World Neurosurg
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Endovascular treatment of posterior cerebral artery aneurysms is challenging because of the particular features of posterior circulation vessels. We performed a systematic review of the literature, to assess safety and efficacy associated to their endovascular treatment. ⋯ Endovascular treatment of posterior cerebral artery aneurysms is associated with increased degree of occlusion and low recurrence rate. However, a parent artery occlusion implies complications, even although most of them are minor events such as hemianopsia.
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Multicenter Study
A Simple Scoring System to Predict the Resectability of Skull Base Meningiomas via an Endoscopic Endonasal Approach.
To identify clinico-radiologic factors associated with incomplete anterior cranial fossa (ACF) meningioma resection via an endoscopic endonasal approach. ⋯ The use of a simple scoring system outlined in our study can facilitate proper patient selection for endoscopic endonasal resection of ACF meningiomas.
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Multicenter Study
A multicenter analysis of CT angiography alone versus digital subtraction angiography for surgical treatment of poor-grade aneurysmal subarachnoid hemorrhage.
Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with increased intracranial pressure, and these patients are unstable with a high risk of rebleeding. Computed tomography angiography (CTA) has been proposed as an examination tool for the rapid detection of ruptured aneurysms. We aimed to determine the safety and efficacy of CTA alone for surgical treatment of poor-grade aSAH compared with digital subtraction angiography (DSA). ⋯ Although CTA alone can be safely and effectively used in most patients requiring surgical treatment, additional DSA may be considered in patients with smaller ruptured aneurysms or in those with multiple aneurysms.
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Case Reports
Delayed Abdominal Pseudohernia in a Young Patient After an LLIF Procedure: Case Report.
To describe a rare complication of the extreme lateral interbody fusion technique. ⋯ Abdominal pseudohernia is a rare complication of LLIF procedures. The interest of the present case is 3-fold: 1) it is the first delayed case of abdominal pseudohernia after an LLIF procedure; 2) it is the first case described in a young patient in whom risk factors have been identified and discussed; and 3) it is the first case that did not resolve spontaneously and required surgical repair. This exceptional complication must be borne in the mind of the spine surgeon when using the LLIF technique, and special precautions, such as laxatives or respiratory physiotherapy, apart from meticulous atraumatic dissection and closure of the abdominal wall and specific intraoperative monitoring, should be taken in high-risk patients to prevent it.
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Although paraclinoid aneurysms are now frequently referred for endovascular treatment, the durability of obliteration is still to be determined. Therefore, direct surgery for paraclinoid aneurysms still remains indispensable. The present study aimed to evaluate the risk factors for the visual impairments in patients with unruptured intradural paraclinoid aneurysms. ⋯ The present study showed that carotid cave location and plug-in method during dural closures were related to postoperative continued visual impairments. Neurosurgeons should carefully consider the surgical indication for unruptured carotid cave aneurysms and avoid plug-in methods.