Abstract：
:Concordance between the Unruptured Intracranial Aneurysm Treatment Score (UIATS), Earlier Subarachnoid Hemorrhage, Location, Age, Population, Size, Shape (ELAPSS) score, and Population, Hypertension, Age, Size, Earlier Subarachnoid Hemorrhage, Site (PHASES) score with real-world management decisions in unruptured intracranial aneurysms (UIAs) remains unclear, especially in current practice. This study aimed to investigate this concordance, while developing an optimal model predictive of recent decision practices at a quaternary referral center. A prospective database of patients presenting with UIAs to our institution from January 1 to December 31, 2018, was used. Concordance between the scores and real-world management decisions on every UIA was assessed. Complications and length of stay (LOS) were compared between aneurysms in the UIATS-recommended treatment and observation groups. A subgroup analysis of concordance was also conducted among junior and senior surgeons. An optimal logistic regression model predictive of real-world decisions was also derived. The cohort consisted of 198 patients with 271 UIAs, of which 42% were treated. The UIATS demonstrated good concordance with an AUC of 0.765. Of the aneurysms in the UIATS-recommended "observation" group, 22% were discordantly treated. The ELAPSS score demonstrated good discrimination (AUC = 0.793), unlike the PHASES score (AUC = 0.579). Endovascular treatment rates, complications, and LOS were similar between aneurysms in the UIATS-recommended treatment and observation groups. Similar concordance was obtained among junior and senior surgeons. The optimal predictive model consisted of several significantly associated variables and had an AUC of 0.942. Cerebrovascular specialists may be treating aneurysms slightly more than these scores would recommend, independently of years in practice. Wide variation still exists in management practices of UIAs.
journal_name
Neurosurg Revjournal_title
Neurosurgical reviewauthors
Feghali J,Gami A,Caplan JM,Tamargo RJ,McDougall CG,Huang Jdoi
10.1007/s10143-020-01356-6subject
Has Abstractpub_date
2020-07-22 00:00:00eissn
0344-5607issn
1437-2320pii
10.1007/s10143-020-01356-6pub_type
杂志文章abstract：:Hyponatremia following acute or chronic central nervous system injury which is due to excessive Na+ loss in the urine without an increase in the body fluid, has been described as Cerebral Salt Wasting Syndrome (CSWS). This syndrome is often confused with dilutional hyponatremia secondary to inappropriate ADH secretion...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/BF00512052
更新日期：1996-01-01 00:00:00
abstract：:The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/s10143-018-1009-2
更新日期：2020-04-01 00:00:00
abstract：:Based on extensive personal experiences during the past three decades, a review is given on infections and infestations of the central nervous system, which are found in India and in other tropical and subtropical areas. Besides the main disease such as tuberculosis, pyogenic infections and parasitic infestations, rar...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/BF01742760
更新日期：1983-01-01 00:00:00
abstract：:A retrospective clinical study was made on 987 patients with lumbar disc disease treated by discectomy. All patients had been operated on in the Department of Neurosurgery (University-Hospital Mainz). 545 patients were males, and 442 females (1.2:1). Patients in the 4th decade of life were affected most often (33.5%)....
