How artificial intelligence can provide information about subdural hematoma: Assessment of readability, reliability, and quality of ChatGPT, BARD, and perplexity responses.

Subdural hematoma is defined as blood collection in the subdural space between the dura mater and arachnoid. Subdural hematoma is a condition that neurosurgeons frequently encounter and has acute, subacute and chronic forms. The incidence in adults is reported to be 1.72-20.60/100.000 people annually. Our study aimed to evaluate the quality, reliability and readability of the answers to questions asked to ChatGPT, Bard, and perplexity about "Subdural Hematoma." In this observational and cross-sectional study, we asked ChatGPT, Bard, and perplexity to provide the 100 most frequently asked questions about "Subdural Hematoma" separately. Responses from both chatbots were analyzed separately for readability, quality, reliability and adequacy. When the median readability scores of ChatGPT, Bard, and perplexity answers were compared with the sixth-grade reading level, a statistically significant difference was observed in all formulas (P < .001). All 3 chatbot responses were found to be difficult to read. Bard responses were more readable than ChatGPT's (P < .001) and perplexity's (P < .001) responses for all scores evaluated. Although there were differences between the results of the evaluated calculators, perplexity's answers were determined to be more readable than ChatGPT's answers (P < .05). Bard answers were determined to have the best GQS scores (P < .001). Perplexity responses had the best Journal of American Medical Association and modified DISCERN scores (P < .001). ChatGPT, Bard, and perplexity's current capabilities are inadequate in terms of quality and readability of "Subdural Hematoma" related text content. The readability standard for patient education materials as determined by the American Medical Association, National Institutes of Health, and the United States Department of Health and Human Services is at or below grade 6. The readability levels of the responses of artificial intelligence applications such as ChatGPT, Bard, and perplexity are significantly higher than the recommended 6th grade level.

Is There Any Relationship Between Cervical Disc Herniation and Blood Inflammatory Response?

Objective Inflammation plays an important role in the pathophysiology of disc herniation. The aim of this study was to evaluate blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-reactive protein (CRP) levels in cervical disc herniation (CDH) patients. Materials and methods We retrospectively analyzed the medical records of 126 patients with neck pain who were treated as inpatients at the Neurosurgery Department of Harran University Faculty of Medicine. The NLR, PLR, and CRP levels during hospital admissions were documented. Results The study included 73 patients with CDH and neck pain, 53 patients with normal cervical MR examination and neck pain, and 50 healthy control subjects. The group with cervical disc hernia had a significantly higher mean serum leucocyte count, neutrophil count, NLR, and CRP level compared to those with a normal MR but neck pain and the control group. NLR was significantly higher in the multi-level CDH group compared to the control group, while the single-level CDH and multi-level CDH had no significant difference with respect to mean serum inflammatory parameters. Conclusion Higher NLR and CRP in patients with CDH compared to patients with neck pain but normal cervical MR and the controls may be due to a developing inflammatory response. It may be speculated that among patients with neck pain, those with non-elevated NLR and CRP levels may have normal neck MR imaging, and in patients with elevated NLR and CRP levels, early protective approaches may play a preventive role in disc degeneration and cervical disc hernia development.

Spontaneous Extrusion of Ventriculoperitoneal Shunt Catheter through the Right Lumbar Region: A Case Report and Review of the Literature.

Ventriculoperitoneal shunt surgery is the most frequently performed procedure in the management of hydrocephalus. Many varied complications related to this procedure have been reported. Distal migration of the peritoneal catheter and extrusion from the intact skin in an area unrelated to the surgical incision constitute a rare complication. We report a 1-year-old patient with the extrusion of the peritoneal catheter from the intact skin in the right lumbar region and present a literature review.

Antiedema effects of proanthocyanidin on experimental traumatic brain edema.

AIM: Brain edema developing due to central nervous system trauma is still a significant reason of mortality and morbidity. There is still no definite approach for the medical treatment of brain edema despite many clinical and laboratory studies in recent years. We therefore investigated the effect of proanthocyanidin, an antioxidant agent, on brain edema in this study. MATERIAL AND METHODS: A total of 30 rats were used and divided into three as the control, trauma and treated trauma groups. Subjects were sacrificed after 72 hours. The brain tissue-water ratio was evaluated and biochemical analysis of brain tissue performed. RESULTS: The difference between the treated trauma and control groups was statistically significant while the trauma and control groups were relatively similar. Rats that had undergone trauma and received proanthocyanidin treatment were statistically significant and different from the trauma group rats regarding the biochemical analysis results, brain tissue water ratio, and the cold damage enzymatic antioxidant defense system of cortical neural tissue. CONCLUSION: We believe that proanthocyanidin, an antioxidant substance, can be an effective treatment for brain edema.

The effect of bevacizumab on spinal epidural fibrosis in a postlaminectomy rat model.

AIM: Spinal epidural fibrosis is an inherent result of surgical trauma after laminectomy. The conditions in which epidural fibrosis is excessive are in the etiology of failed back syndrome. There have been many attempts to prevent formation of epidural fibrosis. Bevacizumab which is an anti-angiogenic medication, inhibits the effect of VEGF and thereby decreases the new blood vessel formation and as a result prevents adhesions. This study shows the effect of bevacizumab on spinal epidural fibrosis developing after laminectomy in rats. MATERIAL AND METHODS: In this study, 20 Wistar rats were used. Rats were divided into two groups; a control group, and a bevacizumab group. Three-level laminectomy was performed on the rats. Rats in the control group only had the laminectomy. In the bevacizumab group, 2.5 mg/kg bevacizumab diluted in 0.9% NaCl with a factor of 1:10 impregnated on cotton was applied on the dura topically for 5 minutes. Three weeks later, rats were sacrificed for histopathologic examination. Epidural fibrosis tissue was graded following sacrifice. RESULTS: Statistically, it was found that the bevacizumab group had significantly less epidural fibrosis compared to the control group (p < 0.05). CONCLUSION: Bevacizumab reduced the spinal epidural fibrosis significantly that developed in rats after laminectomy via its anti-VEGF effect by blocking VEGF receptors.