Journal of neurosurgery
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Journal of neurosurgery · Nov 2014
Multicenter StudyAge-related differences in unruptured intracranial aneurysms: 1-year outcomes.
The aim of this study was to determine age-related differences in short-term (1-year) outcomes in patients with unruptured intracranial aneurysms (UIAs). ⋯ Surgical treatment of UIAs appears to be safe, prevents 1-year hemorrhage, and may confer a survival benefit in patients < 50 years of age. However, surgery poses a significant risk of morbidity and death in patients > 65 years of age. Risk of endovascular treatment does not appear to increase with age. Risks and benefits of treatment in older patients should be carefully considered, and if treatment is deemed necessary for patients older than 65 years, endovascular treatment may be the best option.
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Journal of neurosurgery · Nov 2014
Randomized Controlled Trial Multicenter StudyA randomized controlled dual-center trial on shunt complications in idiopathic normal-pressure hydrocephalus treated with gradually reduced or "fixed" pressure valve settings.
This study was undertaken to investigate whether a gradual reduction of the valve setting (opening pressure) decreases the complication rate in patients with idiopathic normal-pressure hydrocephalus (iNPH) treated with a ventriculoperitoneal (VP) shunt. ⋯ Gradual lowering of the valve setting to a mean of 7 cm H₂O led to the same rate of shunt complications and overdrainage symptoms as a fixed valve setting at a mean of 13 cm H₂O but was associated with a significantly better outcome.