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF00313019
更新日期：1990-01-01 00:00:00
abstract：:Experimental brain tumours were produced in cats by stereotactic implantation of 4 million suspended cells of a rat glioma clone into the internal capsule. Three weeks after implantation a spherical tumour developed with a diameter of up to 10 mm which was surrounded by vasogenic white matter oedema. In untreated anim...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF01743708
更新日期：1981-01-01 00:00:00
abstract：:Patients infected with the human immunodeficiency virus (HIV) or suffering from acquired immunodeficiency syndrome (AIDS) are now surviving for longer periods of time secondary to improvements in medical management. As the classical causes of morbidity and mortality in this patient population have come under better co...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/s10143-004-0371-4
更新日期：2005-04-01 00:00:00
abstract：:There is growing evidence that the nervous system influences spinal cord vasculature. However, most descriptions of the spinal cord have paid little attention to this important aspect. We reviewed the literature on the innervation of spinal cord vessels with an emphasis on findings that may be applicable to human medi...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/s10143-016-0788-6
更新日期：2018-07-01 00:00:00
abstract：:Excision of a circumscribed spongioblastoma with intrapontine-intramesencephalic extension was performed via the floor of the fourth ventricle in two girls 14 and 5 years of age. The preoperative neurological deficits (severe hemiparesis, cerebellar, and sixth and seventh cranial nerve disturbances) showed slow but co...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF01743035
更新日期：1983-01-01 00:00:00
abstract：:The objective of this study was to ascertain if stereotactic neurosurgical biopsy (SNB) optimizes the therapy of undefined CNS masses. The design was of retrospective treatment and outcome analysis and the setting was a large general hospital. We studied a total of 141 patients with undefined, space-occupying CNS lesi...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s101430050043
更新日期：1999-10-01 00:00:00
abstract：:A rare case of fourth ventricle meningioma with a combined intraventricular-intracerebellar localization, successfully removed by surgical treatment, is reported. The features of this type of meningioma as compared to the purely intra-ventricular variety are discussed. ...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF00313514
更新日期：1992-01-01 00:00:00
abstract：:Teflon is utilized in neurosurgery as well as in plastic, vascular and heart surgery. Although the effect of Teflon on different types of cells and tissues has been previously studied, we are not aware of any study in which the effect of Teflon was tested on cells of the central nervous system. We have therefore exami...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF00346368
更新日期：1990-01-01 00:00:00
abstract：:Recently, a bioactive glass ceramic (BGC) has been developed for use as intervertebral cages for anterior cervical discectomy and fusion (ACDF). However, the effectiveness and safety of BGC cages remain to be evaluated. We completed a retrospective comparison of the radiological and clinical outcomes of 36 patients (5...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-019-01225-x
更新日期：2020-10-01 00:00:00
abstract：:Surgical approaches for medically refractory mesial temporal lobe epilepsy (MTLE) that previously have been reported include anterior temporal lobectomy (ATL), transcortical selective amygdalohippocampectomy, transsylvian amygdalohippocampectomy, and subtemporal amygdalohippocampectomy. Each approach has its advantage...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-015-0657-8
更新日期：2016-01-01 00:00:00
abstract：:The spinal nerve can be pinched between the transverse process of the fifth lumbar vertebra and the sacral ala. The patients are divided into two types: elderly persons with degenerative scoliosis and somewhat younger adults with isthmic spondylolisthesis. For the first time, we describe extraforaminal impingement of ...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-010-0300-7
更新日期：2010-04-01 00:00:00
abstract：:Overcoming the metabolic restrictions of hypoxia may allow the progression of lower-grade tumors to glioblastoma multiforme. Our findings of up-regulation of HIF-1alpha and its downstream targets VEGF, GLUT-1, and CAIX in higher-grade gliomas support this hypothesis. We compared the gene expression profiles of the U-2...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-007-0070-z
更新日期：2007-07-01 00:00:00
abstract：:Traumatic brain injury is a major problem worldwide. Our objective is to synthesize available evidence in the literature concerning the effectiveness of neuroprotective drugs (cerebrolysin, citicoline, and piracetam) on Glasgow outcome score (GOS), cognitive performance, and survival in traumatic brain injury patients...
journal_title：Neurosurgical review
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s10143-016-0775-y
更新日期：2018-04-01 00:00:00
abstract：:For the past three decades, surgery of glomus jugulare tumors (GJTs) has been characterized by extensive combined head and neck, neuro-otologic, and neurosurgical approaches. In recent years, the authors have modified the operative technique to a less invasive approach for preservation of cranial nerves while achievin...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-013-0482-x
更新日期：2013-10-01 00:00:00
abstract：:Histological, immunocytochemical, and biological features of 38 giant cell gliomas were investigated. The invasion of these tumors and its giant cells by histiocytes, lymphocytes, plasma cells, and especially by eosinophilic granulocytes is viewed as an immune response, which may explain a favorable clinical course. F...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF01782050
更新日期：1987-01-01 00:00:00
abstract：:Acute management of deep-seated hematomas remains controversial. Since patients with these hematoma later tend to develop severe edema and necrosis around the lesion, when surgery is indicated it should be done as early as possible. The purpose of this study was to compare whether early surgical removal and conservati...
