World Neurosurg
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Case Reports
Emergent Carotid Endarterectomy with Open Thrombectomy for Acute Carotid Stent Occlusion.
Acute occlusion of a carotid stent is a rare complication that necessitates rapid diagnosis and treatment to prevent devastating neurologic injury. Management options may include thrombolysis, mechanical thrombectomy, or open surgical revascularization; however, the optimal treatment is unclear due to the low reported incidence of this complication. Video 1 illustrates the surgical technique for open revascularization with carotid stent removal, thrombectomy, and endarterectomy. ⋯ Intraoperatively, the clot from the internal carotid artery was manually aspirated via a 5-French catheter. Postoperative imaging demonstrated appropriate vessel patency. In follow-up, the patient made a full neurologic recovery.
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The article uses ultrasound imaging standard section to examine the fetal central nervous system (CNS) in early pregnancy, combined with ultrasound imaging in the diagnosis of fetal CNS malformation in the middle and late pregnancy, to determine the feasibility of ultrasound imaging in the detection of CNS abnormalities in the first trimester of the fetus. ⋯ The positive cases detected in early pregnancy were severe malformations of the CNS. The diagnosis of other CNS malformations in the fetus needs further study.
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Observational Study
Admission neutrophil-lymphocyte ratio predicts rebleeding following aneurismal subarachnoid hemorrhage.
The relationship between neutrophil-lymphocyte ratio (NLR) and the occurrence of rebleeding in aneurysmal subarachnoid hemorrhage (aSAH) is poorly understood. Our study aimed to investigate the association between NLR on admission and rebleeding following aSAH. ⋯ Higher NLR predicts the occurrence of rebleeding and poor outcome, and NLR combined with Fisher grade significantly improves the prediction of rebleeding following aSAH.
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We compared the efficacy and safety of neurosurgical clipping with those of endovascular coiling for patients with intracranial aneurysm (IA) stratified by country, publication year, study design, sample size, mean age, percentage of male patients, percentage of aneurysms located in the anterior circulation, and follow-up duration. ⋯ Surgical clipping might be superior to endovascular coiling for ruptured IAs. However, clipping was associated with a greater incidence of poor outcomes and bleeding compared with coiling for unruptured IAs.
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Case Reports
Treatment of Extracranial Vertebral Artery Aneurysm with Flow Diversion: A Case Report.
Aneurysms of the extracranial vertebral artery are rare, and the treatment options are not standardized. We present a case of an extracranial vertebral artery aneurysm treated with flow diversion. ⋯ Flow diversion is a simple and promising treatment option for a V3 segment aneurysm. Postoperative asymptomatic partial in-stent stenosis is tolerable.