Performance of Aneurysm Wall Enhancement Compared with Clinical Predictive Scales: PHASES, ELAPSS, and UIATS.


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.


World Neurosurg


World neurosurgery


Roa JA,Sabotin RP,Varon A,Raghuram A,Patel D,Morris TW,Ishii D,Lu Y,Hasan DM,Samaniego EA




Has Abstract


2020-12-31 00:00:00








  • Three-Piece Orbitozygomatic Craniotomy: Anatomical and Clinical Findings.

    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


    authors: Matsuo S,Komune N,Hayashi D,Amano T,Nakamizo A

    更新日期:2019-08-01 00:00:00

  • Use of Simple Neck Extension to Improve Guiding Catheter Accessibility in Tortuous Cervical Internal Carotid Artery for Endovascular Embolization of Intracranial Aneurysm: A Technical Note.

    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


    authors: Takata M,Fukuda H,Kinosada M,Miyake K,Murao K

    更新日期:2017-09-01 00:00:00

  • Very Low Rate of New Brain Lesions After Vulnerable Carotid Artery Stenting Cases Using Only FilterWire EZ as Distal Embolic Protection.

    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


    authors: Ishida A,Asakuno K,Shiramizu H,Yoshimoto H,Nakase K,Kato M,Matsuo S

    更新日期:2020-09-01 00:00:00

  • Analysis of Morphometric Parameters in Cervical Canal Stenosis on Neutral and Dynamic Magnetic Resonance Imaging.

    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


    authors: Tykocki T,du Plessis J,Wynne-Jones G

    更新日期:2018-06-01 00:00:00

  • Pipeline Embolization Device for Recurrent Cerebral Aneurysms after Microsurgical Clipping.

    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


    authors: Adeeb N,Griessenauer CJ,Moore J,Stapleton CJ,Patel AB,Gupta R,Patel AS,Thomas AJ,Ogilvy CS

    更新日期:2016-09-01 00:00:00

  • Usefulness of High-Resolution Three-Dimensional Multifusion Medical Imaging for Preoperative Planning in Patients with Cerebral Arteriovenous Malformation.

    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


    authors: Yoshino M,Kin T,Hara T

    更新日期:2019-01-22 00:00:00

  • Unilateral approach for bilateral foramen decompression in minimally invasive transforaminal interbody fusion.

    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


    authors: Lin JH,Chiang YH

    更新日期:2014-11-01 00:00:00

  • Determination of Normal Values of the Basal Angle in the Era of Magnetic Resonance Imaging.

    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


    authors: Ferreira JA,Botelho RV

    更新日期:2019-12-01 00:00:00

  • Intracranial Meningioma in Patients Age

    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


    authors: Motebejane MS,Kaminsky I,Choi IS

    更新日期:2018-01-01 00:00:00

  • Intraoperative and Postoperative Bleeding in Microvascular Decompression for Trigeminal Neuralgia.

    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


    authors: Kasuya H,Kuroi Y,Yokosako S,Koseki H,Tani S

    更新日期:2018-10-01 00:00:00

  • Combined simultaneous multiportal approach (CSMA) via minimally invasive transciliary and endoscopic endonasal approaches for tumors invading both the skull base and the sinonasal area.

    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


    authors: Fischer-Szatmári T,Fülöp B,Szakács L,Gyura E,Bella Z,Barzó P

    更新日期:2021-01-05 00:00:00

  • A Case of Salivary Duct Carcinoma Intracranial Invasion due to Perineural Invasion Through the Facial Nerve.

    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



    authors: Enomoto T,Aoki M,Miyagawa K,Matsumoto J,Kobayashi H,Takeuchi T,Abe H,Nonaka M,Sakata T,Inoue T,Nabeshima K

    更新日期:2020-08-01 00:00:00

  • Virtual Cerebral Aneurysm Clipping with Real-Time Haptic Force Feedback in Neurosurgical Education.

    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


    authors: Gmeiner M,Dirnberger J,Fenz W,Gollwitzer M,Wurm G,Trenkler J,Gruber A

    更新日期:2018-04-01 00:00:00

  • Transposterior Arch Lateral Mass Screw for C1 Fixation: Application of a 3.5-mm-Diameter Screw in the Vertebral Artery Groove with a Height of ≤3.5 mm.

    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


    authors: Li C,Sun N,Li L,Duan J,Zhang Y

    更新日期:2019-07-01 00:00:00

  • Return to the Emergency Room with or without Readmission After Endoscopic Transsphenoidal Surgery in Socioeconomically Disadvantaged Patients at an Urban Medical Center.

    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


    authors: Silva NA,Taylor BES,Herendeen JS,Reddy R,Eloy JA,Liu JK

    更新日期:2018-12-20 00:00:00

  • Is It Possible To Evaluate the Ideal Cervical Alignment for Each Patient Needing Surgery? An Easy Rule To Determine the Appropriate Cervical Lordosis in Preoperative Planning.

