World Neurosurg
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The purpose of this study was to investigate the imaging characteristics of fenestrated anterior communicating artery (AcomA) aneurysm and clinical outcome of patients with fenestrated AcomA aneurysm. ⋯ Fenestrated AcomA aneurysms are associated with higher clinical complications, and identification of AcomA fenestration contributes to successful clipping of AcomA aneurysms.
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Few prognostic markers are available for patients with non-small-cell lung cancer (NSCLC) undergoing neurosurgical resection of symptomatic brain metastases. ⋯ Patients requiring surgical resection of an epidermal growth factor receptor-mutated NSCLC brain metastasis had an associated improved survival compared with patients without this mutation, independent of tyrosine kinase inhibitor use. Decreased survival was associated with older age, multiple previous brain radiation therapies, and extracranial metastasis.
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Infectious pseudoaneurysm of the intracavernous carotid artery is rare, often caused by sphenoid sinusitis or transsphenoidal surgery. Management of intracranial infectious aneurysms (IIAs) remains a controversial topic lacking randomized controlled trials to guide clinical decision making. ⋯ Unfortunately, the patient died because the IIA recurred and ruptured. Therefore we speculated that stent-assisted coil placement for the treatment of ruptured infectious pseudoaneurysms of the internal carotid artery may not be safe.
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Comparative Study
Comparative evaluation of angioscopy and intravascular ultrasound for assessing plaque protrusion during carotid artery stenting procedures.
Evaluation of plaque protrusion after carotid artery stenting (CAS) is important for predicting periprocedural ischemic complications. In contrast to intravascular ultrasound (IVUS), angioscopy allows direct visualization of the plaque. The aim of this study was to evaluate utility and safety of angioscopy during CAS and compare it with IVUS. ⋯ Angioscopy provided direct visualization of stent lumens after CAS. Angioscopy detected more plaque protrusion than IVUS and allowed clearer observation of plaque characteristics. Angioscopy may be more useful than IVUS for examination of plaque protrusion and plaque evaluation after CAS, especially for plaque identified as potentially vulnerable by preprocedural examination.
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Traumatic brain injury (TBI) is major contributor to the global burden of disease, especially in low- and middle- income countries, where most TBIs are traffic-related. Evidence shows that helmets protect against severe TBI. Cambodia continues to have the greatest motorcycle fatality rate in Southeast Asia. We investigated whether the National Motorcycle Helmet Law introduced in January 2016 had an impact on the epidemiology of motorcycle-related TBI in a neurosurgical referral center in Phnom Penh. ⋯ With growing urbanization and motorization, TBI is a significant cause of morbidity and mortality in Cambodia. Two years after helmets became compulsory, most patients with TBI are still unhelmeted. Likely contributing factors are low penalty for noncompliance and inconsistent law enforcement. TBI is a major public health problem warranting further efforts to understand how to improve prevention strategies and advocate for change.