Abstract:
BACKGROUND:Comparative outcomes of extracranial-to-intracranial (EC-IC) and intracranial-to-intracranial (IC-IC) bypass for complex aneurysm treatment based on rupture status are not well described in the literature. In this study, we compare outcomes of EC-IC and IC-IC bypass for complex intracranial aneurysm treatment based on rupture status. METHODS:A prospective neurosurgical patient database was retrospectively reviewed. Sixty-three consecutive patients with aneurysm managed with revascularization were identified between July 2014 and December 2018. RESULTS:During the study period, 41 patients with aneurysm underwent EC-IC bypass (65%; 24 [58.5%] ruptured, 17 [41.5%] unruptured) and 22 patients with aneurysm underwent IC-IC bypass (34.9%; 13 [59.1%] ruptured, 9 [40.9%] unruptured). Graft spasm occurred in 4 patients (9.8%) in the EC-IC group (all ruptured aneurysms) and all anastomoses were patent on immediate postoperative imaging. Perioperative mortality occurred in 5 patients who underwent EC-IC bypass (12.2%; 3 ruptured, 2 unruptured) EC-IC and 2 patients who underwent IC-IC bypass (9.1%; both ruptured); (P = 0.709). Bypass-related complications occurred only in patients with ruptured aneurysm (2 [8.3%] in the EC-IC group and 0 [0%] in the IC-IC group; P = 0.285). For unruptured aneurysms, the overall complication rate was lower in IC-IC compared with the EC-IC group (P = 0.006). Modified Rankin Scale scores on discharge were significantly lower in IC-IC compared with EC-IC bypass for unruptured aneurysms (P = 0.008). There was a trend for shorter temporary occlusion and hospitalization times and overall better outcomes with IC-IC compared with EC-IC bypass. CONCLUSIONS:Although often considered riskier than EC-IC bypass, IC-IC in situ bypass showd a favorable technical and safety profile for the treatment of complex, unruptured aneurysms.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Ravina K,Rennert RC,Brandel MG,Strickland BA,Chun A,Lee Y,Carey JN,Russin JJdoi
10.1016/j.wneu.2020.10.056subject
Has Abstractpub_date
2020-10-17 00:00:00eissn
1878-8750issn
1878-8769pii
S1878-8750(20)32248-8pub_type
杂志文章abstract:BACKGROUND:Minimally invasive techniques in spine surgery have continued to advance as robotic technology has evolved over several generations. Although traditional techniques for placing pedicle screws are still widespread in practice, newer technology has increased the reliability of accurately placing instrumentatio...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.010
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The literature on multiple intracranial aneurysms (MIA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) focuses largely on risk factor analysis and consists essentially of retrospective cohort studies of limited sample size, or studies in populations outside Europe and North America. The purpose o...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.046
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Direct surgery for complex internal carotid artery (ICA) aneurysms can be difficult. In certain situations, sacrificing the parent artery is a unique way to obliterate the aneurysm and extracranial-to-intracranial (EC-IC) bypass is indispensable to prevent postoperative cerebral ischemia. This article discuss...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.07.043
更新日期:2011-03-01 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:BACKGROUND:Acute myelopathy in cases of thoracic disc herniation (TDH) is an exceptional condition for which the treatment is not codified. Here we present the results of a standardized procedure in 10 patients who underwent surgery for acute myelopathy on TDH between December 2009 and December 2016. METHODS:Our appro...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.100
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:We present a case of multiple myxoma-related intracranial aneurysms and reviewed the recent relevant literature to investigate their natural course and develop a reasonable treatment algorithm. METHODS:We have reported a new case of multiple myxoma-related intracranial aneurysms and performed a search of cur...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.09.014
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:This manuscript discusses the case of huge presacral Tarlov cysts (TCs) and the substantial neurologic recovery noted in the patient following spontaneous rupture of the most prominent cyst. Perineural or TCs are nerve root cysts, which are usually incidental findings on magnetic resonance imaging (MRI) and ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.098
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Olfactory neuroblastoma (ON) is a highly aggressive and locally recurrent neoplasm. Distant systemic metastases are not uncommon, but remote leptomeningeal dissemination is extremely rare. CASE DESCRIPTION:We report 2 cases of ON previously treated with endoscopic endonasal radical surgical resection and ra...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2019.11.042
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Previous studies compared outcomes of intracranial meningioma surgery in octogenarians with outcomes in younger patients without accounting for different tumor locations and sizes. The aim of the current study was to evaluate outcomes of intracranial meningioma surgery in octogenarians taking into account pa...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.001
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:In pituitary tumors, the presence of residual tumor after transsphenoidal surgery and recurrence of the tumor after resection are frequent, and the best treatment is not well established. The effects and complications of stereotactic radiosurgery have not been extensively studied. OBJECTIVE:We aimed to reve...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2019.11.041
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:During the coronavirus disease 2019 (COVID-19) pandemic, a rapid screening method for COVID-19 detection is needed to decide the appropriate strategy to treat stroke patients. In acute ischemic stroke treatment, the efficacy and safety of emergent carotid artery stenting (eCAS) for hyperacute ischemic stroke...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.166
