World Neurosurg
-
To study the anatomy and clinical application of monolateral pterional keyhole approaches for treating bilateral cerebral aneurysms. ⋯ Contralateral aneurysms of the M1 segment (anterior, superior, and inferior), MCA bifurcation (superior and lateral), A1 segment, A2 segment (anterior, posterior, and medial), internal carotid artery bifurcation, DICA (anterior and medial), and OICA (medial) were fully exposed from different angles and surgical maneuvers were performed via pterional keyhole approaches, including in patients presenting with subarachnoid hemorrhage.
-
Case Reports
Minimally Invasive treatment for a Sacral Tarlov Cyst through tubular retractors: Case report.
Tarlov cysts (TC) are focal dilations of arachnoid and dura mater of the spinal posterior nerve root sheath that appear as cystic lesions of the nerve roots typically in the lower spine, especially in the sacrum, which can cause radicular symptoms when they increase in size and compress the nerve roots. Different open procedures have been described to treat TCs, but no minimally invasive procedures have been described to effectively address this pathology. ⋯ Minimally invasive spine surgery through tubular retractors can be safely performed for successful excision and ligation of TC using a Scanlan modified technique.
-
We tested the prognostic value of cumulative intracranial tumor volume (CITV) in the context of a disease-specific Graded Prognostic Assessment (ds-GPA) model for renal cell carcinoma (RCC) patients with brain metastasis (BM) treated with stereotactic radiosurgery (SRS). ⋯ CITV is an important prognostic variable in SRS-treated RCC patients with BM. The prognostic value of the ds-GPA scale for RCC brain metastasis was enhanced by the incorporation of CITV.
-
Observational Study
The Effects of Red Blood Cell Transfusion on Functional Outcome after Aneurysmal Subarachnoid Hemorrhage.
The optimal red blood cell transfusion (RBCT) trigger for patients with aneurysmal subarachnoid hemorrhage (SAH) is unknown. In patients with cerebral vasospasm, anemia may increase susceptibility to ischemic injury; conversely, RBCT may worsen outcome given known deleterious effects. ⋯ Blood transfusions are associated with unfavorable outcome after SAH particularly when DCI is absent. Propensity analysis suggests that RBCT may be associated with poor outcome rather than being a marker of disease severity. However, when DCI is present, RBCT may help improve outcome.
-
Transvenous (TV) embolization is ideal for endovascular treatment of intracranial dural arteriovenous fistulas (DAVF). However, it is not always feasible because of various factors, and transarterial (TA) embolization could then be tried. We aimed to determine the incidence of distally enlarged feeding artery phenomenon and the major feeding artery in DAVF. If the TV approach is difficult and this phenomenon is observed, we could use this vessel for transarterial intravenous (TAIV) embolization as an endovascular treatment modality for DAVF. ⋯ Distally enlarged feeding artery phenomenon was observed in 32% of patients with intracranial DAVF. This group was predominantly the restrictive type. We conclude that this phenomenon might help determine a patient's eligibility for TAIV embolization when TV embolization is difficult or impossible.