World Neurosurg
-
Mechanical thrombectomy (MT) has become the standard treatment for acute ischemic stroke caused by large vessel occlusion (LVO). Despite successful recanalization, approximately one-half of the patients do not achieve a favorable outcome, which is known as "futile recanalization" (FR). The present study aimed to explore the association between stress hyperglycemia and FR after MT. ⋯ Results of this study revealed that older age, an increased number of passes, and greater SHR were independently associated with FR after MT in patients with acute ischemic stroke caused by LVO.
-
This article reviews the historical progression of ventriculoperitoneal shunt valve designs with the goal of providing an understanding of their functionality and failure mechanisms. While shunting is the predominant treatment for hydrocephalus, the statistics of overall shunt failure remain high, and valve failure is responsible for a significant percentage of revision surgeries. ⋯ Information is provided on the importance of valves in hydrocephalus treatment with discussion on each class of valves and their advantages and shortcomings. Substantial development over decades has significantly improved valve functionality, and ongoing research continues to provide more robust valves and shunt systems for hydrocephalus management.
-
Large or giant paraclinoid aneurysms have been treated with various strategies, including clipping, coiling, and parent artery occlusion (PAO). In addition, flow diverters (FDs) have been introduced for the management of these aneurysms. The aim of this study was to examine the management of unruptured large/giant paraclinoid aneurysms in Japan when FDs were being introduced by a nationwide survey. ⋯ All treatment modalities offer high rates of complete occlusion and good clinical outcomes. Coiling has the disadvantage of high rates of recurrence and retreatment. Clipping and PAO have the disadvantage of a high rate of major procedure-related complications; however, PAO can provide comparable treatment outcomes even in cases with refractory giant aneurysms. FDs are the optimal choice for the management for large/giant paraclinoid aneurysms due to its safety and efficacy.
-
Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement. ⋯ The study highlights that ossification of posterior longitudinal ligament and high baseline neck pain are significant risk factors for persistent sleep disturbances postsurgery in DCM patients. Early identification and targeted interventions may be necessary to improve outcomes.