    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


    authors: Ajello M,Marengo N,Pilloni G,Penner F,Vercelli G,Pecoraro F,Zenga F,Vaccaro AR,Ducati A,Garbossa D

    更新日期:2017-01-01 00:00:00

  • Predictive Accuracy of Neutrophil-to-Lymphocyte Ratio on Long-Term Outcome in Patients with Spontaneous Intracerebral Hemorrhage.

    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


    authors: Zhang F,Ren Y,Fu W,Yang Z,Wen D,Hu X,Tao C,Li X,You C,Xin T,Yang M

    更新日期:2019-05-01 00:00:00

  • Clinical Features, Radiologic Findings, and Surgical Outcomes of 65 Intracranial Psammomatous Meningiomas.

    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


    authors: Lin Z,Zhao M,Ren X,Wang J,Li Z,Chen X,Wang Y,Li X,Wang C,Jiang Z

    更新日期:2017-04-01 00:00:00

  • Palatal Position of Patient Tracker for Magnetic Neuronavigation System: Technical Note.

    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


    authors: Catapano G,Sgulò FG,Acurio Padilla PE,Spennato P,Di Nuzzo G,Boniello V,de Notaris M

    更新日期:2018-08-01 00:00:00

  • Visual complications after stent-assisted endovascular embolization of paraophthalmic and suprasellar variant superior hypophyseal aneurysms: the Duke Cerebrovascular Center experience in 57 patients.

    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


    authors: Ferrell AS,Lessne ML,Alexander MJ,Shah P,Golshani K,Zomorodi A,Smith TP,Britz GW

    更新日期:2012-09-01 00:00:00

  • Neuroendoscopy: general aspects and principles.

    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


    authors: Esposito F,Cappabianca P

    更新日期:2013-02-01 00:00:00

  • Cerebral Aneurysms: Are They Associated with Anatomic Variations of Carotid and Main Cerebral Arteries?

    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


    authors: Polak J,Ciuk S,Kucybała I,Giliavas J,Gajdosz A,Urbanik A

    更新日期:2019-01-10 00:00:00

  • Trends in Utilization and Cost of Inpatient Spinal Cord Stimulation: Analysis of Data from 2008 to 2014.

    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


    authors: Goyal A,Bhandarkar AR,Kerezoudis P,Lamer TJ,Gazelka HM,Belzberg AJ,North RB,Bydon M

    更新日期:2020-12-25 00:00:00

  • Hearing Outcome Following Microvascular Decompression for Hemifacial Spasm: Series of 1434 Cases.

    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


    authors: Jung NY,Lee SW,Park CK,Chang WS,Jung HH,Chang JW

    更新日期:2017-12-01 00:00:00

  • Radiographic Study of Lumbar Sympathetic Trunk in Oblique Lateral Interbody Fusion Surgery.

    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


    authors: Wang H,Zhang Y,Ma X,Xia X,Lu F,Jiang J

    更新日期:2018-08-01 00:00:00

  • Early Patient-Reported Outcomes Predict 3-Year Outcomes in Operatively Treated Patients with Adult Spinal Deformity.

    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


    authors: Jain A,Kebaish KM,Sciubba DM,Hassanzadeh H,Scheer JK,Neuman BJ,Lafage V,Bess S,Protopsaltis TS,Burton DC,Smith JS,Shaffrey CI,Hostin RA,Ames CP,International Spine Study Group.

    更新日期:2017-06-01 00:00:00

  • Prognosis of Pediatric Patients with Pineoblastoma: A SEER Analysis 1990-2013.

    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


    authors: Deng X,Yang Z,Zhang X,Lin D,Xu X,Lu X,Chen S,Lin J

    更新日期:2018-10-01 00:00:00

  • Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study.

    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


    authors: Tayebi Meybodi A,Lawton MT,Griswold D,Mokhtari P,Payman A,Tabani H,Yousef S,Kola O,Benet A

    更新日期:2017-08-01 00:00:00

  • 18F-Fluorodeoxyglucose Positron Emission Tomography-Magnetic Resonance Monitoring of Brain Metabolic Changes in a Case of Arteriovenous Malformation-Related Steal Phenomenon Symptoms.

    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


    authors: Anglani M,Cecchin D,Cester G,Simonato D,Baracchini C,Della Puppa A,Causin F

    更新日期:2019-06-01 00:00:00

  • External Validation of Scoring Models to Predict Shunt Insertion after Aneurysmal Subarachnoid Hemorrhage.

    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


    authors: Vyas D,Booker J,Smith D,Al-Tamimi YZ

    更新日期:2020-12-01 00:00:00