Abstract:
OBJECTIVE:Unruptured intracranial aneurysms are common incidental findings on brain imaging. Short-term follow-up for conservatively treated aneurysms is routinely performed in most cerebrovascular centers, although its clinical relevance remains unclear. In this study, the authors assessed the extent of growth as well as the rupture risk during short-term follow-up of conservatively treated unruptured intracranial aneurysms. In addition, the influence of patient-specific and aneurysm-specific factors on growth and rupture risk was investigated. METHODS:The authors queried their prospective institutional neurovascular registry to identify patients with unruptured intracranial aneurysms and short-term follow-up imaging, defined as follow-up MRA and/or CTA within 3 months to 2 years after initial diagnosis. Medical records and questionnaires were used to acquire baseline information. The authors measured aneurysm size at baseline and at follow-up to detect growth. Rupture was defined as a CT scan-proven and/or CSF-proven subarachnoid hemorrhage (SAH). RESULTS:A total of 206 consecutive patients with 267 conservatively managed unruptured aneurysms underwent short-term follow-up at the authors' center. Seven aneurysms (2.6%) enlarged during a median follow-up duration of 1 year (range 0.3-2.0 years). One aneurysm (0.4%) ruptured 10 months after initial discovery. Statistically significant risk factors for growth or rupture were autosomal-dominant polycystic kidney disease (RR 8.3, 95% CI 2.0-34.7), aspect ratio > 1.6 or size ratio > 3 (RR 10.8, 95% CI 2.2-52.2), and initial size ≥ 7 mm (RR 10.7, 95% CI 2.7-42.8). CONCLUSIONS:Significant growth of unruptured intracranial aneurysms may occur in a small proportion of patients during short-term follow-up. As aneurysm growth is associated with an increased risk of rupture, the authors advocate that short-term follow-up is clinically relevant and has an important role in reducing the risk of a potential SAH.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Molenberg R,Aalbers MW,Metzemaekers JDM,Mazuri A,Luijckx GJ,Groen RJM,Uyttenboogaart M,van Dijk JMCdoi
10.3171/2019.4.FOCUS1995subject
Has Abstractpub_date
2019-07-01 00:00:00pages
E7issue
1issn
1092-0684pii
2019.4.FOCUS1995journal_volume
47pub_type
杂志文章abstract::The potential advantages of a mini-open transforaminal interbody fusion (TLIF) operation are reduced blood loss, shorter length of stay, and less soft-tissue trauma compared to the standard open technique. Prior reports from our group and others have demonstrated successful outcomes using MIS techniques in lumbar fusi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2013.V2.FOCUS13187
更新日期:2013-07-01 00:00:00
abstract::Considerable financial and human resources have been directed toward the emerging field of comparative effectiveness research (CER) in the US. Fundamentally, the concept of CER is so logical as to be almost self-evident; namely, that research regarding therapeutic strategies should go beyond efficacy and examine objec...
journal_title:Neurosurgical focus
pub_type: 社论
doi:10.3171/2012.5.FOCUS12127
更新日期:2012-07-01 00:00:00
abstract::Epidermoid cysts or tumors comprise 1% of intracranial tumors with a predilection for the cerebellopontine angle or parasellar cisterns. These tumors are derived from an ectopic ectodermal implant seeded between fusing ectodermal surfaces. This results in a benign proliferation of stratified squamous epithelium along ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15466
更新日期:2016-01-01 00:00:00
abstract::Stereotactic radiosurgery is an effective management strategy for properly selected patients with arteriovenous malformations (AVMs). However, the risk of postradiosurgical radiation-related injury is higher in patients with large AVMs. Multistaged volumetric management of large AVMs was undertaken to limit the radiat...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.6.FOCUS14217
更新日期:2014-09-01 00:00:00
abstract:OBJECT:Mild traumatic brain injury (MTBI), often referred to as concussion when it occurs in sports, produces persistent cognitive problems in at least 15% of patients. Unfortunately, conventional neuropsychological tests usually yield results within normal limits in this population. The main objective of this event-re...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.10.FOCUS12253
更新日期:2012-12-01 00:00:00
abstract::Primary central nervous system lymphoma (PCNSL) is an aggressive neoplastic process that occurs in both immunocompetent and immunocompromised patients. Over the past 30 years there has been a steady increase in the number of cases in both patient populations. The imaging features for the disease and demographic charac...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2006.21.5.5
更新日期:2006-11-15 00:00:00
abstract::OBJECT Spinal tumor resection has historically been performed via open approaches, although minimally invasive approaches have recently been found to be effective in small cohort series. The authors compare surgical characteristics and clinical outcomes of surgery in patients undergoing mini-open and open approaches f...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.5.FOCUS15187
更新日期:2015-08-01 00:00:00
abstract::Correction of rigid scoliotic deformities involving the thoracic spine has required that a thoracotomy be performed to obtain anterior release to mobilize the deformity, as well as placement of corrective spinal instrumentation either via a separate posterior or anterior thoracic approach. To the best of the author's ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.5.2
更新日期:1999-11-15 00:00:00
abstract::Forty-four patients with cervical spondylotic myelopathy who underwent a ventral surgical approach were evaluated with respect to the results of surgery. The neurological status of the patients was categorized according to the modified Japanese Orthopedic Association scale (0-18). Three patients had a functional score...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1996.1.6.6
更新日期:1996-12-15 00:00:00
abstract:OBJECT:Coil embolization of aneurysms has been shown to be as safe and effective as surgical clip ligation, but has a higher recurrence rate. Advances in coil technology aim to reduce aneurysm recurrence by coating the devices with biological substances. An example of this is MicroVention's HydroCoil, which is a platin...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2005.18.2.6
更新日期:2005-02-15 00:00:00
abstract:OBJECT:Symptomatic adjacent-segment lumbar disease (ASLD) after lumbar fusion often requires subsequent surgical intervention. The authors report utilizing cortical bone trajectory (CBT) pedicle screw fixation with intraoperative CT (O-arm) image-guided navigation to stabilize spinal levels in patients with symptomatic...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.1.FOCUS13521
