World Neurosurg
-
Review Case Reports
Hemodynamics in a Middle Cerebral Artery Aneurysm prior to its Growth and Fatal Rupture: a Case Study and a Review of the Literature.
Hemodynamics plays an important role in the natural history of intracranial aneurysms. However, it is difficult to obtain longitudinal aneurysm image data. In this study, we had a rare chance to follow the process of growth and rupture of a middle cerebral artery (MCA) aneurysm. The aim of this study was to investigate the role of hemodynamics for growth and rupture in this particular aneurysm patient. ⋯ This case suggests that aneurysm rupture might be associated with low WSS and high OSI, whereas aneurysm growth may be related to high WSS in this particular individual MCA aneurysm patient.
-
Review Case Reports
Management of concomitant Moyamoya disease, arterial venous malformation, and intracranial aneurysm: case illustration, literature review and management algorithm.
Moyamoya disease (MMD), arterial venous malformations (AVMs), and intracranial aneurysms are distinct cerebrovascular disease processes that most commonly occur in isolation. The literature on the treatment algorithm of each individual condition is well established. An association between MMD and intracranial aneurysms is also known, but MMD in association with AVM is rare. ⋯ Our strategy of surgical revascularization for MMD, radiosurgery for AVM, and endovascular coiling for aneurysm resulted in a positive long-term clinical outcome. In view of the rarity of the condition, the authors propose a management algorithm for such patients.
-
Multicenter Study Observational Study
Intelligent Surgeon's Arm Supporting System iArmS in Microscopic Neurosurgery Utilizing Robotic Technology.
Based on our previous reports, stabilizing the surgeon's arm with an intraoperative armrest is linked to improved precision of microsurgical and endoscopic procedures. We developed the robotic intelligent surgeon's arm supporting system iArmS, which automatically follows the surgeon's arm and fixes it at an adequate position. ⋯ iArmS allows continuous precise manipulations that provide high-quality surgical results in neurosurgical techniques. Moreover, iArmS is a useful automatic tool for holding and following the surgeon's arm.
-
Cranioplasty after decompressive craniectomy can be associated with significant morbidity. Dural substitutes during the initial decompression could improve outcomes. ⋯ The use of dural substitutes was associated with superior operative metrics, complication rates, and long-term outcomes.
-
Randomized Controlled Trial
Comparative Outcomes of Perioperative Epidural Steroids After Percutaneous Endoscopic Lumbar Discectomy for Lumbar Disc Herniation: A Randomized Placebo-Controlled Trial.
To assess postoperative outcomes and complications after percutaneous endoscopic lumbar discectomy (PELD) with or without epidural steroids (ES) administration in lumbar disc herniation. ⋯ Administration of ES with PELD for lumbar disc herniation does not improve postoperative pain, morphine requirements, or disability scores in the short-term and midterm periods.