World Neurosurg
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To assess the clinical significance of cerebrospinal fluid (CSF) free fatty acid (FFA) levels in Chinese patients with acute ischemic stroke. ⋯ CSF FFA levels at the time of admission were associated with stroke severity and lesion volumes. In addition, CE stroke can be distinguished from other stroke etiologies by measuring CSF FFA levels very early.
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Case Reports
An Intracranial Petri Dish? Formation of Abscess in Prior Large Stroke After Decompressive Hemicraniectomy.
Development of brain abscess after an infarction is a rare clinical condition. There have been 11 cases in the literature. Many patients were treated with potent antibiotics only and did not survive. We present 2 cases in which patients received aggressive surgical resection of brain abscess and survived. The analysis of the literature confirmed our finding that surgical intervention of brain abscess in patients after stroke is advisable. ⋯ Secondary abscess formation after significant ischemic stroke is a rare condition that carries potential for high morbidity/mortality. The limited body of literature with the addition of our 2 cases supports aggressive management with surgical evacuation of brain abscess to increase survival.
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The dura mater can be easily biopsied during most cranial neurosurgical operations. We describe a protocol that allows for robust generation of induced pluripotent stem cells (iPSCs) and neural progenitors from acutely harvested dura mater. ⋯ IPSCs and neural progenitor cells can be efficiently derived from the dura of patients who need to undergo cranial neurosurgical operations. IPSCs were obtained with a nonintegrating virus and exhibited a normal karyotype, making them candidates for future autotransplantation after targeted differentiation to treat functional deficits.
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Hemodynamic stress, conditioned by the geometry and morphology of the vessel trees, plays an important role in the formation of intracranial aneurysms. The aim of this study was to identify image-based location-specific morphologic parameters that are associated with posterior communicating artery (PCoA) aneurysms. ⋯ Larger PCoA diameters are associated with the presence of PCoA aneurysms. These parameters may provide objective metrics to assess aneurysm formation and growth risk stratification in high-risk patients.
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Craniotomy poses a risk for postoperative venous thromboembolism (VTE), but the utility of anticoagulation in this patient population is unclear. We sought to identify risk factors predictive of VTE in patients undergoing craniotomy. ⋯ The risk of postoperative VTE after craniotomy can be quantified by a simple risk score, with increasing risk factors conferring increased risk of VTE. On the basis of risk scoring, a subset of patients who would benefit from anticoagulation post craniotomy may be identified.