Journal of neurosurgery
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Journal of neurosurgery · Dec 2024
Incidence, presentation, and outcomes of intracranial hemorrhage in left ventricular assist device patients.
The objective was to evaluate the etiology, natural history, and impact of surgical intervention on outcomes of left ventricular assist device (LVAD) patients presenting with intracranial hemorrhage (ICH). ⋯ ICH as a complication of LVAD placement is increasing in frequency. GCS score on presentation best predicted mortality at 90 days. Neurosurgical intervention did not impact outcomes in the authors' study, which warrants further investigation in prospective cohorts.
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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
Early radiological reduction of periventricular anastomosis after direct bypass surgery for adult moyamoya disease.
Periventricular anastomosis (PA), a recently recognized cause of hemorrhage in moyamoya disease, is reducible after bypass surgery. The timing of the reduction, however, remains poorly understood. The objectives of the present study were to demonstrate radiological reduction of PA occurring within 48 hours after surgery and to identify factors associated with reduction. ⋯ PA could be reduced within 48 hours after direct bypass surgery, suggesting an early preventive effect against hemorrhage. Early reduction, a potential predictor for late-phase reduction, might be promoted by targeted bypass surgery.
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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.