World Neurosurg
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Treatment of anterior choroidal artery (AchoA) aneurysms is challenging because of the risk of artery injury. The objective of the study was to evaluate the incidence and predictors of AchoA infarction in patients who underwent surgical or endovascular procedure. ⋯ Repair of an AchoA aneurysm is associated with the risk of incurring post-procedural AchoA infarction. Surgical clipping and endovascular coiling have similar complication rates, but risk factors specific to each intervention exist. Careful surgical planning to avoid these risk factors in each therapeutic modality may improve patient outcomes.
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Genomic instability and aberrant tumor mutation burden are widely accepted hallmarks of cancer. Glioblastoma (GBM) is a common brain tumor in adults, and survival of patients with GBM is poor. This study aimed to investigate the prognostic value of genomic instability-derived genes in GBM. ⋯ The risk score constructed by 9 genomic instability-derived genes could reliably predict prognosis of GBM patients. The nomogram based on age and risk score also had a good prognostic predictive value.
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The microscopic transciliary SupraOrbital keyhole (mtSO) approach has been used for a wide variety of anterior and middle fossa pathologies, including aneurysms, meningiomas, craniopharyngiomas, and other skull-base tumors. Several clinical series have proven its efficacy and safety, but detailed anatomical demarcations of the anterior and middle cranial base exposure are lacking. Our aim was to define the surgical limitations of the mtSO approach to the ipsilateral and contralateral anterior and middle skull base. ⋯ Our findings define the surgical limitations of the mtSO approach for the treatment of anterior and middle cranial base pathologies. These limits can be reliably identified on imaging studies allowing assessment of exposure to guide preoperative case selection.
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Moderate-to-severe traumatic brain injury (TBI) is a major source of morbidity and mortality in elderly patients. Little is known about long-term mortality in elderly patients following mild, nonfatal TBI and how the injury mechanism predicts survival. This study aimed to compare long-term mortality in elderly patients with mild TBI and traumatic subdural hematoma (tSDH) due to ground-level fall (GLF) versus those with TBI and tSDH due to another cause (i.e., non-ground-level fall [nGLF]). ⋯ Elderly patients with mild TBI and tSDH due to GLF have significantly higher long-term mortality than patients with injuries due to nGLF.
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Case Reports
Aberrant Vessel with potential catastrophic vascular complications in a patient with Chiari Malformation.
Craniovertebral junction anomalies are known to be associated with many bony, soft tissue, and vascular anomalies. We encountered a case of Chiari malformation type 1 with C2-D2 syrinx, in which computed tomography angiography showed an aberrant vessel (probably vein) coursing through the soft tissue along the posterior aspect of C1-C7 vertebral bodies along the right-sided joints, superiorly coursing posterior to C1-C2 joint and curving anteriorly over C1 to enter into the foramen magnum. Had this abnormality not been detected, catastrophic vascular consequences could have occurred.