Journal of neurointerventional surgery
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With the advancement of an aging society in the world, an increasing number of elderly patients have been hospitalized due to aneurysmal subarachnoid hemorrhage (aSAH). There is no study that compares the elderly cases of aSAH who receive the definitive treatment with those who treated conservatively. The aim of this study was to investigate the feasibility of the definitive surgery for the acute subarachnoid cases aged 80 or older. ⋯ Better prognosis was obtained when ruptured aneurysm was repaired in the elderly than it was treated conservatively. From the results of this study, we should not hesitate to offer the definitive surgery for the elderly with aSAH.
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In order to determine the risk factors related to aneurysm rupture, we studied the aneurysms at the paraclinoid segment of the internal carotid artery by applying morphologic and hemodynamic numerical analyzes. ⋯ Irregular shape, larger EL and concentrated inflow jet were independently associated with the rupture status of paraclinoid aneurysms. These findings need to be further confirmed based on large multicenter and multipopulation data.
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Lymphatic malformations are low flow congenital lesions that frequently occur in the head and neck, and often require treatment. Multiple therapeutic modalities exist, including percutaneous sclerotherapy, which has been performed successfully with numerous sclerosants. Few data exist on use of ethanolamine oleate to treat lymphatic malformations. This study reports single center results using this agent to treat lymphatic malformations of the head and neck. ⋯ Percutaneous sclerotherapy using ethanolamine oleate to treat lymphatic malformations of the head and neck appears safe and efficacious. This agent should be considered when treating these complex lesions, particularly those that are exclusively macrocystic. Further investigation of such treatments should evaluate this agent alongside the many others currently utilized.
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Spinal cord stimulation is a known modality for the treatment of chronic back and neck pain. Traditionally, spine surgeons and pain physicians perform the procedures. We report our experience in performing neuromodulation procedures in an outpatient interventional neuroradiology practice. ⋯ Neuromodulation procedures can be performed safely in an outpatient interventional radiology setting. Although the infection rate was relatively higher in this study population, the other complication rates and trial-to-implant ratio are similar to published data.
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Review Meta Analysis
Seizure control for intracranial arteriovenous malformations is directly related to treatment modality: a meta-analysis.
Seizures are a common presenting sign of intracranial arteriovenous malformations (AVMs). The object of this meta-analysis was to determine if the modality selected to treat AVMs affects the rate of seizure outcomes. ⋯ This is the first meta-analysis designed to study relative rates of seizure outcomes following the currently utilized AVM treatment modalities. In general, MS results in the highest proportion of seizure control. However, if SRS results in successful obliteration of the AVM, then this modality is the most effective in achieving seizure control.