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:En bloc resections aim at surgically removing a tumor in a single, intact piece. Approach must be planned for the complete removal of the tumor without violation of its margins. The shared knowledge of the morbidity, mortality, risk assessment for local disease recurrence, complications, and de...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.10.086
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Obese and morbidly obese patients undergoing lumbar spinal fusion surgery are a challenge to the operating surgeon. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open-TLIF have been performed for many years with good results; however, functional outcomes after lumbar spine surgery ...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2014.12.034
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:Currently, no spinal classification system has achieved universal acceptance. Therefore, it is important to choose a reliable classification within clinical practice. The objective of this study was to determine and compare the intraobserver and interobserver agreement of the Load Sharing Classification (LSC)...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.138
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliabil...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.094
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Altered mental status (AMS) has been associated with inferior surgical outcomes. The factors leading to AMS after spine surgery are unknown. The aim of this study is to determine the risk factors and independent predictors of 30-day readmission for AMS in patients with spine deformity after undergoing electi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.02.001
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:It is known that meningiomas are common intracranial benign tumors that can be enhanced significantly on computed tomography or magnetic resonance imaging scans after the administration of contrast medium. The authors report here on an extremely rare case of meningioma with distinctive pathological features ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.02.099
更新日期:2017-05-01 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: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:OBJECTIVE:To determine infection rate (IR) and to identify modifiable risk factors (RF) in cranial neurosurgery in a neurosurgical department for tertiary referral as part of an infection control surveillance to reduce surgical site infections (SSI). METHODS:A prospective SSI incidence cohort study from February 2013 ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.062
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:External ventricular drains (EVDs) historically have a high rate of infection, and EVD infections are a cause of significant morbidity and mortality. We have shown previously that a simple infection control protocol reduced the rate of EVD infections during a 3-year period, and the present study examines whet...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.12.042
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The sellar spine is a rare, bony growth that typically arises from the dorsum sellae. Few cases have been described in the literature thus far, and most are asymptomatic and incidentally found. We describe the case of a 19-year-old female in whom a sellar spine was noted to be associated with pituitary gland...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.046
更新日期:2016-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.07.051
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Lack of risk stratification among patients with varying severities of compound head injury has resulted in too-inconsistent and conflicting results to support any management strategy over another. The purpose of this study was to validate a new clinico-radiological grading scheme with implications on outcome...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.058
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To assess the value and limitation of cervical traction in the evaluation of the reducibility of atlantoaxial dislocation (AAD) and basilar invagination (BI) using the intraoperative O-arm. METHODS:A total of 22 patients with hyperextensive, irreducible AAD were included. The cervical traction test under gen...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.160
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Recent studies have suggested that retethering in patients operated for a tight or fatty filum is higher than previously predicted. In this retrospective review, outcome, complications, and risk of reoperation for recurrent tethered cord syndrome (TCS) at our own institution were investigated. METHODS:The me...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.05.017
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Cavum septum pellucidum (CSP), which is often found incidentally in a few populations, occasionally becomes symptomatic if enlarged significantly. Wilson disease (WD) is an uncommon autosomal recessive inborn defect in copper metabolism characterized by abnormal accumulation of copper in various tissues, par...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.032
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Novel audiovisual feedback methods were developed to improve image guidance during skull base surgery by providing audiovisual warnings when the drill tip enters a protective perimeter set at a distance around anatomic structures ("distance control") and visualizing bone drilling ("virtual drilling"). OBJEC...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.142
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to evaluate the efficacy of stereotactic radiotherapy combined with bevacizumab (SRT-Bv) compared with Bv treatment for recurrent high-grade gliomas (HGGs). METHODS:Data for patients with recurrent HGGs who received SRT and Bv (n = 29) or Bv (n = 29) between June 2014 and September 2016 were...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.03.161
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Preservation of neurologic function is mandatory when offering a surgical intervention to patients with low-grade gliomas (LGGs), given that the goal of any treatment is the patient's return to their normal everyday life. OBJECTIVE:To determine whether a structured evaluation by an occupational therapist ca...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.04.033
更新日期:2017-07-01 00:00:00