World Neurosurg
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Contrast-enhanced computed tomography angiography (CTA) can be used to detect contrast extravasation in intracerebral hemorrhage. However, investigation for contrast extravasation in subarachnoid hemorrhage (SAH) is insufficient. We evaluated the efficacy of dual-phase CTA to improve evaluation of contrast extravasation in SAH. ⋯ Dual-phase CTA with a short interval enhances detection frequency of contrast extravasation in SAH and might be a better evaluation tool for SAH.
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There has been no precise guide for treatment management of aneurysmal subarachnoid hemorrhage (aSAH) based on the patient's age and treatment method. This study clarifies each risk management for aSAH according to age and treatment method listed in a nationwide database. ⋯ Management for patients with aneurysmal subarachnoid hemorrhage was recommended in high-volume and academic institutes with the administration of antiplatelet drugs and consideration of several risk factors. Elderly patients undergoing endovascular coiling might be better given a statin drug, and patients with chronic heart failure or an anterior communicating artery aneurysm should be treated more carefully.
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Studies have begun investigating grit (continued fortitude in the face of hardship) and resilience (ability to recover from a setback) and their relationship to burnout (emotional exhaustion [EE] caused by prolonged stress or frustration) within medicine. We investigated the prevalence of burnout among neurosurgery residents and aimed to determine the relationship among burnout, grit, and resilience. ⋯ There is an inverse relationship between grit/resilience and burnout. Increased social/personal stressors are associated with increased levels of burnout and decreased grit and resilience. Grit and resilience are higher when social and personal stressors are decreased, indicating that these characteristics may fluctuate over time.
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The ophthalmic artery (OA) is a very important branch of the supraclinoid segment of the internal carotid artery. Origination of the OA from the anterior cerebral artery is an extremely rare condition. Being unaware of the origin anomalies of OAs can lead to unfavorable results, especially in cases in which craniofacial surgery or cerebral therapeutic angiography is planned. ⋯ Anomalous origin of the OA from the anterior cerebral artery may be explained by a failure in the caudal migration of the ventral OA. Because of high soft tissue resolution and absence of radiation, three-dimensional time-of-flight magnetic resonance angiography is preferred for detection of orbital and cerebral vascular anomalies.