Journal of neurosurgery
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Journal of neurosurgery · Dec 2024
Impact of smoking on the detection of brain aneurysms in general population screening: a systematic review and meta-analysis.
While the relationship between smoking and subarachnoid hemorrhage is well established, data regarding the probability of detecting unruptured intracranial aneurysms (UIAs) in smokers remain sparse. The aim of this systematic review and meta-analysis is to provide a comprehensive understanding of the relationship between smoking and the likelihood of identifying UIAs in healthy asymptomatic patients who underwent brain imaging for indications unrelated to UIAs. ⋯ This study suggests a potentially higher risk of UIAs in patients who smoked than in those who never smoked. However, the results of this meta-analysis revealed that smoking was not statistically associated with higher UIA detection. This result could be explained by the limited number of studies published on this topic. If these findings reach statistical significance in future larger studies, it could justify revising guidelines to include cigarette smokers in intracranial aneurysm screening.
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Journal of neurosurgery · Dec 2024
The association of statin therapy with reduced intracranial aneurysm recurrence after endovascular coiling: a post hoc propensity score-matched analysis of a randomized clinical trial.
Endovascular intracranial aneurysm (IA) management has significantly evolved over the last 2 decades. Despite these advancements, the aneurysm recanalization rate after coil embolization remains a concern. Statins have been found to affect vascular repair and remodeling; therefore, the authors hypothesized that patients receiving statin therapy at the time of coil embolization would have lower aneurysm recurrence and retreatment rates compared with patients not receiving statin therapy. ⋯ Statin use was associated with a reduced rate of aneurysm recurrence in patients who underwent endovascular coiling for IAs with a decreased rate of retreatment during the follow-up period. Statins are a relatively low-risk treatment and may be an effective therapy to reduce recanalization of IAs, although further prospective studies are warranted to validate these findings.
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Journal of neurosurgery · Dec 2024
Investigation of predictors of latent visual impairment in patients with sellar lesions.
Patients with sellar lesions compressing the optic nerve sometimes perceive visual improvement after lesion resection, despite the absence of visual impairment on preoperative ophthalmological examination. This study investigated the indicators of latent visual impairment in patients with sellar lesions. ⋯ Angle assessment of optic nerve bending due to compression caused by sellar lesions on the sagittal image may be useful in identifying sellar lesions with latent visual impairment.
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Journal of neurosurgery · Dec 2024
Natural history of dolichoectatic vertebrobasilar aneurysms: a multinational study.
Dolichoectatic vertebrobasilar aneurysms (DVBAs) are expansions of arterial tissue leading to aneurysmal formations without an obvious neck. Their natural history is poorly understood; usually patients are admitted with thromboembolic complications and/or neurological symptoms from the mass effect. There have not been international collective data, and correct timing for highly risky treatments has been under discussion. The goal of this study was to define the natural history of DVBA by long-term follow-up in an international population of patients with DVBA. ⋯ This study verifies the malignancy of DVBAs and encourages invasive treatment in the early phase of disease progression based on radiological characteristics and patient age when a treatment option is considered suitable. This also stresses the need for continued investigations to develop new therapeutics with acceptable safety profiles.