World Neurosurg
-
The Pipeline Embolization Device (PED) has been used and shown to be safe under monitored anesthesia care (MAC). We present the results of the first study, to our knowledge, assessing the safety and feasibility of same-day discharge in patients undergoing treatment with the PED, using MAC. ⋯ PED treatment under MAC is feasible and safe. This has brought forth an era of outpatient treatment of CAs where patients are discharged home 6 hours after the procedure.
-
The objective of this study is to classify patients using federally mandated categories of ethnicity and race and to determine whether subgroups are associated with patient outcomes and aneurysmal subarachnoid hemorrhage (SAH). ⋯ There are differences in baseline characteristics and the proportion of SAH. Future studies must take into account risk factors and outcomes not reported in the database.
-
For older patients (>65 years) who undergo surgical treatment of vestibular schwannoma (VS), the reported rates of facial nerve preservation, hearing preservation, and complications are inconsistent. Many surgeons believe that older patients have worse outcomes than their younger counterparts and advise against surgical treatment. We analyzed a consecutive series of patients with VS treated with surgery to determine whether age was a factor in outcome. ⋯ With no difference in surgical complications, facial nerve outcome, or hearing preservation rates between older and younger patients in our series, age alone may not be an absolute contraindication to surgical management of VS.
-
The auditory brainstem response (ABR) may be a predictor of postoperative cochlear nerve function. In this study, the course of intraoperative ABR monitoring was analyzed to find predictive markers for postoperative hearing function. ⋯ Intraoperative ABR development is a predictive factor for postoperative hearing outcome. Deterioration should be avoided, because ABR improvement as a result of good status at the beginning of surgery could not be assumed.
-
The aim of this study was to clarify the correlation between clinical features (especially cyst formation and cavernous sinus invasion) and minor secretion of anterior pituitary hormones, especially adrenocorticotropic hormone (ACTH) and gonadotropin, by clinically nonfunctioning pituitary adenomas (CNFPAs) in cell culture. ⋯ Minor secretion of ACTH and gonadotropin may be related to clinical features, especially cystic changes and invasiveness of CNFPAs, suggesting that our cell culture method could be helpful for elucidating the mechanisms of pituitary cyst formation and the invasiveness of CNFPAs.