Journal of neurosurgery
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Journal of neurosurgery · Jan 2025
Risk factors of short-term poor functional outcomes and long-term durability of ruptured large or giant intracranial aneurysms.
Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates. In particular, functional outcomes of SAH caused by large or giant (≥ 10 mm) ruptured intracranial aneurysms are worsened by high procedure-related complication rates. However, studies describing the risk factors for poor functional outcomes specific to ruptured large/giant aneurysms are sparse. In addition, high recurrence and rebleeding rates following treatment of such aneurysms remain a concern. This study aimed to clarify the specific risk factors for poor short-term outcomes and long-term durability of SAH due to ruptured large/giant intracranial aneurysms using a multicenter observational database in Japan. ⋯ Increasing aneurysm size was identified as a risk factor for poor functional outcomes after SAH due to large/giant aneurysms and was affected by the interaction with other conventional risk factors. Endovascular therapy was more likely to be associated with better short-term outcomes; however, a higher delayed rebleeding rate after 1 year was a concern.
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Journal of neurosurgery · Jan 2025
Outcomes and complications of external ventricular drainage in primary and secondary intraventricular hemorrhage: a descriptive observational study.
Intraventricular hemorrhage (IVH) is a serious condition with high mortality rates and poor functional outcome in survivors. Treatment includes external ventricular drains (EVDs), which are associated with several complications. This study reports the clinical outcome and complication rate in patients with primary IVH (pIVH) and secondary IVH treated with EVDs. ⋯ This study provides a comprehensive historical reference of complications, mortality rate, and functional outcome of EVD-treated patients with pIVH and secondary IVH. These findings provide a baseline for evaluating novel catheter-based interventions in IVH management.
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Journal of neurosurgery · Jan 2025
Predictive factors for traumatic cerebral contusion volume, expansion, and outcomes.
Traumatic hemorrhagic cerebral contusions are a well-established cause of morbidity and mortality in neurosurgery. This study aimed to determine prognostic factors for long-term functional outcomes and longitudinal contusion volume changes in traumatic brain injury (TBI) patients. ⋯ Functional outcomes in traumatic cerebral contusion patients may be associated with age and admission GCS score, and verbal GCS score may predict initial contusion volume and contusion expansion. These findings supplement an evolving understanding of factors that influence outcomes in patients with cerebral contusions, and further study into the utility of GCS to guide these decisions could help to guide the clinical management of these highly complex patients.
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Journal of neurosurgery · Jan 2025
Neurological and functional outcomes of 32 patients with hemorrhagic brainstem cavernous malformations: a practical guide for surgical planning.
Brainstem cavernous malformations (BSCMs) were once considered inoperable. Microsurgical resection now represents a valuable option for treating patients with hemorrhagic or symptomatic lesions. The aim of this study was to provide a practical guide for surgical planning by analyzing postoperative neurological and functional outcomes. ⋯ Early surgery after the first bleed following systematic surgical planning may be considered as an effective option for managing hemorrhagic BSCMs with acceptable operative morbidity and relatively favorable early- and long-term neurological and functional outcomes.