World Neurosurg
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As previous studies reported, the balloon guide catheter is useful for identifying the fistula point during diagnosis of direct carotid-cavernous sinus fistula (d-CCF). We demonstrate an additional advantage of the balloon guide catheter during intraarterial endovascular treatment of d-CCF. ⋯ Using a balloon guiding catheter can reduce internal carotid artery flow near the fistula point at the cavernous segment of the internal carotid artery. As a result, better identification of the fistula point can be made, which allows easier placement of the microcatheter into the fistula point and more stable coil deployment.
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A recent systematic review and meta-analysis found that there was a lack of consensus regarding risk factors for cerebral vasospasm in aneurysmal subarachnoid hemorrhage (aSAH). ⋯ In the first nationwide analysis of cerebral vasospasm, risk factors included younger age, female sex, smoking history, hemodynamic compromise, and clinical severity of aSAH. Recently proposed biomarkers, including leukocytosis and hypokalemia, were supported by our findings. This study may assist risk stratification and earlier detection of vasospasm.
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Narrowing of intervertebral space height (ISH) is an important pathological change in degenerative spinal disease, and ideal intraoperative distraction and postoperative intervertebral space maintenance is one of the most expectant goals pursued by spinal surgeons. The effect of postoperative ISH changing on the clinical and radiological outcomes after cervical disc replacement is not fully understood, however. ⋯ This study revealed that cervical disc replacement cannot maintain the intervertebral disc height obtained immediately after surgery. There is no obvious correlation between the change in intervertebral space height and clinical efficacy in the early postoperative stage. Nonetheless, the intervertebral disc height may affect the NDI index 1 year after surgery. If the postoperative intervertebral space height change can be maintained at 2-4 mm at 1 year, satisfactory ROM, intervertebral foramen diameter, and relatively low adjacent segment degeneration may be obtained after cervical disc replacement.