7 am, with other times classified as daytime treatment. Off-hours treatment was defined when more than 50% of the procedure was performed between 7 pm and 7 am, with other times classified as on-hours., Results: This study included 493 patients, with 84.2% (415) treated during the daytime, 15.8% (78) during the nighttime, 67.5% (333) during on-hours, and 32.5% (160) during off-hours. These groups did not differ according to age, sex, World Federation of Neurosurgical Societies and Fisher scales, aneurysm size, location, and surgical or endovascular treatment. Outcomes were favorable (modified Rankin Scale 0-2) for 72.0% (299) of patients treated during the daytime and 60.0% (46) of patients treated during the nighttime. Aneurysm treatment during the nighttime (OR: 0.50 [95% CI: 0.28-0.91], P = .023) but not during off-hours (OR: 0.76 [0.50-1.14], P = .18) was independently associated with unfavorable outcomes., Conclusion: Nighttime treatment was associated with poorer outcomes. Further studies are needed to evaluate outcomes if treatment is postponed to daytime hours., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Background and Objectives: In low- and middle-income countries (LMICs), approximately 5 million essential neurosurgical operations per year remain unaddressed. When compared with high-income countries, one of the reasons for this disparity is the lack of microsurgery training laboratories and neurosurgeons trained in microsurgical techniques. In 2020, we founded the Madison Microneurosurgery Initiative to provide no-cost, accessible, and sustainable microsurgery training opportunities to health care professionals from LMICs in their respective countries., Methods: We initially focused on enhancing our expertise in microsurgery laboratory training requirements. Subsequently, we procured a wide range of stereo microscopes, light sources, and surgical instrument sets, aiming to develop affordable, high-quality, and long-lasting microsurgery training kits. We then donated those kits to neurosurgeons across LMICs. After successfully delivering the kits to designated locations in LMICs, we have planned to initiate microsurgery laboratory training in these centers by providing a combination of live-streamed, offline, and in-person training assistance in their institutions., Results: We established basic microsurgery laboratory training centers in 28 institutions across 18 LMICs. This was made possible through donations of 57 microsurgery training kits, including 57 stereo microscopes, 2 surgical microscopes, and several advanced surgical instrument sets. Thereafter, we organized 10 live-streamed microanastomosis training sessions in 4 countries: Lebanon, Paraguay, Türkiye, and Bangladesh. Along with distributing the recordings from our live-streamed training sessions with these centers, we also granted them access to our microsurgery training resource library. We thus equipped these institutions with the necessary resources to enable continued learning and hands-on training. Moreover, we organized 7 in-person no-cost hands-on microanastomosis courses in different institutions across Türkiye, Georgia, Azerbaijan, and Paraguay. A total of 113 surgical specialists successfully completed these courses., Conclusion: Our novel approach of providing microsurgery training kits in combination with live-streamed, offline, and in-person training assistance enables sustainable microsurgery laboratory training in LMICs., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Objective: The neutrophil-to-lymphocyte ratio (NLR) is used for the prognosis of diseases characterized by inflammatory processes. This study aims to discuss the long-term outcomes and NLR in pediatric traumatic brain injury cases., Patients and Methods: This study investigated traumatic brain injury patients younger than 18 years. Patients were grouped into 5 groups according to their Glasgow outcome scores (GOS). Initial admission Glasgow coma scale (GCS) values, neurological examinations, pupil conditions, cardiopulmonary resuscitation (CPR) administration, and seizure occurrence were recorded. Neutrophil counts and lymphocyte counts, derived from complete blood count (CBC) values taken during the patient's first 8 hours of admission, were used to calculate the NLR value., Results: A total of 150 patients, 54 (36%) females and 96 (64%) males, were assessed in the study. The most frequent accident type was falling from a height [84 patients (56%)]. The GCS, CPR, pupillary reflex, anisocoria, surgical procedure, and neutrophil counts were significantly different between the GOS scores. There was no statistically significant difference between the GOS and the NLR (p=0.400). There was a significant difference in NLR value according to CPR, seizures, and brain injury type (p<0.05)., Conclusions: NLR values are not correlated with 1-year outcome scores in pediatric traumatic brain injury patients, unlike proven parameters such as initial GCS scores and neurological status.

Both structural and functional alterations in the retina and the choroid of the eye, as parts of the central nervous system, have been shown in psychotic disorders, especially in schizophrenia. In addition, genetic and imaging studies indicate vascular and angiogenesis anomalies in the psychosis spectrum disorders. In this ocular imaging study, choroidal structure and vascularity were investigated using enhanced depth imaging (EDI) optical coherence tomography (OCT) in first-episode psychosis (FEP), ultra-high risk for psychosis (UHR-P), and age- and gender- matched healthy controls (HCs). There were no significant differences between groups in central choroidal thickness, stromal choroidal area (SCA), luminal choroidal area (LCA) and total subfoveal choroidal area. The LCA/SCA ratio (p<0.001) and the choroidal vascularity index (CVI) (p<0.001) were significantly different between FEP, UHR-P and HCs. CVI and LCA/SCA ratio were significantly higher in patients with FEP compared to help-seeking youth at UHR-P. CVI and LCA/SCA ratio were not different between UHR-P and HCs. However, CVI was higher in UHR-P compared to HCs after excluding the outliers for the sensitivity analysis (p = 0.002). Current findings suggest that choroidal thickness is normal, but there are abnormalities in choroidal microvasculature in prodromal and first-episode psychosis. Further longitudinal studies are needed to investigate oculomics, especially CVI, as a promising biomarker for the prediction of conversion to psychosis in individuals at clinical high-risk., Competing Interests: Conflict of interest The authors have no conflicts of interest regarding subject of this manuscript., (Copyright © 2023 Elsevier B.V. and ECNP. All rights reserved.)

Objective: To evaluate whether lumbar subcutaneous fat tissue thickness (LSFTT) on midsagittal magnetic resonance imaging (MRI) is associated with lumbar spinal stenosis (LSS)., Study Design: Observational cross-sectional study., Place and Duration of Study: Department of Radiology and Neurosurgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey between January 2018 and December 2020., Methodology: The study group included 79 patients, who had undergone surgery for lumbar spinal stenosis. The control group included MRI scans of 80 individuals without lumbar spinal stenosis. Association between LSFTT and LSS was analysed through a comparison of both the groups., Results: The agreement between the two observers was found to be very good agreement with a two-way mixed intra-class correlation coefficient of 0.986 or higher (p <0.001). There was statistically significant differences between the LSS and non-LSS groups for both L5-S1 and L4-5 level measurements, p=0.001, and p=0.004, respectively. L5-S1 level measurements in the LSS group showed 29% increase in average with respect to the non-LSS group; and in L4-L5 level measurements, the increase was 40% in median. Females exhibited significantly higher values in both levels, (p <0.001 and p <0.001, respectively)., Conclusions: Lumbar subcutaneous fat tissue thickness is significantly associated with lumbar spinal stenosis. Measuring LSFTT on mid-sagittal MRI is an easily applicable, reproducible alternative method for predicting LSS. Key Word: Lumbar, Spinal canal, Stenosis, Subcutaneous fat tissue, Magnetic resonance imaging.