World Neurosurg
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Flow diverter stents have become a useful tool for treatment of complex intracranial aneurysms. A serious complication is incomplete wall apposition after flow diverter placement. The aim of this study was to present a comprehensive investigation of hemodynamic changes induced by incomplete expansion of a flow diverter. ⋯ The results of this study can be considered during treatment planning of complex cases where the risk of incomplete flow diverter expansion exists. Further studies are required before results can also be used to support the decision process about antiplatelet therapy and additional interventions to improve wall apposition.
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Multicenter Study
Gelatin Paste as an Alternative Cost-Effective Hemostatic Agent in Cranial Surgery: Doing More with Less.
To present an alternative cost-effective hemostatic agent (HA) for cranial surgery and to describe the technique to produce it. ⋯ The presented technique offers a reliable and cost-effective way of achieving hemostasis in cranial surgery, therefore allowing hospitals with limited resources to perform advanced procedures in a safer way.
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Case Reports
Proximal Middle Cerebral Artery Aneurysms: Microsurgical Management and Therapeutic Results.
Management of proximal (M1) middle cerebral artery (MCA) aneurysms can be challenging. Because of the diversity of aneurysm morphology and location of M1 aneurysms, the surgical strategy should be tailored to each individual case, especially for complex cases. We assessed the safety and efficacy of an algorithmic strategy for the management of M1 aneurysms. ⋯ Our present treating strategy might provide a benefit for patients with proximal MCA aneurysms.
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Traumatic subdural hematomas (tSDHs) have high morbidity and mortality and often require neurosurgical intervention. The risk of venous thromboembolism (VTE) after tSDH ranges from 1%-20%, yet a consensus chemoprophylaxis protocol does not exist. An increased understanding of VTE risk factors following tSDH may inform development of prophylaxis guidelines. ⋯ While overall VTE risk is low following tSDH, elderly patients and those with severe injuries requiring prolonged hospitalizations have increased thrombotic risk. Development of tiered VTE prophylaxis regimens based on early postinjury thrombotic risk profiles warrants future study.
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Comparative Study
Comparison of Endovascular Embolization and Surgery in the Treatment of Spinal Intradural Dorsal Arteriovenous Fistulas.
We compared the outcomes of endovascular embolization and surgery and investigated the factors affecting the clinical outcomes of spinal intradural dorsal arteriovenous fistulas (SIDAVFs). ⋯ Our results have shown that surgery results in a low recurrence rate and superior clinical outcomes. A multidisciplinary and ordered decision is crucial for the treatment choice to ensure better outcomes, especially for patients with a definite neurologic deficit at diagnosis.