World Neurosurg
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Review Historical Article
A brain hidden in Ferrara cathedral: a novel interpretation of a Renaissance masterpiece.
The aim of present report was to briefly review the history of the anatomical studies during the Italian Renaissance and to outline their relationship to the figurative arts, focusing, in particular, on neuroanatomical studies that have been at the center of the medical and philosophical debate from the 14th to 16th centuries. Therefore, we have presented the interpretation of different Renaissance masterpieces for which some references to brain anatomy have been previously reported. We propose a new interpretation, in neuroanatomical key, of the fresco of the universal judgment in the vault of San Giorgio's Cathedral in Ferrara, Italy, painted around the end of the 16th century.
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Randomized Controlled Trial
Different Effects of Intravenous, Topical, and Combined Application of Tranexamic Acid on Patients with Thoracolumbar Fracture.
To observe the efficacy of intravenous, topical, and combined application of tranexamic acid (TXA) in patients with thoracolumbar fracture fixed with percutaneous pedicle screw, and to identify the optimal application method of TXA. ⋯ Preoperative intravenous drip of TXA can remarkably reduce intraoperative HBL and IBL in patients with thoracolumbar fracture fixed with percutaneous pedicle screw. Nonetheless, intraoperative topical application of TXA before wound closure is not recommended.
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Middle meningeal arteriovenous fistula (MM-AVF) is rare; however, it will sometimes be followed by intracranial hemorrhage or progressive symptoms caused by abnormal shunt flow. Radiological examination and endovascular treatment of this condition have recently advanced; thus, we have described the pathogenesis, clinical features, and appropriate diagnostic and therapeutic management of MM-AVF. We also reviewed the reported data of the past 35 years, including 30 cases of MM-AVF. ⋯ MM-AVF is caused, not only by coup injury, but also by contrecoup injury. Time-of-flight magnetic resonance angiography and magnetic resonance arterial spin labeling are useful for detecting MM-AVF. Endovascular transarterial embolization is an effective and safe treatment.
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Review Case Reports
Cerebral Abscess Following Endovascular Treatment of Aneurysm: Report of Two Cases and Review of the Literature.
Endovascular treatment is growing in popularity globally as an important treatment option for intracranial aneurysms. Cerebral infection as a complication of endovascular treatment of aneurysms is sufficiently rare that only 6 isolated cerebral abscess cases have been reported thus far. ⋯ This report was written to discuss the possible mechanisms underlying cerebral abscess after endovascular treatment of aneurysms and to suggest potential treatment and prevention methods.
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The use of the Pipeline embolization device (PED) for posterior circulation aneurysms is controversial. The aim of this study was to explore the safety and efficacy of PED for these aneurysms in a meta-analysis. Meta-regression was used to identify predictors for incomplete aneurysm occlusion and procedure-related complications. ⋯ PED is an alternative to treat intracranial aneurysms of the posterior circulation, achieving high complete occlusion rates, but it is less effective in elderly patients. The risk of procedure-related complications is not negligible. Further larger, long-term follow-up studies are needed before definitive conclusions can be drawn.