Abstract:
OBJECTIVE:To correlate the presence of objectively measured wall enhancement on high-resolution vessel wall imaging (HR-VWI) with the clinical predictive scales PHASES, ELAPSS, and UIATS. METHODS:Patients with unruptured intracranial aneurysm (UIAs) prospectively underwent HR-VWI on a 3-T magnetic resonance imaging scanner at diagnosis. Aneurysmal wall enhancement was objectively quantified on T1 postcontrast magnetic resonance imaging using signal intensity values adjusted for the pituitary stalk to calculate a contrast ratio (CRstalk). UIAs with CRstalk ≥0.60 were considered "enhancing." Patients' demographics, comorbidities, and aneurysm morphology were reviewed to calculate PHASES, ELAPSS, and UIATS scores. Pearson coefficients were applied for statistical correlation. Univariable and multivariable logistic regressions were performed to assess for confounders. RESULTS:One-hundred and twenty-three patients harboring 178 UIAs underwent HR-VWI. A total of 101 patients with 135 UIAs were analyzed. Enhancing UIAs were larger (8.4 ± 5.5 mm vs. 5.5 ± 2.3 mm; P < 0.001), had higher aspect ratio (2.3 ± 1.5 vs. 1.8 ± 0.7; P = 0.008), higher size ratio (3.0 ± 1.8 vs. 2.4 ± 1.1; P = 0.016), scored higher on PHASES (5.6 ± 3.9 vs. 4.4 ± 2.6; P = 0.04) and ELAPSS (19.4 ± 8.9 vs. 15.4 ± 7.3; P = 0.006) compared with nonenhancing UIAs. Treatment allocation as defined by UIATS was measured independently to enhancement status. No significant differences were found for UIATS between enhancing and nonenhancing UIAs (P = 0.63). Multivariable regression showed that size was the only independent factor significantly associated with UIA enhancement (odds ratio, 1.76; P = 0.005). CONCLUSIONS:Enhancing UIAs score higher in PHASES and ELAPSS scales. This association is largely explained by aneurysm size, aspect, and size ratios. Morphologic UIA features should be accounted for in clinical predictive scales of aneurysm instability.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Roa JA,Sabotin RP,Varon A,Raghuram A,Patel D,Morris TW,Ishii D,Lu Y,Hasan DM,Samaniego EAdoi
10.1016/j.wneu.2020.12.123subject
Has Abstractpub_date
2020-12-31 00:00:00eissn
1878-8750issn
1878-8769pii
S1878-8750(20)32690-5pub_type
杂志文章abstract:OBJECTIVE:To describe the technical details of 3-piece orbitozygomatic (OZ) craniotomy using a diamond threadwire saw as an alternative to cutting the orbital rim and zygoma. METHODS:The details of this procedure are presented by cadaver dissection and a surgical case. RESULTS:Three-piece OZ craniotomy consists of 3 ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.235
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:In endovascular embolization of intracranial aneurysms, a tortuous cervical internal carotid artery can limit guiding catheter access to a sufficiently high position. Although intermediate distal access catheters can go beyond the tortuous segment of internal carotid arteries, they may increase the risk of p...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.023
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Although carotid artery stenting (CAS) has been widely acknowledged as an effective alternative option for patients at high risk of carotid endarterectomy, embolic stroke is a major complication of CAS. Several reports have emphasized that distal protection filter alone is associated with a high risk of embo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.05.028
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:A dynamic compression injury of the cervical spinal cord (SC) is widely accepted in the pathophysiology of cervical myelopathy. Flexion/extension magnetic resonance imaging (MRI) provides information on the dynamic cervical injury. We sought to compare morphometric parameters on neutral and flexion/extension ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.179
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Microsurgical clipping is regarded as the most durable treatment for cerebral aneurysms. Aneurysm recurrence after clipping is uncommon and is associated with an increased risk of rupture. Reoperation for recurrent cerebral aneurysms is particularly challenging because of adhesions and scaring, and it carrie...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2016.06.065
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Successful resection of arteriovenous malformation (AVM) depends on preoperative assessment of the detailed morphology of the AVM. Simultaneous detailed three-dimensional visualization of the feeding arteries, draining veins, and surrounding structures is needed. The aim of this study was to evaluate the use...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.217
更新日期:2019-01-22 00:00:00
abstract:OBJECTIVE:To evaluate the efficiency and safety of a unilateral approach for bilateral foramen decompression in minimally invasive transforaminal lumbar interbody fusion (miTLIF) for the treatment of bilateral foraminal stenosis. METHODS:Treatment of 52 levels of bilateral foraminal stenosis in 48 patients was perform...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.06.009
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:The flexion of the skull base (basal angle [BA]) is the inclination between the anterior fossae and the basilar ramp of the occipital and sphenoid bones. An increased BA, termed platybasia, is usually associated with basilar invagination. BA reference values in the magnetic resonance imaging (MRI) era and th...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.09.056
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Intracranial meningiomas are most common among patients in their fifth to seventh decade of life and rare in children and young adults. They constitute 1.5% of all neoplasms in patients age <20 years, but account for 13.5% of all neoplasms in patients age 20-34 years. They are often associated with hereditar...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.161
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The surgical approach for the trigeminal nerve involves veins connected to the superior petrosal and tentorial sinus, and we should pay special attention to these veins. We investigated intraoperative and postoperative bleeding using our database. METHODS:A prospectively accumulated database of 247 microvasc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.139
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:For a long time, a combined transcranial and transfacial approach was the gold standard in the aspect of surgical management of large tumors with sinonasal and skull base involvement. The extended endoscopic endonasal approach for such pathologies has its advantages, but flaws as well, such as anatomical lim...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.150
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Salivary duct carcinoma (SDC) is a rare parotid tumor that often develops as a rapidly growing mass with a poor prognosis. It has a high rate of distant metastases, sometimes with infiltration along nerves. We describe a case of SDC that originated outside the cranium and extended into the cranium along the ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.05.180
