Neurological research
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Neurological research · Apr 2012
Microneurosurgical management of anterior choroidal artery aneurysms: a 16-year institutional experience of 102 patients.
Surgical treatment of anterior choroidal artery aneurysms (AChAAs) continues to be challenging and technically demanding for vascular neurosurgeons. Ischemic stroke is the most common complication after surgical clipping of AChAAs. We retrospectively studied a series of 102 consecutive patients with AChAAs to evaluate the clinical outcomes and ischemic complications after surgical clipping. ⋯ The surgery of AChAAs is not easy, surgical management of AChAAs carries with it a high risk of postoperative ischemic complications, especially for those aneurysms originating entirely or partially from the AChA itself.
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Neurological research · Apr 2012
Variation in a locus linked to platelet aggregation phenotype predicts intraparenchymal hemorrhagic volume.
Alteration in platelet aggregation has been shown to promote bleeding and affect outcome after intracerebral hemorrhage (ICH).We investigated the influence of genetic variants of platelet aggregation, and their effects on admission ICH volume and clinical outcome. ⋯ We identified SNP rs342286 as an independent predictor of admission hematoma volume. Our findings suggest that PIK3CG function, which is previously linked to this SNP and affects platelet aggregation, impacts the severity of the intraparenchymal bleed.
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Neurological research · Apr 2012
Intraoperative tissue fluorescence using 5-aminolevolinic acid (5-ALA) is more sensitive than contrast MRI or amino acid positron emission tomography ((18)F-FET PET) in glioblastoma surgery.
The sensitivity of 5-aminolevolinic acid (5-ALA) in detecting intraoperative glioblastoma (GBM) tissue compared to postoperative (18)F-fluoroethyl-L-tyrosine and T1 contrast uptake of tumor cells in positron emission tomography (PET) and magnetic resonance imaging (MRI) scans was investigated in a retrospective image correlative study. ⋯ Residual faint 5ALA uptake is documented in large areas at the end of GBM resection and corresponds to tumor infiltration. These 5-ALA positive resection plans exceeded the (18)F-FET uptake areas in postoperative PET scans. Thus, intraoperative 5-ALA residual fluorescence seems to be a more sensitive marker than (18)F-FET PET for residual tumor in malignant gliomas.
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Neurological research · Apr 2012
Vascular, electrophysiological, and metabolic consequences of cortical spreading depression in a mouse model of simulated neurosurgical conditions.
Cortical spreading depression (CSD) is a metabolically taxing wave of cellular depolarization that propagates slowly across the brain. Though CSD is known to occur after brain injury in humans, it is unknown if CSD occurs during neurosurgical procedures. This study evaluates CSD in a mouse model of simulated neurosurgical conditions. ⋯ CSD is consistently elicited by simulated neurosurgical stimuli under simulated intraoperative conditions in mice. These events caused ECoG depression, transient vasoconstriction, and metabolic demand that propagated from the manipulation site. It is likely that CSD occurs during neurosurgery and may contribute to surgical brain injuries otherwise poorly explained.