World Neurosurg
-
To evaluate blood flow changes after bypass surgery for refractory symptomatic intracranial atherosclerotic stenosis (ICAS). ⋯ For refractory ICAS in patients with compromised hemodynamics, direct bypass might induce early occlusion of a stenotic area. MCA lesions may have a greater tendency toward early occlusion conversion.
-
Comparative Study Controlled Clinical Trial
Use of intracranial pressure monitoring frequently refutes diagnosis of idiopathic intracranial hypertension.
The diagnosis and management of patients with idiopathic intracranial hypertension (IIH) frequently relies on lumbar puncture to ascertain intracranial pressure (ICP). However, ICP values derived this way may be spurious owing to patient body habitus and behavior. We recently incorporated direct continuous ICP monitoring into the work-up for IIH. ⋯ Direct ICP monitoring is the gold standard for determining ICP and can be safely and effectively applied to the work-up and treatment of patients with IIH to reduce the occurrence of misdiagnosis and unnecessary surgery.
-
Case Reports Comparative Study
Overlapped Stenting Combined with Coiling for Blood Blister-like Aneurysms: Comparison of Low-profile Visualized Intraluminal Support (LVIS) Stent and Non-LVIS Stent.
To evaluate the safety and efficacy of overlapped stenting for blood blister-like aneurysms (BBAs) and to compare the outcomes between Low-profile Visualized Intraluminal Support (LVIS) and non-LVIS stents. ⋯ Overlapped LVIS stenting combined with coiling is feasible and safe for BBAs. Overall, the LVIS stent provided less risk of BBA recurrence compared with the non-LVIS stent and did not increase the risk of procedure-related complications.
-
Clinical Trial
Assessment and treatment of peritumoral cortical veins in parasagittal meningiomas with application of 3D imaging fusion model.
Operation of cortical veins is the keystone of parasagittal meningioma (PSM) resection. Little is known about pathologic changes of the veins and proper treatment. We built 3-dimensional (3D) image fusion models by neuronavigation to analyze the features of peritumoral cortical veins for PSMs and explore intraoperative treatment options. ⋯ The anastomoses of cortical veins may provide compensation for venous transaction. There may be a time-evolution relationship between different cortical veins (type a to c to b). Treatment of cortical veins should follow the following principles: single-end veins must be protected, tumor-to-end veins should be transacted directly, and end-to-end veins could be cut selectivity based on the degree of occlusion of the superior sagittal sinus. Detailed preoperative assessment of peritumoral cortical veins is critical for proper treatment.
-
Comparative Study
Drain Insertion in Chronic Subdural Hematoma: An International Survey of Practice.
To investigate whether, after the publication of grade I evidence that it reduces recurrence rates, the practice of drain insertion after burr-hole drainage of chronic subdural hematoma has changed. Further, we aimed to document various practice modalities concerning the insertion of a drain adopted by neurosurgeons internationally. ⋯ The publication of grade I evidence in favor of drain use influenced positively this practice worldwide. Some surgeons are still reluctant to insert a drain, especially when the subdural space is narrow after drainage of the hematoma. The insertion of a subperiosteal drain could be a good alternative solution. However, its outcome and efficacy must be evaluated in larger studies.