World Neurosurg
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Review Case Reports
Flow-Diverter Stent for an Unruptured Aneurysm at the Junction of the Internal Carotid Artery and Persistent Primitive Trigeminal Artery: A Case Report and Literature Review.
Persistent primitive trigeminal artery (PPTA), which is a fetal carotid-basilar anastomosis, is the most common embryologic vascular remnant persisting in adults. Aneurysms can arise between the internal carotid artery (ICA) and PPTA. Here we present a case of ICA-PPTA aneurysm treated with a flow-diverter stent. ⋯ This is the first case report of ICA-PPTA aneurysm successfully treated with a flow-diverter stent. We could stop blood flow from the posterior circulation by embolizing the PPTA with a coil, allowing the use of a flow-diverter stent. This report can be used as a reference for the procedure in future work.
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Multicenter Study
Persistently high serum substance P levels and early mortality in patients with severe traumatic brain injury.
Substance P is a neuropeptide belonging to the tachykinin family and is involved in neuroinflammation. In a previous study by our team, we found higher serum substance P levels on day 1 of traumatic brain injury (TBI) in nonsurviving than in surviving patients. Thus, the objective of this study was to determine whether serum substance P levels during the first week of TBI could predict early mortality. ⋯ The new finding of our study is that the presence of elevated serum substance P levels during the first week of TBI is associated with increased mortality.
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Review Case Reports
Mechanical thrombectomy for middle cerebral artery occlusion suspected of ovarian hyperstimulation syndrome.
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic disorder associated with infertility treatment. The main pathology of OHSS is intravascular dehydration and hyperestrogenemia. In mild cases, abdominal symptoms are the main symptoms, but in severe cases, thrombosis such as cerebral infarction may occur. ⋯ We experienced the first case of mechanical thrombectomy for middle cerebral artery occlusion suspected to be caused by OHSS. It is necessary to suspect OHSS involvement if young women, especially those on infertility treatment, show neurologic deficits.
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Intracranial hemorrhage (ICH) is a common complication in patients with left ventricular assist devices (LVADs) and carries a dismal prognosis. Limited data are available on the management and outcomes in this population, which are essential to determine an optimal treatment strategy. We conducted a systematic literature review to determine the clinical characteristics and survival of this population. ⋯ There is minimal existing literature on patients with LVAD with ICH that report patient outcomes in a nonstandardized fashion. The studies included in this analysis report mortality consistent with previous reports, indicating a need for further investigation to identify risk factors and improve outcomes in these patients.
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Spinal alignment, particularly with respect to spinopelvic parameters, is highly correlated with morbidity and health-related quality-of-life outcomes. Although the importance of spinal alignment has been emphasized in the deformity literature, spinopelvic parameters have not been considered in the context of spine oncology. Because the aim of oncologic spine surgery is mostly palliative, consideration of spinopelvic parameters could improve postoperative outcomes in both the primary and metastatic tumor population by taking overall vertebral stability into account. This review highlights the relevance of focal and global spinal alignment, particularly related to spinopelvic parameters, in the treatment of spine tumors.