World Neurosurg
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Despite 50 years of research, prognostication post cardiac arrest traditionally occurs at 72 hours. We tested the accuracy of a novel bedside score within 24 hours of hospital admission, in predicting neurologically intact survival. ⋯ This study demonstrates that a score based on clinical and easily accessible variables within 24 hours can predict neurologically intact survival following cardiac arrest.
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Ischemic stroke has been associated with stunned myocardium and neurogenic pulmonary edema (NPE). We studied a population of patients with large vessel brainstem ischemic stroke to see if there was an increased risk of pulmonary edema associated with strokes in this region independent of myocardial stunning. ⋯ In a retrospective case control study, large vessel brainstem stroke was associated with the development of pulmonary edema independent of cardiac abnormalities associated with myocardial stunning, suggesting a separate brainstem pathophysiologic mechanism which directly affects the lungs but not the heart.
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We aimed to evaluate the relationship between aneurysm morphology, thalamoperforators' ischemia, outcome, and oculomotor nerve palsy (ONP) that continued during the follow-up period in 23 patients with complex unruptured basilar apex aneurysms (BAAs) treated with clipping. ⋯ The present study suggested that unruptured BAA patients with LIC should be meticulously treated in case of performing clipping because it was related to thalamoperforators' ischemia, poor outcome, and continued ONP.
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An anterior transpetrosal approach (ATPA) is suitable for treating upper petroclival lesions. However, the limit of the ATPA is reached when the tumor extends posterolaterally over the internal auditory canal (IAC) along the petrous edge. In such cases, ligation of the posterior part of the superior petrosal sinus (SPS) is necessary. To overcome this limitation, we combined the ATPA with a partial posterior petrosectomy in 8 patients who had petroclival meningiomas extending posterolaterally over the IAC. ⋯ The ATPA combined with partial posterior petrosectomy is an effective method for removal of complicated petroclival meningiomas that extend posterolaterally over the IAC along the petrous edge.
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For the diagnosis and surgical treatment of diseases around the cavernous sinus (CS), radiologists should achieve complete mastery of the sectional anatomy of the CS, and neurosurgeons need to understand the stereoscopic orientation of the CS and circumjacent structures. However, despite the complicated structure of the CS, the current educational resources for its sectional and stereoscopic anatomy are insufficient. Another problem is that the definition of CS walls varies for each researcher. The purpose of this study is to redefine the walls of the CS and to provide related educational materials. ⋯ The combination of the hexahedron theory, the sectioned images, and the 3D models in this study will enhance the efficiency of studying CS anatomy. The educational resources of this study can be obtained free of charge by medical students, radiologists, and neurosurgeons requiring knowledge of CS anatomy.