Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2015
Microsurgical efficacy and safety of a right-hemispheric approach for unruptured anterior communicating artery aneurysms.
We investigated the effectiveness of a right hemispheric surgical approach in treating unruptured anterior communicating artery aneurysms. ⋯ Microsurgical clipping of the unruptured Acom aneurysm through a right-side surgical approach showed favorable postoperative clinical and anatomical outcomes, especially aneurysms smaller than 10mm.
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Clin Neurol Neurosurg · Oct 2015
Multicenter Study Clinical TrialPROSAIKA: a prospective multicenter registry with the first programmable gravitational device for hydrocephalus shunting.
Cerebrospinal fluid (CSF) overdrainage is a major problem in shunt therapy for hydrocephalus. The adjustable gravitational valve proSA allows for the first time a targeted compensation for overdrainage in the upright position without interfering with the differential pressure valve. To evaluate benefit, safety and reliability, the multicenter prospective registry PROSAIKA was conducted in 10 German neurosurgical centers. ⋯ This is the first clinical report on the implantation of the adjustable gravitational valve proSA with a follow-up of 12 months in a substantial number of patients. Irrespective of different hydrocephalus etiologies and indications for shunt surgery, the overall results after 12 months were very satisfying. The high frequency of valve readjustments underlines the fact that preoperative selection of the appropriate valve opening pressure is difficult. The low number of revisions and complications compared to other valves proves that proSA implantation adds no further risk; this valve is reliable, helpful and safe.
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Clin Neurol Neurosurg · Oct 2015
Long-term follow-up study of 35 cases after endovascular treatment for vertebrobasilar dissecting aneurysms.
Vertebrobasilar dissecting aneurysm (VBDA) management is challenging despite the availability of multiple treatment strategies. We reviewed our experiences using endovascular treatment for VBDA patients to assess the efficacy and safety of several VBDA treatment strategies. ⋯ For patients with ruptured VBDAs, the complication rate associated with endovascular treatment is acceptable. CE+PT is better than stent coiling in preventing aneurysmal rerupture, but is associated with a high incidence of ischemic stroke. For unruptured VBDAs, endovascular treatment is associated with good clinical outcome without perioperative complications, including rerupture and ischemic stroke. However, the high postoperative recurrent aneurysm risk suggests the necessity of long-term angiographic follow-up monitoring of VBDA patients who undergo endovascular treatments.