World Neurosurg
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Chronic subdural hematoma (CSDH) is considered an angiogenic and inflammatory disease. Interleukin-6, a well-known inflammatory cytokine, activates the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway. We previously reported that the JAK/STAT pathway is activated in fibroblasts in the outer membrane of CSDH. More recently, signal transducer and activator of transcription 3 (STAT3) has been shown to have a role in angiogenesis. We examined the expression of STAT3 in endothelial cells in the outer membrane of CSDH. ⋯ Interleukin-6 might dominantly activate STAT3 in endothelial cells, which might have a central role in endothelial cell proliferation and angiogenesis of CSDH outer membranes.
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Multicenter Study Comparative Study
Post-Operative Complications for Elderly Patients after Single-Level Lumbar Fusions for Spondylolisthesis.
A large-scale study on postoperative complications of lumbar fusion surgery for spondylolisthesis comparing patients >80 years old with younger patients has not been performed. The purpose of this study is to assess the effects of extreme age (>80 years old) on early postoperative outcomes after single-level lumbar fusions for spondylolisthesis. ⋯ This is the first large study comparing the rates of postoperative complications of lumbar fusion surgery for spondylolisthesis in patients >80 years old versus younger patients. The data support that age alone should not exclude a patient for this procedure. However, extra caution is warranted given the slightly increased morbidity.
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Multicenter Study
A multicenter analysis of CT angiography alone versus digital subtraction angiography for surgical treatment of poor-grade aneurysmal subarachnoid hemorrhage.
Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with increased intracranial pressure, and these patients are unstable with a high risk of rebleeding. Computed tomography angiography (CTA) has been proposed as an examination tool for the rapid detection of ruptured aneurysms. We aimed to determine the safety and efficacy of CTA alone for surgical treatment of poor-grade aSAH compared with digital subtraction angiography (DSA). ⋯ Although CTA alone can be safely and effectively used in most patients requiring surgical treatment, additional DSA may be considered in patients with smaller ruptured aneurysms or in those with multiple aneurysms.
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Reducing complications from unruptured aneurysms (UAs) treatment is important. We clarify the criteria for achieving safe and complete treatment for UAs ≤10 mm by clipping or coil embolization. ⋯ The treatment for UAs within the criteria, with the most recent points of concern, can lead to safe and complete results.
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Case Reports
3T MRI follow-up of large or giant vertebrobasilar dissecting aneurysms which were totally embolized on angiography.
To evaluate the outcomes of large or giant vertebrobasilar dissecting aneurysms (VBDAs) after endovascular total embolization by follow-up 3T magnetic resonance imaging (MRI). ⋯ The efficacy of conventional endovascular treatment (e.g., internal trapping with coils, stent-assisted coiling, and stent placement without coils) for large or giant VBDAs is uncertain. Follow-up angiography alone does not adequately predict the outcome. High-resolution MRI is a worthwhile adjunct to follow these lesions.