World Neurosurg
-
Temporary artery occlusion (TAO) during intracranial aneurysm surgery is an integral element in facilitating aneurysm dissection and clipping. Despite its significance, knowledge of effects of TAO on long-term clinical outcome is limited. The purpose of this study was to evaluate the impact of TAO in patients with subarachnoid hemorrhage (SAH) at one institution. ⋯ Limited duration of TAO during aneurysm surgery did not affect long-term clinical outcome and appears to be safe in patients with aneurysmal SAH. Established SAH risk factors including Hunt and Hess grades, Fisher computed tomography grades, and presence of clinical vasospasm clearly correlated with long-term clinical outcomes.
-
This study sought to investigate outcomes after a novel nontransfer protocol for mild traumatic brain injuries patients with small intracranial hemorrhage (ICH) in a rural trauma center without neurosurgical capabilities. ⋯ Our 6-year study corroborates the low neurosurgical rate reported in the literature for mTBI with small ICH. Nontransfer protocols may lead to a more efficient use of hospital resources while providing safe, effective and economical health care.
-
Case series have identified that de novo intracranial aneurysms occur. However, the risk for this occurrence has not been established. We examined the risk for the de novo intracranial aneurysm detection in a consecutive surgical case series. ⋯ There is a 10-year de novo aneurysm detection rate of between 10% and 16% after surgery. Smoking increases the risk of de novo aneurysm detection. Consideration needs to be given to surveillance angiography after aneurysm treatment.
-
To determine national trends for patients with subarachnoid hemorrhage (SAH) and pulmonary complications including acute respiratory distress syndrome (ARDS). ⋯ Patients with SAH are at increased risk of developing ARDS. The identification of certain risk factors may alert and aid practitioners in preventing worsening disease.
-
In recent literature, there have been case reports of prenatal diagnosis of hemimegalencephaly, an extremely rare entity characterized by enlargement of all or portions of 1 cerebral hemisphere and intractable seizures. A unique case is presented of hemimegalencephaly of a fetus diagnosed in utero. ⋯ In utero diagnosis of complex developmental brain anomalies allows a multidisciplinary approach to provide optimal prenatal patient treatment and parental counseling.