Journal of neurosurgery
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Journal of neurosurgery · Jul 2009
Alteration of intraaneurysmal hemodynamics by placement of a self-expandable stent. Laboratory investigation.
Development of a flexible self-expanding stent system and stent-assisted coiling technique facilitates endovascular treatment of wide-necked brain aneurysms. The hemodynamic effect of self-expandable stent placement across the neck of a brain aneurysm has not been well documented in patient-specific aneurysm models. ⋯ The flexible self-expandable stents significantly altered flow velocity and also flow structure in these aneurysms. Overall flow alterations by the stent appeared favorable for the long-term durability of aneurysm embolization. The possibility that the placement of a low-profile self-expandable stent might induce unfavorable flow patterns such as a fast flow stream in the aneurysm dome cannot be excluded.
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Journal of neurosurgery · Jul 2009
Influence of weekend versus weekday hospital admission on mortality following subarachnoid hemorrhage. Clinical article.
Several studies have indicated that short-term mortality risk is higher among patients who are admitted on the weekends. This "weekend effect" has been observed among patients admitted with a variety of diagnoses, including myocardial infarction, pulmonary embolism, ruptured abdominal aortic aneurysm, and stroke. This study examines the relationship between short-term mortality risk and weekend admission among patients hospitalized following subarachnoid hemorrhage (SAH). ⋯ Weekend admission is not associated with significantly increased short-term mortality risk among patients hospitalized with SAH.
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Journal of neurosurgery · Jul 2009
Case ReportsRelationship between the ophthalmic artery and the dural ring of the internal carotid artery. Clinical article.
The ophthalmic artery (OphA) usually arises from the intradural internal carotid artery (ICA), and the extradural origin has also been known. However, the interdural origin is extremely rare. The purpose of this paper was to clarify the origin of the OphA in patients with a paraclinoid aneurysm in the ICA based on intraoperative findings. ⋯ The incidence of the interdural origin was 6.7% and was not as rare as the authors expected. Neurosurgeons should know the possible existence of the interdural origin of the OphA to section the medial side of the dural ring.
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Journal of neurosurgery · Jul 2009
Predictors and outcome of seizures after spontaneous intracerebral hemorrhage. Clinical article.
Seizures are an important neurological complication of spontaneous intracerebral hemorrhage (ICH). A better understanding of the risk factors of seizures following ICH is needed to predict which patients will require treatment. ⋯ Higher mean ICH volumes at presentation were predictive of seizure, and the presence of late seizures was predictive of developing epilepsy. Most seizures occurred within 2 years of spontaneous ICH over a minimum of 3 years of follow-up.
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Journal of neurosurgery · Jul 2009
Case ReportsRemote distal outflow occlusion: a novel treatment option for complex dissecting aneurysms of the posterior inferior cerebellar artery. Report of 3 cases.
The authors report a novel management option for patients with complex dissecting aneurysms of the posterior inferior cerebellar artery (PICA). The authors reviewed the medical records and neuroimaging studies of 3 patients who underwent a novel surgical treatment for complicated dissecting PICA aneurysms. The mean follow-up period was 1.1 years, and no patient was lost to follow-up. ⋯ Intraoperative and delayed follow-up angiography demonstrated progressive diminution in size of the aneurysmal dilation but persistent filling of the proximal PICA segments supplying the brainstem. Outcome was good in all cases. This novel technique has been used successfully in 3 cases and, to the authors' knowledge, has not been reported previously.