journal_title：Neurosurgical review
pub_type： 临床试验,杂志文章
doi：10.1007/pl00012391
更新日期：2001-07-01 00:00:00
abstract：:The management of posterior cranial fossa meningioma [PCFM] is challenging and many neurosurgeons advise gamma knife radiosurgery [GKRS] as a modality for its upfront or adjuvant treatment. Due to the varying radiosurgical response based on lesion location, tumor biology, and radiation dosage, we performed a pioneer a...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-019-01144-x
更新日期：2020-08-01 00:00:00
abstract：:Cerebral cysticercosis is the result of infestation of the brain with the larval stage of the intestinal tape worm Taenia Solium. The disease, endemic in some parts of the world, especially Mexico, South America, India, Eastern Europe, is still encountered practically all over the world. There appear to be distinct ge...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/BF01742763
更新日期：1983-01-01 00:00:00
abstract：:200 stereotactic biopsies were evaluated. The validity of the intraoperative histopathological results were compared with the final diagnosis using conventional embedding and staining techniques. Further comparison between the histology of the biopsy and the post mortem or open operative findings were possible in 41 c...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF00309989
更新日期：1994-01-01 00:00:00
abstract：:A hypothalamic hamartoma associated with true precocious puberty in a 7-month-old girl is hereby reported. Hormonal studies disclosed elevated serum levels of luteinizing hormone (LH) and follicle stimulating hormone, both of which responded well to LH-releasing hormone stimulation. Following a subtotal removal of the...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF00258250
更新日期：1993-01-01 00:00:00
abstract：:Multilevel discectomy and inter-vertebral body fusion combined with anterior plate-screw fixation is the common procedure in cervical spine surgery. The correct placement of the screws is an important factor for the outcome of these operations. Yet no systematic approach has been undertaken to optimize the geometry of...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-005-0386-5
更新日期：2005-10-01 00:00:00
abstract：:Otogenic brain abscesses are a significant cause of mortality and morbidity in developing countries. Usually they occur either by distant thrombophlebitis of cerebral veins or by direct extension in an unsafe type of chronic suppurative otitis media. This case of cerebellar abscess was prepared for surgical excision, ...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF01111489
更新日期：1998-01-01 00:00:00
abstract：:There are many satisfactory long-term outcomes after posterolateral fusion (PLF) for degenerative lumbar spondylolisthesis (DLS); nonunion cases have also achieved good clinical outcomes. Facet fusion (FF), a minimally invasive evolution of PLF, also resulted in good clinical outcomes. We aimed to assess the course of...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/s10143-021-01479-4
更新日期：2021-01-20 00:00:00
abstract：:The orbitotomy has a central importance in craniofacial surgery. It is indicated for premature craniosynostoses, malformations and tumor surgery. The aim of the treatment is to correct functional disturbances and aesthetic impairments. Anatomical structures must be respected. Functional and anatomical aspects of the o...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF01787121
更新日期：1989-01-01 00:00:00
abstract：:The transformation of sensory information to movement patterns in spinal interneuronal systems is far from just being a stereotyped reflex pattern. Information from the different sensory modalities (skin-, muscle, and joint receptors) is integrated at the interneuronal level and transformed into patterns of coordinate...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/BF00313016
更新日期：1990-01-01 00:00:00
abstract：:80-90% of individuals suffering from aneurysmal bone cyst (ABC) are children or adolescents. Primary ABC is a non-neoplastic lesion. Diagnostic assessment and detection of recurrence demands repeated plain x-rays or CT scans. These repeated radiographic examinations expose these young patients to large doses of ionizi...
journal_title：Neurosurgical review
pub_type： 杂志文章
doi：10.1007/BF00383659
更新日期：1990-01-01 00:00:00
abstract：:Von Hippel-Lindau disease (VHL) is a hereditary cancer syndrome caused by germline mutations of the VHL tumor suppressor gene. Major progress has been made in the last decade in both clinical and fundamental aspects of VHL. The VHL gene product, pVHL, has major and multiple functions: pVHL regulates not only first ang...
journal_title：Neurosurgical review
pub_type： 杂志文章,评审
doi：10.1007/s101430050024
更新日期：2000-03-01 00:00:00
