Neurosurgery
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Peritumoral edema is a recognized complication following stereotactic radiosurgery (SRS). ⋯ SRS meningioma treatment demonstrated a low incidence of toxicity; however, large tumor volumes and single-fraction SRS treatment had an increased risk for posttreatment edema. Risk factors for edema should be considered in meningiomas treatment.
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Multicenter Study
The silk flow-diverting stent in the endovascular treatment of complex intracranial aneurysms: technical aspects and midterm results in 24 consecutive patients.
The flow-diverting stent is a new option in endovascular therapy specifically designed for the endovascular reconstruction of a segmentally diseased artery. The safety of flow-diverting stents is still equivocal. ⋯ Many previously untreatable cerebral aneurysms may be successfully treated with the Silk flow-diverting stent, but the associated risk of thromboembolic events is justifiable only if conventional endovascular or surgical treatment options are not applicable. Perioperative thromboembolic events should be prepared for and treated without unnecessary delays because they frequently respond to adjunctive medical therapy.
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Review
Carotid endarterectomy with primary closure: analysis of outcomes and review of the literature.
Despite abundant published support of patch angioplasty during carotid endarterectomy (CEA), primary closure is still widely used. The reasons underlying the persistence of primary closure are not quite evident in the literature. ⋯ In conjunction with contemporary medical management, primary closure during CEA may yield results comparable or superior to patch angioplasty. Advantages of primary closure include shorter cross-clamp times and elimination of graft-specific complications.
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Type II odontoid fractures with additional chip fragments are rare in clinical practice, accounting for < 10% of all odontoid fractures. Hadley et al were the first to describe these fractures as an individual subtype (IIA). ⋯ Hadley type IIA odontoid fractures are inherently unstable and impede proper realignment. These fractures have a significantly increased risk for secondary loss of reduction and bony nonunion, particularly after nonoperative management. Early surgery should be considered to avoid further complications.
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Case Reports Comparative Study
Evaluation of serial intraoperative surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography in patients with cerebral arteriovenous malformations.
With the use of indocyanine green (ICG) as a novel fluorescent dye, fluorescence angiography has recently reemerged as a viable option. ⋯ We found that ICG videoangiography is helpful for resecting cerebral arteriovenous malformation. It is especially effective in visualizing the nidus and superficial drainers, as well as changes in flow after clipping or coagulating of feeders.