Abstract:
BACKGROUND:Chronic subdural hematoma (cSDH) is an increasingly common condition due to the growing use of anticoagulation. Currently, there remains a lack of evidence to guide the optimal timing of anticoagulant reinitiation for stroke prevention in atrial fibrillation after cSDH evacuation. We aimed to better understand the perceived risks of hemorrhagic and embolic complications along with current practice patterns on restarting anticoagulation after surgical evacuation of cSDH. METHODS:We conducted a survey of Canadian neurosurgeons and stroke neurologists using a novel self-administered questionnaire using clinical cases that included questions on clinical experience, practice setting, practice patterns, and perceptions on stroke/bleeding risk with anticoagulation reinitiation after cSDH evacuation. The instrument was evaluated for clinical sensibility by 5 neurosurgeons, neurologists, and intensivists. RESULTS:The response rate after 4 mailings was 40% for neurosurgeons (55/136) and 21% for stroke neurologists (26/122). Almost all participants would restart anticoagulation for stroke prevention in atrial fibrillation after cSDH evacuation (91.8% in low-risk patients, 98.6% in high-risk patients). Time to reinitiation of anticoagulation varied considerably, particularly for high-risk patients where 36% of participants would restart anticoagulation within 1 week of surgery, 44% between 1 and 4 weeks after surgery, and 19% after 4 weeks postoperatively. The perceived risk of stroke and SDH reaccumulation varied considerably among participants and was dependent on timing of anticoagulation reinitiation. CONCLUSIONS:There is considerable variation in current practice patterns and perceived risks of embolic and hemorrhagic complications with anticoagulation reinitiation after cSDH evacuation. These results demonstrate clinical equipoise that warrant further targeted investigation in large-scale randomized controlled trials.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Nassiri F,Hachem LD,Wang JZ,Badhiwala JH,Zadeh G,Gladstone D,Scales DC,Pirouzmand Fdoi
10.1016/j.wneu.2019.12.080subject
Has Abstractpub_date
2020-03-01 00:00:00pages
e616-e622eissn
1878-8750issn
1878-8769pii
S1878-8750(19)33109-2journal_volume
135pub_type
杂志文章abstract::The National Hospital, Queen Square, London was founded as a charitable institution in 1860, becoming the first dedicated neuroscience hospital in the world. Sir Victor Horsley, the first neurosurgeon was appointed in 1886, and since that time, Queen Square neurosurgeons have been prominent on the World neurosurgical ...
journal_title:World neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1016/j.wneu.2017.02.021
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To quantify the risk of a first or recurrent hemorrhage and the associated functional impairment in patients with sporadic solitary cerebral cavernous malformations (CCMs) and to investigate the potential risk factors. METHODS:We undertook an observational study (n = 199) of consecutive patients with the dia...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.080
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Fungal infection is a rare pathology in the sphenoid sinus, and extension into the pituitary fossa with visual loss has only been described in a few reports in the literature. Following publication of a recent report of pituitary abscess by Candida glabrata, we describe our own experience with a similar path...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.054
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Symptomatic intracerebral hemorrhage (sICH) is a severe complication of mechanical thrombectomy (MT). This study is to identify predictive factors and create a nomogram to evaluate the risk of sICH after MT treatment. METHODS:We conducted a retrospective analysis on 127 consecutive stroke patients treated b...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.08.181
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Venous thromboembolism (VTE) is an important complication after spine surgery with an incidence of 31%. To our knowledge, no study has reported a time-dependent examination of factors influencing VTE. We report factors influencing first and multiple VTE events and perform a time-dependent analysis. METHODS:A...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.03.068
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Pneumocephalus is commonly associated with cranial trauma including surgical interventions. Spontaneous pneumocephalus on the other hand is a rare diagnosis. Reported cases were predominantly unilateral. We report a unique case of a bilateral spontaneous pneumocephalus probably related to a bilateral tegmen ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.232
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Embolization of the middle meningeal artery (MMA) has recently been proposed as an alternative to surgery for treatment of chronic subdural hematoma (SDH). There is increasing evidence that fragile neovasculature arising from distal branches of the MMA found within the membrane that forms around a chronic SD...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.241
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Internal carotid artery (ICA) reconstruction is still the most effective treatment for a blood blister-like aneurysm (BBA) on the supraclinoid segment of the ICA, and clipping after wrapping has the most precise effects. However, the materials used are most often artificial. This study examined the use of au...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.186
