Neurosurgery
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In this study, we evaluated the difference in incidence of symptomatic vasospasm between ruptured aneurysms in the anterior and posterior circulation using multiple logistic regression analysis. ⋯ Although a poor clinical grade and a severe SAH classification on admission such as Hunt and Hess grade and Fisher's classification are established powerful predictors of symptomatic vasospasm, ruptured vertebrobasilar aneurysm are for the first time reported to be a predictor of symptomatic vasospasm based on results of a recent reliable statistical analysis.
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Biography Historical Article
Head injury management algorithm as described in Hippocrates' "peri ton en cephali traumaton".
HIPPOCRATIC WORKS LEND themselves still today to the modern physician for further analysis of his approach to the diagnosis and treatment of various pathological conditions. We present an attempt to systematize his methodology regarding the management of head trauma and present it in the format of a modern-era algorithm.
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Meningiomas are the most frequently reported primary intracranial neoplasms, accounting for approximately 25% of all such lesions diagnosed in the United States. Few studies have examined the risk factors associated with a diagnosis of meningioma with two categories of exposure, hormones (both endogenous and exogenous) and radiation, most strongly associated with meningioma risk. Limited data are also available on long-term outcomes for meningioma patients, although it is clear that the disease is associated with significant morbidity and mortality. ⋯ This will increase the focus on this disease over the coming years as well as likely increase the reported prevalence of the disease. The increased emphasis on research dedicated to the study of brain tumors coupled with the advent of new tools in genetic and molecular epidemiology make the current era an ideal time to advance knowledge for intracranial meningioma. This review highlights current knowledge of meningioma epidemiology and new directions for research efforts in this field.
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Review Case Reports
Aneurysmal rupture during coiling: low incidence and good outcomes at a single large volume center.
To study the incidence and clinical outcomes of intraoperative aneurysm rupture (IOR) during endovascular coil embolization at a single large volume center and to review the literature on this subject to determine whether IOR rupture rate and mortality correlate with volume of aneurysms treated at a given center and years since the institution of Guglielmi detachable coils as a treatment modality. ⋯ IOR remains a serious risk of endosaccular coiling of intracranial aneurysms, with aneurysms presenting with subarachnoid hemorrhage at greater risk for this complication. This risk can be minimized with very low associated morbidity and mortality (incidence 1%, 17% morbidity, 0% mortality at our institution).
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Case Reports Multicenter Study
Balloon-in-stent technique for the constructive endovascular treatment of "ultra-wide necked" circumferential aneurysms.
Circumferential aneurysms, which incorporate >180 degrees of the circumference of the parent vessel, present a unique therapeutic challenge, particularly in circumstances in which a deconstructive treatment strategy is not feasible. We detail a novel technique for endovascular parent vessel reconstruction with aneurysm embolization. ⋯ The balloon-in-stent technique provides a practical and safe treatment strategy for the management of circumferential aneurysms that are not amenable to deconstructive embolization.