World Neurosurg
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Distal middle cerebral artery (dMCA) aneurysms are very rare. Most ruptured dMCA aneurysms lead to subarachnoid hemorrhage (SAH) coexisting with intracerebral hematoma (ICH), resulting in a deteriorating state. The risk factors of rupture of dMCA aneurysms remain unknown. To elucidate the risk of rupture, we studied differences between 4 ruptured and eleven unruptured dMCA aneurysms. ⋯ Distal MCA aneurysms, even if they are small, may be likely to rupture leading to SAH complicated by ICH and result in a poor neurological state and unfavorable outcomes. We recommend aggressive treatment for dMCA aneurysms considering morphological factors such as the size ratio even if they are small and unruptured.
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The objective of the study was to explore the significance of the distribution of lumbar facet joint effusion (unilateral or bilateral) and the amount of joint effusion in the process of lumbar degeneration. ⋯ A bilateral effusion signal is more likely to indicate lumbar instability than a unilateral effusion signal. The distribution width and area of effusion were positively correlated with lumbar stability and LSA.
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A first local recurrence is common after resection or radiotherapy for brain metastasis (BM). However, patients with BMs can develop multiple local recurrences over time. Published data on second local recurrences are scarce. This study aimed to report predictors associated with a second local recurrence in patients with BMs who underwent a craniotomy for a first locally recurrent BM. ⋯ A second local recurrence occurred after 43.5% of craniotomies for first recurrent lesions. Subtotal resection and infratentorial location were the strongest risk factors for worse second local recurrence prognosis following resection of first recurrent BM.
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The aim of this study was to evaluate the course of occluded distal vessels before mechanical thrombectomy (MT) for acute large vessel occlusion (LVO) with non-contrast magnetic resonance imaging (MRI). The variable flip-angle three-dimensional turbo spin-echo (VRFA-3D-TSE) method was used to evaluate the course of occluded distal vessels quickly and clearly in acute LVO cases before MT. ⋯ In patients with acute LVO, VRFA-3D-TSE MRI enabled rapid and good depiction of the course of occluded distal vessels before MT without the use of contrast medium.
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Outflow patency correlates with radiosurgical outcomes of lateral sinus dural arteriovenous fistula.
To explore the impact of outflow patency on radiosurgical outcomes of lateral sinus dural arteriovenous fistulas (DAVFs). ⋯ Lateral sinus DAVFs with a CCS of >6, indicating a nearly patent sinovenous outflow, were more likely to be obliterated after GKRS. Sinovenous outflow patency is a factor associated with therapeutic outcomes in radiosurgery for lateral sinus DAVFs.