Journal of neurosurgery
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Journal of neurosurgery · Oct 2024
Morphological analysis of the trigeminal nerve in trigeminal neuralgia using the nerve's centerline and multiple cross-sections of a 3D model.
Morphological changes such as angulation and torsion of the trigeminal nerve have been reported to cause trigeminal neuralgia (TN). The authors sought to quantify and objectively evaluate the morphological changes of the trigeminal nerve and to elucidate the cause of TN. ⋯ It is possible to analyze the morphological changes of the trigeminal nerve by using this method. In the preoperative trigeminal nerve on the affected side, the centerline is long and curved, and the cross-sectional area is small and flat. Further analyses may help clarify the pathophysiology, aid in diagnoses, and predict the efficacy of treatment.
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Journal of neurosurgery · Oct 2024
Defining ideal middle cerebral artery bifurcation aneurysm size for Woven EndoBridge embolization.
The Woven EndoBridge (WEB) device was approved to treat wide-necked bifurcation aneurysms. The device is designed as an intrasaccular flow disruptor covering aneurysm widths up to 10 mm. Although prior studies combined all aneurysm sizes, it is known that aneurysms behave differently in response to endovascular treatment based on their size. Therefore, the authors' objective was to identify ideal middle cerebral artery (MCA) aneurysm width and neck sizes most suitable for WEB treatment. ⋯ This study shows that MCA bifurcation aneurysms ≤ 6.1 mm in width and ≤ 4.6 mm in neck size are significantly better candidates for WEB treatment, leading to improved occlusion status and reduced retreatment rate, which are important considerations when using WEB devices.
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Journal of neurosurgery · Oct 2024
Conservative management of brain arteriovenous malformations: results of the prospective observation registry of a pragmatic trial.
Many patients recruited in the Treatment of Brain Arteriovenous Malformations Study (TOBAS) are managed conservatively. The aim of this study was to monitor what happened to those patients. ⋯ Nearly half of TOBAS participants were observed. Rates of untoward neurological events were within expected boundaries.
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Journal of neurosurgery · Oct 2024
Creating and validating a neurosurgical intervention rule-out tool for patients with mild traumatic brain injury and isolated subdural hematoma: a 5-year, six-center retrospective cohort study.
Because there is no reliable method on admission to predict whether a patient will require neurosurgical intervention in the future, the general approach remains to treat each patient with mild traumatic brain injury (mTBI) and subdural hematoma (SDH) as if they will require such an intervention. Consequently, there is a growing population of patients with mTBI and SDH that is overtriaged despite having a low probability of needing neurosurgical intervention. This study aimed to train and validate a predictive rule-out tool for neurosurgical intervention in patients with mTBI and SDH. ⋯ In this study, the largest of its kind to date, the authors successfully developed and validated a new tool for ruling out the necessity of neurosurgical intervention in patients with mTBI and isolated SDH. By successfully identifying more than half of patients who are unlikely to require neurosurgery within the first 2 days of admission, this tool can be used to improve treatment efficiency and provide patients and clinicians with valuable prognostic information.
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Journal of neurosurgery · Oct 2024
Visual deterioration secondary to medial sphenoid wing meningioma: systematic assessment of patient-reported outcomes and factors contributing to recovery after surgical treatment.
Visual acuity (VA) constitutes an important outcome measure in surgery for medial sphenoid wing meningioma (SWM). This study aimed to assess the recovery of tumor-associated impairment of VA and its impact on patient-reported outcome measures (PROMs) as an indication of vision-related quality of life in patients who had undergone surgery for medial SWM. ⋯ The overall preoperative duration of tumor-related visual impairment significantly correlates to the extent of postoperative visual improvement as well as vision-related PROMs in medial SWM surgery. These results might aid in preoperative patient counseling and help optimize decision-making and preoperative estimation of long-term visual outcome.