World Neurosurg
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The association between venous reflux patterns with aggressive intracranial lesions (AILs), including intracranial edema (IE), intraparenphymal hemorrhage (IPH), and subarachnoid hemorrhage (SAH), has not been well established in cranial dural arteriovenous fistulas (DAVFs). We propose an updated classification system based on venous drainage. ⋯ Our proposed classification system effectively demonstrates a correlation between venous reflux patterns and AILs and outcomes of endovascular treatment in patients with DAVFs.
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The aim of this study was to determine the effectiveness of treating vertebral fusiform aneurysms (VFAs) only with stents. Using computational fluid dynamics, we evaluated the hemodynamic patterns of VFAs after stent-only treatment (SOT) and monitored hemodynamic changes in the side branches. ⋯ We found a significant increase in RRT of successful reconstruction of aneurysms. There may be less effect on the flow in branches arising from VFAs after SOT, whether the aneurysms showed complete occlusion or not.
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Revascularization of the upper posterior circulation (UPC), including the superior cerebellar artery (SCA) and posterior cerebral artery (PCA), may be necessary as part of the surgical treatment of complex UPC aneurysms or vertebrobasilar insufficiency. The existing bypass options have relative advantages and disadvantages. However, the use of a superficial temporal artery graft (STAg) in a bypass from the internal maxillary artery (IMA) to the UPC has not been previously assessed. We studied the surgical anatomy and assessed the technical feasibility of the IMA-STAg-UPC bypass. ⋯ The proposed bypass is anatomically feasible and provides a suitable caliber match between the bypass components. Our results provide the anatomic basis for clinical assessment of the bypass in tackling complex lesions of the vertebrobasilar system requiring revascularization.
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Atypical meningioma has a higher recurrence rate than benign meningioma. The mainstay of treatment is surgery with or without radiation therapy (RT). The objective of this study was to investigate progression-free survival (PFS) and factors associated with postoperative recurrence in patients with atypical meningioma. ⋯ Tumor location and pial invasion were significantly correlated with increased incidence of tumor recurrence, and postoperative RT was found to be significantly associated with decreased tumor progression and recurrence.
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Case Reports
Application of a three-dimensional printed product to fill the space after organ removal - a case report.
Maintaining body integrity, especially in Asian societies, is an independent predictor of organ donation. ⋯ This new clinical application may have supportive psychological effects on the family and caregivers; however, given the varied responses to our procedure, this ethical issue is worth discussing.