Neurosurgery
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Multicenter Study
Targeted Embolization of Aneurysms Associated With Brain Arteriovenous Malformations at High Risk for Surgical Resection: A Case-Control Study.
High-risk components of brain arteriovenous malformations (BAVMs) can be targeted to reduce the risk of lesion rupture. ⋯ For BAVMs at high risk for surgical resection, TAE can be performed safely and effectively. Patients treated with TAE had better outcomes than matched patients undergoing other combinations of treatment. TAE can be considered for BAVMs with high operative risk prior to radiosurgery or when no other treatment options are available.
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Delayed cerebral ischemia (DCI) is a cause of poor outcome after aneurysmal subarachnoid hemorrhage. Risk scales to predict DCI have scarcely been evaluated for predictive accuracy. Accounting for volume of intraventricular hemorrhage (IVH) in the modified Fischer scale (mFS) may improve its predictive accuracy. ⋯ The mFS and the mGS have similar prognostic utility. Accounting for IVH volume improved prediction of DCI by the mFS.
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To date, the traditional approach to intraspinal tumors has been open laminectomy or laminoplasty followed by microsurgical tumor resection. Recently, however, minimally invasive approaches have been attempted by some. ⋯ This study both demonstrates that it is feasible and safe to remove select, primary intradural spinal tumors using MIS, and augments the previous literature in favor of MIS for these tumors.
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Neonatal brachial plexus palsy (NBPP) results in reduced function of the affected arm with profound ramifications on quality of life. Advances in surgical technique have shown improvements in outcomes for appropriately selected patients. Patient selection, however, remains difficult. ⋯ We developed a decision tree prediction algorithm that can be applied shortly after birth to determine surgical candidacy of patients with NBPP, the first of its kind utilizing only maternal and neonatal factors. This conservative decision tree can be used to offer early surgical intervention for appropriate candidates.