World Neurosurg
-
We aimed to investigate risk factors for the recurrence of distal anterior cerebral artery (DACA) aneurysms after endovascular treatment (EVT). ⋯ The wide-angle between two distal branches of DACA aneurysm and irregular shape might be independent risk factors for the recurrence after endovascular treatment for DACA aneurysms.
-
We aimed to: identify independent risk factors of 30-day mortality in patients with surgically treated spontaneous supratentorial ICH, validate the SwICH Score within Polish Healthcare System, and compare the SwICH Score to the ICH Score. We carried out a single-centre retrospective analysis of the medical data juxtaposed with CT scans of 136 ICH patients treated surgically between 2008 and 2022. Statistical analysis was performed using the same characteristics as in the SwICH Score and the ICH Score. ⋯ Differences in healthcare systems seem to affect the accuracy of prognostic scales for patients with ICH, including possible differences in indications for surgery and postoperative care. Thus, it is important to validate assessment tools before they can be applied in a new setting and develop population-specific scores. This may improve the effectiveness of risk stratification in patients with ICH.
-
As the COVID-19 pandemic spread to the United States in 2020, there was an impetus towards postponing or ceasing non-urgent transsphenoidal pituitary surgeries to prevent spread of the virus. Some centers encouraged transcranial approaches for patients with declining neurologic function. However, no large-scale data exists evaluating the effects this had on national pituitary practice patterns. ⋯ In 2020, transsphenoidal surgery remained the preferred approach for pituitary tumor resection despite initial recommendations against the approach to prevent COVID-19 spread. Pituitary surgeries had a higher risk of periprocedural complications despite accounting for preoperative comorbidities, COVID-19 infection status, and surgical approach, suggesting that an overwhelmed hospital system can negatively influence surgical outcomes in non-infected patients.
-
Adult Spinal Deformity (ASD) significantly impacts the quality of life due to three-dimensional spinal abnormalities. Patient-reported outcome measures (PROMs), such as the Patient-Reported Outcomes Measurement Information System (PROMIS-29), play a crucial role in assessing post-operative outcomes. This study aims to investigate trends in PROMIS-29 scores over 36 months in patients undergoing long-segment thoracolumbar fusion for ASD and provide insights into its long-term utility. ⋯ PROMIS-29 scores demonstrated notable improvements in ASD patients particularly in pain intensity, pain interference, and physical function. However, scores plateaued beyond the 3-month mark, suggesting PROMIS-29's limited sensitivity to nuanced changes in long-term patient recovery. Future investigations exploring optimal combinations of PROMs for comprehensive short and long-term outcome assessments in ASD surgery would be beneficial.
-
Tumors may be responsible for up to 5% of trigeminal neuralgia (TN) cases. Predictors of long-term pain relief after surgical resection of various cerebellopontine angle (CPA) tumor types are not well understood. Previous studies found that size and extent of resection predict long-term pain status, although resection of tumor involving the trigeminal ganglion (TG) may be associated with high morbidity. This study evaluated predictors of TN pain freedom after resection of a non-acoustic CPA tumor, with avoidance of any portion involving the TG. ⋯ This study provides additional evidence that various tumor types causing trigeminal neuralgia may safely undergo surgical resection and decompression of the trigeminal nerve to treat TN. This study presents a cohort of patients that underwent resection of a non-acoustic CPA tumor, with purposeful avoidance of the TG to minimize complications, demonstrating high rates of long-term pain freedom.