World Neurosurg
-
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.
-
Case Reports
Lessons from China when Performing Neurosurgical Procedures During the COVID-19 Pandemic.
The novel coronavirus disease 2019 (COVID-19) pandemic poses a substantial threat to the health of health care personnel on the front line of caring for patients with COVID-19. The Centers for Medicare and Medicaid Services have announced that all nonessential planned surgeries and procedures should be postponed until further notice and only urgent procedures should proceed. Neurologic surgeries and procedures should not be delayed under the circumstance in which it is essential at saving a life or preserving functioning of the central nervous system. ⋯ Following the proposed guidance, urgent neurosurgical surgeries and procedures can be safely performed for the benefit of critical patients with or suspected for COVID-19.
-
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.
-
Chronic subdural hemorrhage (CSDH) is a common neurosurgical pathology. While acute deterioration is managed surgically, the optimal management of patients with neurologically stable CSDH remains uncertain. Despite an increasing interest in the use of corticosteroids, it is unclear whether this reduces the rate of subsequent crossover to surgery. In this study we evaluate rate of crossover to surgery in such patients managed in our Neurosurgical unit. ⋯ Current evidence implicates a potentially beneficial role of dexamethasone in the management of CSDH. However, it remains unclear whether the rate of crossover to surgery is reduced in patients treated with corticosteroids compared with those managed conservatively. A longer duration of study with detailed analysis of individual cases and appropriately randomized cohorts are necessary to draw more reliable conclusions.
-
Case Reports
Treatment of a scalp arteriovenous malformation by a combination of embolization and surgical removal: a case report.
Scalp arteriovenous malformation is a rare disease. In terms of treatment, surgical removal is often effective and performed. With the development of endovascular treatments, a combination of surgical removal and embolization is now often performed. ⋯ Because cerebral blood flow may decrease depending on the progression of the lesion, the cerebral blood flow should be evaluated. Considering the treatment modalities depending on the lesion can provide treatment with less recurrence and higher patient satisfaction.