Journal of neurosurgery
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Journal of neurosurgery · Mar 2024
Safety and effectiveness of stent-assisted coiling with adjunctive techniques in ruptured acute aneurysms: a propensity score-matched cohort study.
The use of stent-assisted coiling (SAC) in acute subarachnoid hemorrhage cases is associated with higher incidence rates of bleeding and ischemic complications. The aim of this study was to evaluate the safety and efficacy of the SAC technique in the treatment of ruptured intracranial aneurysms (RIAs). ⋯ Although stent treatment for RIA results in some incidents of complications, it is safe and effective. Besides, the SAC group showed better vascular imaging results compared with the CA group.
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Journal of neurosurgery · Mar 2024
Impact of subthalamic nucleus stimulation on urinary dysfunction and constipation in Parkinson's disease.
The effect of subthalamic nucleus (STN) deep brain stimulation (DBS) on urinary dysfunction and constipation in Parkinson's disease (PD) is variable. This study aimed to identify potential surgical and nonsurgical variables predictive of these outcomes. ⋯ Anterior active contact location was associated with improvement in constipation in PD patients after STN DBS. PD patients with greater GCA scores before surgery were more likely to experience urinary deterioration after DBS.
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Journal of neurosurgery · Mar 2024
Radionuclide shuntography for cerebrospinal fluid shunt flow evaluation in adults.
Radionuclide shuntography (RS) performed using 99mTc-DTPA injected into the reservoir of CSF shunts enables evaluation of CSF flow for suspected shunt malfunctions. The goal of this study was to report the authors' institutional experience with RS and evaluate its utility and associated complications. ⋯ RS is a useful and safe tool in the workup of shunt malfunction.
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Journal of neurosurgery · Mar 2024
Effectiveness of indirect revascularization for adult hemorrhagic moyamoya disease: a 10-year follow-up study.
The optimal surgical approach for hemorrhagic moyamoya disease (hMMD) continues to be a topic of debate. The authors' prior research demonstrated that both combined and indirect revascularization were efficacious. However, questions remain regarding the long-term prognosis consistency between these two treatments. Therefore, the objective of this study was to evaluate and compare the enduring effects of these surgical modalities on adult hMMD, extending the findings of the authors' previous studies. ⋯ High rebleeding rates persist in adult hMMD patients, even after revascularization. Combined revascularization proved superior to EDAS in preventing long-term rebleeding. In contrast, EDAS alone did not display a clear effect on reducing long-term rebleeding rates.
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Journal of neurosurgery · Mar 2024
Spontaneous shrinkage of sporadic vestibular schwannomas: a clinical and radiological analysis.
The natural history of sporadic vestibular schwannoma (VS) is unpredictable, as tumors may or may not grow and can even spontaneously regress. A spontaneous VS shrinkage MRI-based pattern has been proposed with either a scalloped tumor aspect in the cerebellopontine angle or the appearance of a CSF-filled space surrounding the intracanalicular (IC) tumor within an enlarged canal. The authors of this retrospective study aimed to describe the evolution of sporadic VSs with radiological signs of VS regression and to identify prognostic factors for tumor shrinkage. ⋯ Spontaneous shrinkage of sporadic VSs could be suspected based on two radiological aspects that are indicative of VSs in progressive or stabilized regression and is an additional argument for the conservative management of these tumors. During follow-up, recovery from a reduced to a normal cochlear fluid MRI signal is a good indicator for hearing preservation.