World Neurosurg
-
Inflammatory atherosclerotic remodeling of unruptured intracranial aneurysms (UIAs) wall, which could be detected as aneurysm wall enhancement (AWE) in MR vessel wall imaging (VWI), plays a pivotal role in pathophysiology of progression to rupture. On the other hand, abdominal aortic calcification reflects the extent of systemic atherosclerosis, which in turn predicts the risk of atherosclerotic cardiovascular as well as cerebrovascular diseases. This study sought to investigate whether the abdominal aortic calcification was associated with increased wall enhancement of UIAs in VWI. ⋯ The ACV was significantly associated with increased wall enhancement of UIAs. Systemic atherosclerosis might be a risk factor for the instability of UIAs. Future studies examining the effect of medications for systemic atherosclerosis on the extent of AWE in UIAs is warranted.
-
The superiority of mechanical thrombectomy and intravenous thrombolysis versus intravenous thrombolysis alone for acute ischemic stroke caused by large vessel occlusions has been established. This treatment can be organized into 2 models: drip and ship (DS) versus mothership (MS). We analyzed the National Inpatient Sample (NIS) data to compare the outcomes between these models in real-world settings. ⋯ Analyzing the efficacy and safety profile of DS versus MS models with the NIS database showed a trend toward better discharge outcomes and lower mortality for the MS group, although it did not reach statistical significance.
-
Using flow diverters (FDs) to treat carotid cavernous aneurysms has achieved favorable clinical and radiologic outcomes. However, the treatment of some giant carotid cavernous aneurysms with FDs remains technically challenging. We report the case of a 24-year-old male who presented with headaches and left facial numbness. ⋯ This case highlights the effectiveness of the multiple telescoping FD technique in treatment of long-segment giant petrous and cavernous carotid aneurysms. The technical nuances of the procedure and potential advantages of the Lattice FD are illustrated in this video atlas. Informed patient consent for the procedure and for publication was obtained.
-
Differentiation of suprasellar xanthogranuloma (XG) from adult craniopharyngioma (CP) can be problematic in endoscopic extended transsphenoidal surgery. ⋯ Careful interpretation of preoperative magnetic resonance imaging, intraoperative endoscopic findings, and intraoperative frozen section diagnosis may be important for the differential diagnosis between XG and CP. In endoscopic-extended transsphenoidal surgery, intentional partial removal can be effective for XG after careful diagnosis.
-
Image-guided surgery has shown great utility in neurosurgery, especially in allowing for more accurate surgical planning and navigation. The current gold standard for image-guided neurosurgery is neuronavigation, which provides millimetric accuracy on such tasks. However, these approaches often require a complicated setup and have high cost, hindering their potential in low- and middle-income countries. The aim of this study was to develop and evaluate the performance of a mobile-based augmented reality neuronavigation solution under different conditions in a preclinical environment. ⋯ Our approach provides a viable, low-cost, easy-to-use, portable method for locating points on the scalp surface with an accuracy of 2.6 ± 1.6 mm in the best-case scenario.