World Neurosurg
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Flow diversion has evolved as a minimally invasive treatment for intracranial aneurysms. The Silk Vista Baby (SVB) can be navigated into small cerebral vessels because it can be deployed through a low-profile microcatheter. ⋯ Although the intraoperative foreshortening was not unexpected, the delayed postprocedural behavior of proximal foreshortening and subsequent prolapse of the SVB into the aneurysm have not been previously described. We would like to share this for awareness in this technical note.
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The exhaustive information regarding the types of trigeminal pore (TP) or trigeminal impression (TI), internal acoustic opening (IAO), and related surgical approaches is lacking in the literature. Therefore, this study is performed to further elucidate the types of TP or TI, IAO, and the relationships with critical surgical landmarks in the skull base. ⋯ Investigating the relationship of TI and IAO with relevant structures suggests that surgical approaches involving the TP and IAO indicated that surgical approaches considering the TI and IAO variations may be used in the development of surgical processes and primary surgical interventions.
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Temporal changes in the volume of chronic subdural hematoma (CSDH) following middle meningeal artery (MMA) embolization vary. We aimed to determine whether CSDH density on computed tomography is related to hematoma resolution following particle MMA embolization. ⋯ Rapid resolution of CSDH following MMA embolization was associated with low hematoma density at 1-week postembolization. Based on hematoma density on computed tomography at 1-week postembolization, a 1-month follow-up would be sufficient in cases of low density, but a 3-month follow-up would be required in cases of high-density hematoma. Larger studies and clinical trials are needed to confirm our findings.
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The aim of the present study was to retrospectively analyze and investigate the clinical data of 704 cases of ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs). The risk factors predicting aneurysm rupture were explored from the perspective of the clinical characteristics of intracranial aneurysm (IA). ⋯ The present findings indicated that hyperlipidemia and atherosclerosis have a protective effect on aneurysm rupture, and different anatomical sites of IA may be risk factors for the occurrence of IA rupture. Among the anatomical sites of IA, the anterior communicating artery and posterior communicating artery have a higher fracture risk.
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Observational Study
Impaired dynamic cerebral autoregulation as a predictor for cerebral hyperperfusion after carotid endarterectomy: A prospective observational study.
Cerebral hyperperfusion syndrome (CHS) is a severe complication of carotid endarterectomy (CEA). Because cerebral hyperperfusion (CH) reduces the benefits of CEA, it is important to identify patients at high risk of developing CH. We investigated dynamic cerebral autoregulation (dCA) as a potential predictor of CH after CEA. ⋯ The lower ipsilateral phase may serve as a predictor of CH after CEA.