Acta neurochirurgica
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Acta neurochirurgica · Sep 2015
International differences in the management of intracranial aneurysms: implications for the education of the next generation of neurosurgeons.
The publication of the International Subarachnoid Aneurysm Trial rapidly changed the management of patients with subarachnoid hemorrhage. The present and perceived future trends of aneurysm management have significant implications for patients and how we educate future cerebrovascular specialists. ⋯ Our findings have implications for the design of neurosurgical curricula for residents as well as for certification examinations and procedures. Specialty and educational organizations and those responsible for the education of future clinicians who will care for patients with cerebrovascular problems should adjust educational objectives and implement curricula and learning experiences that will ensure that cerebrovascular specialists are capable of providing the best care possible to the patient with an aneurysm, whether that be open surgery or endovascular management. These findings mean that organizations around the world will need to make these adjustments to the education of future specialists.
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Acta neurochirurgica · Sep 2015
Treatment outcomes of unruptured intracranial aneurysm; experience of 1,231 consecutive aneurysms.
The aim of this study was to review our experience with surgical clipping and endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs), with a special focus on complications. ⋯ Both UIA treatment modalities decided by one hybrid neurosurgeon showed low complication rates and good clinical outcomes in this study. These results may serve as a point of reference for clinical decision-making for patients with UIA.
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Acta neurochirurgica · Sep 2015
Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome.
Meningiomas are more prevalent in elderly individuals; however, the surgical outcome and prognostic factors in this age group are unclear. This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection. ⋯ The outcome of intracranial meningioma resection in elderly individuals is favorable if the preoperative KPS score is >70 and no neurological deficits are present. Treatment decisions should be patient-specific, and additional factors should be considered when operations are performed in patients with a low preoperative KPS score or neurological deficits.
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Acta neurochirurgica · Sep 2015
Stereotactic Gamma Knife surgery safety and efficacy in the management of symptomatic benign confined cavernous sinus meningioma.
Considering the proximity to cranial nerves from II to VI and the internal carotid artery microsurgery for cavernous sinus meningioma (CSM) has its limits of complete resection, with high potential tumor recurrences, cranial nerve and vascular morbidity. Gamma Knife surgery (GKS) is an advanced modality as primary treatment for patients harboring symptomatic benign confined CSM as well as adjuvant therapy to postoperative residual tumor giving a high rate of tumor control, stabilizing or even improving clinical condition with low morbidity. ⋯ Gamma Knife surgery is a safe and effective option for the treatment of cavernous sinus meningioma not only as an adjuvant to surgery but also as an alternative to surgical removal in tumors confined mainly to the cavernous sinus.