Journal of neurosurgery
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Journal of neurosurgery · Jul 2024
Multicenter StudyDevelopment and internal-external validation of the ATHE Scale: predicting acute large vessel occlusion due to underlying intracranial atherosclerosis prior to endovascular treatment.
The diagnosis of intracranial atherosclerosis (ICAS) associated with large vessel occlusion (LVO) before endovascular treatment (EVT) remains a clinical challenge. This study was aimed at developing a predictive model for ICAS-LVO in the anterior circulation preceding EVT. ⋯ The ATHE Scale, incorporating atrial fibrillation, truncal-type occlusion, hyperdense artery sign, and baseline examination NIHSS score, is an accurate, objective tool for predicting ICAS-LVO prior to EVT.
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Journal of neurosurgery · Jul 2024
Multicenter StudyGenetic characterization and mutational profiling of foramen magnum meningiomas: a multi-institutional study.
Foramen magnum (FM) meningiomas pose significant surgical challenges and have high morbidity and mortality rates. This study aimed to investigate the distribution of clinically actionable mutations in FM meningiomas and identify clinical characteristics associated with specific mutational profiles. ⋯ These findings provide important insights into the molecular genetics and clinicopathological characteristics of FM meningiomas. The identification of specific genetic alterations associated with tumor location, volume, calcification, histology, and sex at diagnosis may have implications for personalized treatment strategies in the future.
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Journal of neurosurgery · Jun 2024
Multicenter Study Comparative StudyEndovascular treatment of acute ischemic stroke patients with tandem lesions: antegrade versus retrograde approach.
The optimal technique for treating tandem lesions (TLs) with endovascular therapy is debatable. The authors evaluated the functional, safety, and procedural outcomes of different approaches in a multicenter study. ⋯ The retrograde approach was associated with faster recanalization times with a similar functional and safety profile when compared with the antegrade approach in patients with acute ischemic stroke with TL.
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Journal of neurosurgery · Jun 2024
Multicenter StudyEffect of cerebral arteriovenous malformation location on outcomes of repeat, single-fraction stereotactic radiosurgery: a matched-cohort analysis.
Patients with deep-seated arteriovenous malformations (AVMs) have a higher rate of unfavorable outcome and lower rate of nidus obliteration after primary stereotactic radiosurgery (SRS). The aim of this study was to evaluate and quantify the effect of AVM location on repeat SRS outcomes. ⋯ AVMs located in deep regions had significantly lower favorable outcomes and obliteration rates compared with superficial lesions after repeat SRS. Although the rates of hemorrhage in the latency period and RICs in the two cohorts were comparable, delayed cyst formation occurred later in patients with deep-seated AVMs.
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Journal of neurosurgery · Jun 2024
Multicenter StudyObesity and meningioma: a US population-based study paired with analysis of a multi-institutional cohort.
Whether obesity is associated with meningioma and the impact of obesity by gender has been debated. The primary objective of this study was to investigate differences in BMI between male and female patients undergoing craniotomy for meningioma and compare those with patients undergoing craniotomy for other intracranial tumors. The secondary objective was to compare meningioma location and progression-free survival (PFS) between obese and nonobese patients in a multi-institutional cohort. ⋯ Male and female patients undergoing meningioma resection are more likely to be obese than patients undergoing craniotomy for other intracranial tumors. Obese males are more likely to have meningiomas in the skull base compared with other locations, but this association was not found in females. There was no significant difference in PFS among obese patients. The mechanism by which obesity increases meningioma incidence remains to be determined.