更新日期:2014-03-01 00:00:00
abstract::Hypothalamic hamartomas are uncommon but well-recognized developmental malformations that are classically associated with gelastic seizures and other refractory seizure types. The clinical course is often progressive and, in addition to the catastrophic epileptic syndrome, patients commonly exhibit debilitating cognit...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.3.FOCUS1355
更新日期:2013-06-01 00:00:00
abstract::The Pipeline embolization device (PED) has become a very important tool in the treatment of nonruptured cerebral aneurysms. However, a patient's difficult anatomy or vascular stenosis may affect the device delivery. The purpose of this article was to describe an alternate technique for PED deployment when ipsilateral ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2017.2.FOCUS16485
更新日期:2017-06-01 00:00:00
abstract::Tentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemor...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15420
更新日期:2016-01-01 00:00:00
abstract::OBJECT There are a variety of surgical positions that provide optimal exposure of the dorsal lumbar spine. These include the prone, kneeling, knee-chest, knee-elbow, and lateral decubitus positions. All are positions that facilitate exposure of the spine. Each position, however, is associated with an array of unique c...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.7.FOCUS15268
更新日期:2015-10-01 00:00:00
abstract:OBJECT:The object of this study was to compare the effects and complications of manual and computer-aided shaping of titanium meshes for repairing large frontotemporoparietal skull defects following traumatic brain injury. METHODS:From March 2005 to June 2011, 161 patients with frontotemporoparietal skull defects were...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.2.FOCUS129
更新日期:2012-07-01 00:00:00
abstract::Intravenous and intraarterial recombinant tissue plasminogen activator remains underutilized in the treatment of acute ischemic stroke, largely due to strict adherence to the concept of the therapeutic time window for administration. Recent efforts to expand the number of patients eligible for thrombolysis have been m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.4.FOCUS10296
更新日期:2011-06-01 00:00:00
abstract:OBJECT:Nowadays the role of microsurgical management of intrinsic brain tumors is to maximize the volumetric resection of the tumoral tissue, minimizing the postoperative morbidity. The purpose of this paper was to study the benefits of an original protocol developed for the microsurgical treatment of tumors located in...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.11.FOCUS09234
更新日期:2010-02-01 00:00:00
abstract::Moyamoya disease is an uncommon cerebrovascular condition characterized by progressive stenosis of the bilateral internal carotid arteries with compensatory formation of an abnormal network of perforating blood vessels providing collateral circulation. The etiology and pathogenesis of moyamoya disease remain unclear. ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2009.1.FOCUS08302
更新日期:2009-04-01 00:00:00
abstract::OBJECTIVE Reservoirs integrated into hydrocephalus shunts are commonly used for the removal of CSF and for intra-ventricular pressure measurement. Pumping with the reservoir to diagnose shunt sufficiency is still a matter of controversy. The authors describe an improved flushing device and its characteristic features ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.6.FOCUS15540
更新日期:2016-09-01 00:00:00
abstract::OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patie...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.10.FOCUS15456
更新日期:2016-01-01 00:00:00
abstract::OBJECTIVEEnhanced recovery after surgery (ERAS) is a multidimensional approach to improving the care of surgical patients using subspecialty- and procedure-specific evidence-based protocols. The literature provides evidence of the benefits of ERAS implementation, which include expedited functional recovery, decreased ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.1.FOCUS18700
更新日期:2019-04-01 00:00:00
abstract::Genetic alterations in the cells of intradural spinal tumors can have a significant impact on the treatment options, counseling, and prognosis for patients. Although surgery is the primary therapy for most intradural tumors, radiochemothera-peutic modalities and targeted interventions play an ever-evolving role in tre...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2015.5.FOCUS15143
更新日期:2015-08-01 00:00:00
abstract::OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between Janua...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.11.FOCUS16348
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:The recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be consider...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.12.FOCUS19448
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Advancements in less invasive lateral retropleural/retroperitoneal approaches aim to address the limitation of posterolateral approaches and avoid complications associated with anterior open thoracotomy or thoracoabdominal approaches. METHODS:Consecutive patients treated with a mini-open lateral approach for...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.6.FOCUS20360
更新日期:2020-09-01 00:00:00
abstract:OBJECT:Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)-secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission. METHODS:A retrospective review of a prospecti...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.7.FOCUS10153
更新日期:2010-10-01 00:00:00
abstract:Objective:The aim of this study was to investigate the diagnostic potential of the inflammatory markers interleukin-6 (IL-6), total leukocyte count (TLC), and protein in the CSF and IL-6, C-reactive protein, and white blood cell count in the serum for the early diagnosis of ventriculitis in patients with traumatic brai...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.8.FOCUS19407
更新日期:2019-11-01 00:00:00
abstract::Deep brain stimulation (DBS) has been reported to have beneficial effects in severe, treatment-refractory cases of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). In this report, the authors present the first case in which DBS was used to treat the neuropsychiatric symptoms of Kleefstra syndrome, a rar...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.3.FOCUS1528
更新日期:2015-06-01 00:00:00
abstract::OBJECT Neurosurgery studies traditionally have evaluated the effects of interventions on health care outcomes by studying overall changes in measured outcomes over time. Yet, this type of linear analysis is limited due to lack of consideration of the trend's effects both pre- and postintervention and the potential for...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.9.FOCUS15374
更新日期:2015-12-01 00:00:00