Neurosurgery
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The morphological and hemodynamic features differ between middle cerebral artery (MCA) bifurcations with and without aneurysms. ⋯ A larger φ angle was more prevalent in aneurysmal than nonaneurysmal MCA bifurcations, and the higher flow resistance caused by the larger φ angle might be a potential hemodynamic factor associated with MCA aneurysm presence.
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Posterior cranial vault distraction (PCVD) is a technique widely used in surgical treatment of craniosynostosis when cranial expansion is required. It has proven to be safe and to allow a significant increase of intracranial volume. ⋯ PCVD is an effective surgical method to increase intracranial volume in a variety of clinical entities. Volumetric results of this procedure could be easily evaluated using 3-D photogrammetric imaging or plane radiographs that expose the patients to only low ionizing radiation doses.
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Intraoperative monitoring of brainstem auditory evoked potentials (BAEPs) has been implemented to reduce the risk of hearing impairment during microvascular decompression for hemifacial spasm. ⋯ Intraoperative monitoring of BAEPs evaluated through our scoring system was valuable in predicting hearing impairment after surgery.
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Preoperative seizure is reported to confer favorable prognosis in glioblastoma patients, but studies to date have not investigated how broadly applicable seizure is as a prognostic factor. ⋯ Seizure as the only preoperative symptom independently improved survival, however, when patients developed additional preoperative symptoms, typically due to surgical delay, no prognostic benefit was observed. Prompt diagnosis and neurosurgical intervention is warranted in patients with seizures without other preoperative symptoms to preserve their favorable prognosis.
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The intervertebral disc (IVD) is an avascular structure, and is therefore stable under hypoxic conditions. Previous studies have demonstrated that hypoxia might be related to symptomatic degenerative disc diseases (DDDs); however, the pathomechanism is still poorly understood. ⋯ We found that hypoxia can enhance the angiogenic ability of IVD during inflammatory reactions, and cause progress in development of DDD via extracellular matrix regulation in this in vitro study.