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:Realistic, safe, and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education, and they should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic forc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.042
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To explore the feasibility and effectiveness of C1 lateral mass fixation via the posterior arch using pedicle screws of 3.5-mm diameter in patients whose atlas in the vertebral artery groove (C1 pedicle) was ≤3.5 mm in height. METHODS:A total of 14 patients who underwent transposterior arch lateral mass scre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.175
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Although reducing 30-day hospital readmissions is now a priority in neurosurgical quality improvement, postoperative emergency room (ER) visits have remained poorly understood, in particular, in populations with limited access to outpatient care. After endoscopic transsphenoidal surgery, the unique pathologi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.039
更新日期:2018-12-20 00:00:00
abstract:BACKGROUND:Cervical sagittal alignment parameters are essential to plan stages of surgery. The aims of this study were to evaluate the relationship between cervical sagittal alignment parameters and surgical outcomes after anterior cervical arthrodesis; to identify parameters linked to a better outcome; to determine th...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.09.110
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:It is well established that inflammation plays a critical role in the progression of intracerebral hemorrhage (ICH). Recently the neutrophil-to-lymphocyte ratio (NLR) was identified as a predictor for the short-term outcome in ICH patients. However, the association of NLR with the long-term outcome in patien...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.143
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Intracranial psammomatous meningiomas (PMs) are rarely reported due to their extremely low incidence. Knowledge about intracranial PMs is therefore poor. This study aimed to analyze the incidence, clinical features, radiologic findings, and surgical outcomes of intracranial PMs. METHODS:Approximately 5651 in...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.056
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Recently, the neuronavigation system (NS) has become an essential intraoperative tool for many neurosurgical procedures, allowing for precise lesion localization. It is particularly important to avoid errors during the navigation process. Here we report a novel technique using palatal positioning of the patie...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.221
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To review retrospectively experience with stent-assisted coiling of ophthalmic segment internal carotid artery (ICA) aneurysms to report outcome data and identify the rate of associated visual complications. METHODS:The Duke endovascular database was retrospectively reviewed to identify all ICA aneurysms tre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.12.003
更新日期:2012-09-01 00:00:00
abstract::When used in medicine, endoscopy describes a procedure used to see inside various parts of the body, such as the interior surfaces of an organ, by inserting a tube through a natural or created orifice. The instrument may have a rigid (borescope) or flexible (fiberscope) tube; it provides an image for visual inspection...
journal_title:World neurosurgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.wneu.2012.02.033
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Vascular anatomic variations are very common in the population, but their coexistence with life-threating vascular malformations remains unclear. The objective of the study was to assess the correlation between the presence of anatomic variants of both carotid and main cerebral arteries and the occurrence of ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.161
更新日期:2019-01-10 00:00:00
abstract:OBJECTIVE:In this study, we sought to characterize contemporary trends in cost and utilization of spinal cord stimulation (SCS). METHODS:The Healthcare Cost and Utilization Project-National Inpatient Sample was queried for inpatient admissions from 2008 to 2014 where SCS was performed. We then determined the rates and...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.012
更新日期:2020-12-25 00:00:00
abstract:OBJECTIVE:Although hearing impairment after microvasuclar decompression (MVD) for hemifacial spasm (HFS) is not common, its occurrence could detrimentally affect the patient's surgical outcome. The object of this study is to address the optimal approaches for reducing postoperative hearing problems after MVD for HFS. ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.053
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Oblique lateral interbody fusion (OLIF) surgery provides a convenient and minimal access to the lesion disc with few complications; however, the left lumbar sympathetic trunk (LST) lies in the surgical field with a certain incidence of injury. The aim of this study was to describe the anatomic structures of ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.212
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:For patients with adult spinal deformity (ASD), surgical treatment may improve their health-related quality of life. This study investigates when the greatest improvement in outcomes occurs and whether incremental improvements in patient-reported outcomes during the first postoperative year predict outcomes ...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2017.03.003
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Pineoblastomas are rare, malignant embryonal tumors that have a relatively higher incidence and a poorer prognosis in children. Owing to the rarity of these tumors, there is a paucity of data on associated prognostic factors. We used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.079
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Intracranial-intracranial bypass is a valuable cerebral revascularization option. Despite several advantages, one of the main shortcomings of the intracranial-intracranial bypass is the possibility of ischemic complications of the donor artery. However, when sacrificed, the temporopolar artery (TPA) is not a...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.04.142
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Unruptured brain arteriovenous malformations (AVMs) represent a complex disease in young healthy adults. Most often AVMs are clinically silent but also can display a neurologic syndrome due to hypoperfusion/hypometabolism in perilesional brain tissue called steal phenomenon. CASE DESCRIPTION:A 34-year-old w...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.167
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The current study is an external validation of 4 scoring models proposed in the literature for predicting ventriculoperitoneal shunt insertion after aneurysmal subarachnoid hemorrhage (aSAH) using retrospective patient data from Sheffield Teaching Hospital (STH). METHODS:Data were collected on various demog...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.146
更新日期:2020-12-01 00:00:00