World Neurosurg
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Relative risk is insufficient to guide treatment decision-making for unruptured intracranial aneurysms. Our objective was to introduce a novel risk assessment methodology called the Rupture Criticality Index (RCI), which allows for concurrent evaluation of groups of risk factors (RFs). ⋯ We introduce the concept of RCI and compare how RF combinations are associated with aneurysmal rupture. This novel approach to aneurysmal rupture identifies high-risk clinical presentations and can be used to guide clinical decision-making in patients with non-traditional risks.
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Differential diagnosis of giant cell glioblastoma (GC) and classic glioblastoma (GBM) using conventional radiological modalities is difficult. This study aimed to use diffusion-weighted imaging (DWI) to distinguish GC from GBM and thereby improve the accuracy of preoperative assessment of patients with GB. ⋯ By distinguishing GC from classic GBM, the ADCmin parameter of DWI can improve the accuracy of the preoperative differential diagnosis of the 2 tumor types.
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Artificial intelligence (AI) has the potential to disrupt how we diagnose and treat patients. Previous work by our group has demonstrated that the majority of patients and their relatives feel comfortable with the application of AI to augment surgical care. The aim of this study was to similarly evaluate the attitudes of surgeons and the wider surgical team toward the role of AI in neurosurgery. ⋯ This survey highlights that the majority of surgeons and the wider surgical team both agree and are comfortable with the application of AI within neurosurgery.
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Comparative Study
A Comparison of Reported Outcomes of Anterior Cervical Spinal Surgery Among Neurosurgeons in Africa and North America.
Neurosurgical practice in some African countries has significant differences in patient load and resource availability compared with North America. We designed a survey to determine reported differences in outcome of anterior cervical decompression and fusion surgery, including blood loss, length of stay, and follow-up time, among physicians on different continents. We expected outcomes in all categories to be pronounced between respondents in Africa compared with North America due to a multitude of factors. ⋯ Our findings demonstrate greater advances in reported surgical outcomes for patients in Africa than we expected, but still highlight key areas for improvement, almost certainly due to lack of resources.
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Case Reports
Deconstructive Endovascular Treatment of Ruptured Serpentine Basilar Artery Aneurysm by Mid-Basilar Occlusion.
No clear treatment course for cerebral aneurysms in the main trunk of the basilar artery (BA) has been established thus far. ⋯ Parent vessel sacrifice carries a risk of perforator injury due to extension of thrombosis from the blind pouch into eloquent perforator vessels. Minimizing this risk requires careful evaluation of anatomy and strategic occlusion, which preserves runoff into relatively large vessels, such as the superior cerebellar artery, the anterior inferior cerebellar artery, or the penetrating branch from the blind pouch, as much as possible.