World Neurosurg
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Temporary arterial occlusion (TAO) is valuable for minimizing intraoperative rupture risk during intracranial aneurysm microsurgery; however, it may be associated with ischemic injury. This study aims to identify surgical and intraoperative neurophysiologic monitoring factors that predict perioperative stroke risk after TAO. ⋯ SSEP changes and increased single-episode TAO duration are independently associated with increased perioperative stroke risk. SSEP changes are most predictive for perioperative stroke in unruptured cases.
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Intracranial-intracranial bypass is a valuable cerebral revascularization option. Despite several advantages, one of the main shortcomings of the intracranial-intracranial bypass is the possibility of ischemic complications of the donor artery. However, when sacrificed, the temporopolar artery (TPA) is not associated with major neurologic deficits. We sought to define the role of TPA as a donor for revascularization of the middle cerebral artery (MCA). ⋯ When of favorable diameter, the TPA is a competent donor for intracranial-intracranial bypass to MCA branches at the anterior insula, and anterior frontal and middle temporal opercula (arteries anterior to the precentral gyrus coronal plane).
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Microvascular decompression (MVD) is the most useful treatment for hemifacial spasm (HFS). In cases of vertebral artery (VA) compression of the facial nerve, MVD is often difficult. In this study, we compared the outcome of the biomedical glue sling technique with the traditional technique in MVD for HFS involving the VA. ⋯ When the HFS were associated with the VA, the effective rate of biomedical glue sling technique of MVD was higher than the traditional technique, and there was no statistical difference between the 2 groups about the incidence of complication.
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To investigate facet tropism and its role in development of lumbar isthmic spondylolisthesis (IS) in young men. ⋯ Facet angle tropism is seen in a high proportion of patients with IS and seems to be a predisposing factor in the etiology of IS.
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Nordic countries are the primary source for nationwide data on the incidence of subarachnoid hemorrhage (SAH). Reliable estimates of national incidence rates of SAH in other countries are lacking, yet studies from Nordic countries with exceptional incidence rates are sometimes disregarded because of concerns regarding external validity. Autopsies are rarely performed for sudden deaths; therefore, estimates of the SAH incidence commonly reflect the hospital discharge rates. Our aim was to estimate the nationwide incidence of nontraumatic SAH in Germany using a national hospital discharge register. ⋯ Our estimate of the German nationwide attack rate suggests that the incidence of nontraumatic SAH is more homogeneous than previously assumed. Rejecting the external validity of studies from countries believed to display an exceptional incidence rates may therefore not be justified.