World Neurosurg
-
Mirror intracranial aneurysms with different rupture status is a useful model to investigate features associated with aneurysm rupture. Morphological and hemodynamic analyses of ruptured middle cerebral artery (MCA) mirror aneurysms are rarely reported. The purpose of this study was to determine the morphological or hemodynamic characteristics associated with ruptured MCA mirror aneurysms. ⋯ Larger aneurysms, a larger size ratio, irregular aneurysms, a lower spatial average WSS, and a higher maximum WSS may contribute to evaluating the risk of rupture of MCA aneurysms independent of patient characteristics.
-
Changes in blood pressure during trigeminal combing have been discussed in recent years. In this study, a retrospective analysis of patients with trigeminal neuralgia (TN) requiring microvascular decompression (MVD) with nerve combing was carried out to investigate fluctuation in arterial blood pressure during trigeminal nerve combing and its surgical effect and corresponding pathogenesis. ⋯ This study shows that changes in arterial blood pressure during trigeminal nerve combing in MVD were correlated with the prognosis of patients. Further research is necessary to clarify the mechanism of increased arterial blood pressure.
-
Case Reports
Validation of high precision robot-assisted methods for intracranial applications: Preliminary study.
This work attempts to simulate a robot-based autonomous targeted neurosurgical procedure such as biopsy on a vegetable specimen. The objective of the work is to validate the robot-based autonomous neuroregistration and neuronavigation for neurosurgery in terms of stereotactic navigation and target accuracy. ⋯ The results of the case studies show enhanced and consistent performance characteristics in terms of accuracy, precision, and repeatability with the added advantage of the economy of time. The case studies serve as validation for a high precision robot-assisted neuroregistration and neuronavigation task for neurosurgery and pave the way for further animal and human trials.
-
Spontaneous intracranial hypotension (SIH) remains a diagnostic and therapeutic challenge. Nonspecific clinical features and a reluctance to treat without confirmatory imaging evidence undermine management. Investigations are often insensitive and expensive, with many patients continuing to an epidural blood patch (EBP) despite negative results. Current diagnostic standards are based on a literature base skewed toward difficult-to-treat cases at specialty centers. This study aims to develop a robust diagnostic and treatment algorithm in real-life clinical practice by 1) investigating the prognostic utility of symptoms of SIH and results of associated investigation from which a scoring system is derived and 2) analyzing the role of EBP as a diagnostic and treatment tool. ⋯ This study supports the utility of EBP as a safe, accessible, and accurate diagnostic and therapeutic tool. We propose a simple treatment algorithm that facilitates diagnosis, treatment, and prediction of long-term outcomes in this challenging condition.