Neurosurgery
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In this study, we evaluated the difference in incidence of symptomatic vasospasm between ruptured aneurysms in the anterior and posterior circulation using multiple logistic regression analysis. ⋯ Although a poor clinical grade and a severe SAH classification on admission such as Hunt and Hess grade and Fisher's classification are established powerful predictors of symptomatic vasospasm, ruptured vertebrobasilar aneurysm are for the first time reported to be a predictor of symptomatic vasospasm based on results of a recent reliable statistical analysis.
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To better understand the presentation, management, and outcome of syringobulbia in the pediatric age group. ⋯ Syringobulbia is strongly associated with Chiari malformation and syringomyelia, and patients often present because of cranial nerve palsies. Posterior fossa decompression is a safe and effective treatment.
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To determine the effect of Neuroform stent (Boston Scientific/Target, Fremont, CA) deployment on parent vessel lumen and detect in-stent changes in patients harboring wide-necked intracranial aneurysms treated with the stent-coil technique. ⋯ Intracranial stenting using a soft self-expanding stent without angioplasty induced a statistically, but not clinically, significant decrease in cross sectional area. Further research and longer-term follow-up are needed to elucidate the mechanism and clinical importance of this response.
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The objective of this study was to assess the collateral circulation and blood flow velocity in arteries forming collateral circulation in patients with cerebral aneurysms and the occlusion of the brachiocephalic vessels. ⋯ Occlusion of the brachiocephalic vessels leads to formation of collateral circulation through the circle of Willis and the extracranial collaterals connecting the external and internal carotid arteries. An increase in blood flow velocity is commonly observed in intracranial arteries forming a collateral pathways. In some cases, not excluding arteries with a cerebral aneurysm, the increase in blood flow velocity is insignificant or none at all. This study shows that formation of a cerebral aneurysm is not always related to an increase in the flow velocity of collateral arteries.
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There are few large-volume studies of the repair of complete missile-caused peroneal nerve and peroneal division lesions. In this prospective study, the outcomes of such repairs are studied and the factors influencing the outcomes are analyzed. ⋯ After peroneal nerve or peroneal division repairs, a successful outcome is most probable with low-level lesions repaired in the first 3 months after injury using grafts smaller than 4 cm. Conversely, high-level repairs delayed for more than 7 months after injury and using grafts larger than 8 cm are probably not worthwhile.