World Neurosurg
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Observational Study
End to side microvascular anastomosis on rat femoral vessels using only two-throw knot interrupted sutures and a comparison of Heel first versus Classic techniques.
The use of a 3-throw knot for anastomosis by microvascular neurosurgeons is the usual standard. There is an inherent belief that the third throw adds extra security to the knot; however, the third throw can make the knot heavy and unbalanced and can exert undue extra pressure on the opposing walls of the small-caliber intracranial vessels. This study evaluated the feasibility and efficiency of 2-throw reef knot interrupted sutures for an end-to-side microvascular anastomosis. ⋯ The end-to-side microvascular anastomosis with 2-throw reef knots is feasible, with excellent immediate and delayed patency rates.
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Animal brain tumor models can be useful educational tools for the training of neurosurgical residents in risk-free environments. Magnetic resonance imaging (MRI) technologies have not used these models to quantitate tumor, normal gray and white matter, and total tissue removal during complex neurosurgical procedures. This pilot study was carried out as a proof of concept to show the feasibility of using brain tumor models combined with 7-T MRI technology to quantitatively assess tissue removal during subpial tumor resection. ⋯ This pilot study showed that the use of animal tumor models in combination with 7-T MRI technology provides an opportunity to increase the granularity of data obtained from operative procedures and to improve the assessment and training of learners.
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Review Meta Analysis
Cognitive impairment after intracerebral hemorrhage: a systematic review and meta-analysis.
The present systematic review and meta-analysis analyzes the available clinical literature on post-intracerebral hemorrhage (ICH) cognitive impairment. ⋯ The prevalence of post-ICH cognitive impairment is high. Despite the heterogeneity among studies, the present study identified cognitive domains most commonly affected and predictors of cognitive impairment after ICH. In future, prospective cohort studies with larger sample sizes and standardized cognitive domains testing could more accurately determine prevalence and prognostic factors of post-ICH cognitive decline.
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While headache is a common neurologic symptom, subarachnoid hemorrhage (SAH) is a rare and potentially catastrophic cause of sudden-onset severe headache. The utility of the imaging modalities and interventional procedures are central to the investigation of the causes of headache; however, they are not without their limitations, risks, and complications. ⋯ The current clinical workflow of an LP after a negative CT head for a patient presenting with a sudden-onset severe headache is observed to have a high enough proportion to warrant its continued use despite the sensitivity of modern CT scanners of ≥97%.