World Neurosurg
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Aneurysms of the middle cerebral artery (MCA) account for up to 40% of all unruptured intracranial aneurysms [1-3] and 14% to 20% of ruptured ones. [4-5] Giant MCA aneurysms are rare, representing 10% of cases [6], but carry an aggressive natural history, with the UCAS Japan study reporting an annual rupture rate of ∼ 17%. [7]. Additionally, unruptured giant MCA aneurysms can present with neurological symptoms including headache, focal neurological deficit, seizure, or ischemia infarcts. Here we report a 58-year-old male with a history of alcohol abuse, hypertension, diabetes, and smoking that presented after a first-time seizure. ⋯ Otolaryngology assisted with the RAG extraction during the craniotomy and neck dissection. This case highlights the technical complexities involved in managing giant aneurysms via microsurgical technique, including appropriate pre-operative strategy development. Informed consent from next of kin as well as IRB approval (IRB #23.0720) was obtained for this retrospective study of patients with cerebrovascular disease.
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Degenerative lumbar scoliosis (DLS) often causes various issues such as neural symptoms and osteoporosis (OP). Vertebral bone quality (VBQ) is a crucial factor that surgeons take into consider prior to surgery. However, little attention has been given to the use of VBQ in evaluating vertebral bone mass in DLS patients. The aim of this study was to investigate the ability of MRI-based VBQ score to evaluate bone mass in patients with DLS and its ability to predict OP. ⋯ VBQ can reduce interference from degeneration and deformities and can be used as a complementary method for vertebral quality assessment.
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Aneurysmal subarachnoid hemorrhage (SAH) is frequently complicated by permanent shunt-dependent hydrocephalus, but it is difficult to predict which patients are at highest risk. This study seeks to identify novel variables associated with shunt dependency after aneurysmal SAH and to create a predictive algorithm that improves upon existing models. ⋯ Our study suggests that elevated modified Graeb score on initial computed tomography and high cerebrospinal fluid protein levels prior to EVD wean are important prognostic indicators for the development of shunt dependency after aneurysmal SAH. Integrating these findings into clinical practice may aid in earlier and more targeted decision-making.