World Neurosurg
-
Applicability of Carotid Artery Stenting for Patients 80 Years or Older: A Single-Center Experience.
A meta-analysis found that for internal carotid artery stenosis procedures in elderly patients, the risk of perioperative stroke is significantly greater for carotid artery stenting (CAS) than for carotid endarterectomy. We retrospectively examined characteristics and perioperative results of CAS for patients 80 years and older at a single medical center. ⋯ The plaque of carotid stenosis in octogenarians is often vulnerable, but using a dual protection and blood aspiration method, we safely performed CAS in octogenarian patients.
-
Posterior pituitary tumor is rare, and its optimal surgical strategy is undetermined. Surgical removal of posterior pituitary tumors is often complicated by their hypervascularity. Prevention and preparation for excessive hemorrhage is crucial for safe resection. ⋯ A combined endonasal and transcranial approach with preoperative embolization is a useful strategy for hypervascular posterior pituitary tumors. A 4K 3D video microscope is compact, and it provides high-resolution images, contributing larger surgical space and facilitating a multi-team surgery.
-
Complications arising from cerebral venous occlusion/sacrifice during neurosurgical procedures have received comparatively less attention in the neurosurgical literature. Consequently, cerebral venous complications are not given due recognition, even though most practicing neurosurgeons would agree that they are not uncommon. We present a review of complications arising from venous sacrifice/occlusion during neurosurgery and discuss strategies described in the literature to prevent such occurrences. ⋯ The unpredictable response of the brain to venous injury causes catastrophic complications in a few patients. To avoid these complications, meticulous venous preservation should be a goal in all neurosurgical procedures. Increased recognition of cerebral venous complications over the last 2 decades has resulted in the increasing recognition among neurosurgeons that venous preservation is an essential tenet of neurosurgery.
-
Case Reports
Stent-Assisted Coil Embolization for Ruptured Intracranial Dissecting Aneurysms Involving Essential Vessels.
The optimal treatment strategy for ruptured intracranial dissecting aneurysms involving essential vessels remains controversial. The aim of this study was to review the safety and efficacy of endovascular treatment at our center. ⋯ Careful follow-up is necessary after endovascular coiling for ruptured dissecting aneurysm involving essential vessels. Although additional treatment might be required, stent-assisted coiling could be a less invasive and feasible method for handling these difficult lesions.