Guan Li

Purpose: Mechanical thrombectomy (MT) has improved outcomes for acute ischemic stroke (AIS); however, patients with renal failure remain at elevated risk for adverse events. Sex-based differences in outcomes following thrombectomy have been reported in heterogeneous stroke populations, but data specific to renal failure patients are limited. Understanding whether sex influences in-hospital mortality and discharge disposition in this high-risk subgroup is clinically important.Materials and Methods: We conducted a retrospective cohort study using the 2019–2022 National Inpatient Sample to identify renal failure patients undergoing MT for AIS. Patients were stratified by sex. Multivariable logistic regression was used to assess associations between sex and in-hospital mortality and non-routine discharge, adjusting for demographic, socioeconomic, clinical, and hospital-level covariates.Results: The study included 3,280 unweighted hospitalizations (1,675 males; 1,605 females). After adjustment, female sex was independently associated with higher odds of non-routine discharge (adjusted odds ratio [OR] 1.536, 95% confidence interval [CI] 1.391–1.696; P<0.001) but not with in-hospital mortality (adjusted OR 0.953, 95% CI 0.874–1.038; P=0.266). Increasing age and select comorbidities were associated with both outcomes.Conclusion: Female sex was associated with increased odds of non-routine discharge but not in-hospital mortality among renal failure patients undergoing MT. These findings support equitable application of thrombectomy across sexes while highlighting the importance of sex-aware discharge planning in this high-risk population.

BACKGROUND: Spinal epidermoid cysts are rare, benign lesions accounting for less than 1% of all spinal tumors. They may be congenital or acquired following trauma or spinal procedures. Although slow-growing, their mass effect can cause progressive neurological symptoms. Resection remains the mainstay of treatment, but they may recur when complete removal is limited by adherence to neural structures. OBSERVATIONS: A 71-year-old female with prior lumbar surgery presented with back pain and radiculopathy after multiple falls. MRI revealed a recurrent intradural extramedullary lesion at L1–2. She underwent endoscope-assisted revision laminectomy with gross-total resection. Pathological analysis confirmed an epidermoid cyst. Postoperatively, the patient remained neurologically stable without recurrence at 3 months. LESSONS: Endoscope-assisted microsurgical resection provides excellent visualization for safe, effective removal of spinal epidermoid cysts. Despite favorable outcomes, long-term follow-up is essential due to the risk of recurrence. https://thejns.org/doi/10.3171/CASE25909