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To evaluate whether the postoperative neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker for patients with intracerebral hemorrhage (ICH) undergoing surgical hematoma evacuation. METHODS:This retrospective cohort study was conducted to identify patients with ICH who underwent hematoma evacuation bet...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.154
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Magnetic resonance-guided laser-induced thermotherapy (MR-LITT) is a minimally invasive technique that shows promise in neuro-oncology because of its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage. In this analysis, we investigate initial data...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.10.037
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Rosai-Dorfman disease (RDD) is a rare, benign histiocytosis disorder with only approximately 100 reported central nervous system cases in the literature. Even less common is skull base involvement of RDD, with about 41 reported cases. Radiographically, RDD can appear similar to a meningioma; the true diagnos...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2019.12.032
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Intraoperative resection or occlusion control is indispensable in the surgery of vascular anomalies. This can be conducted using local vascular imaging modalities or angiographic techniques. This series was performed to assess whether cerebral arteriovenous malformations (AVMs) and dural arteriovenous fistul...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.065
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare, with fewer than 100 cases reported in the literature to date and only 1 previously documented surgical series. Because MGAs are radiologically indistinguishable fro...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.174
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The introduction of image-guided methods to bypass surgery has resulted in optimized preoperative identification of the recipients and excellent patency rates. However, the recently presented methods have also been resource-consuming. In the present study, we have reported a cost-efficient planning workflow ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.11.038
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Bipolar coagulation has enhanced the capabilities and safety profile of contemporary neurosurgery and has become indispensable in the neurosurgical armamentarium. Nevertheless, significant heat transfer issues remain to be resolved before it can achieve the status of minimal risk. METHODS:The Codman irrigat...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.10.007
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To investigate correlations between radiologic measurements and clinical outcomes in patients with basilar invagination (BI). METHODS:The medical records and radiologic data of 46 patients (27 women) who had undergone posterior atlantoaxial fusion or occipitocervical fusion for BI from January 2010 to June 2...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.080
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Idiopathic intracranial hypertension (IIH) is characterized by headaches, visual obscurations, and papilledema, and the diagnosis involves lumbar puncture (LP) with an elevated opening pressure (OP) ≥20 cm H20. When papilledema is absent, the diagnosis becomes less clear. Some physicians have argued that the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.036
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Readmission and reoperation are used as hospital and surgeon quality metrics. Venous thromboembolic (VTE) events, including deep vein thrombosis and pulmonary embolism (PE), are a major cause of readmission, morbidity, and mortality after spine surgery. Specific procedural, perioperative, and patient charact...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.11.168
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To report a series of patients with aneurysmal subarachnoid hemorrhage (SAH) and associated intracranial hematoma (ICH) who underwent coiling of the aneurysm followed immediately by open surgical decompression with evacuation of the hematoma. METHODS:With the hypothesis that aneurysm coiling before hematoma ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.06.051
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:The prognosis for patients with glioblastoma depends particularly on the degree of tumor resection. Patients with tumor remnants in postsurgical magnetic resonance imaging (<72 hours) may benefit from early reoperation. We present our results concerning the impact on overall survival (OS) and progression-fre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.04.072
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Intracranial extraskeletal mesenchymal chondrosarcomas (MCSs) are rare tumors accounting for <0.16% of intracranial tumors. They are usually described as occurring in the age group of 20-30 years and are commonly found in the frontoparietal region arising from the falx and surrounding dura. We describe 3 cas...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.08.049
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Arachnoiditis ossificans (AO) is a rare entity characterized by the presence of calcified plaques formed by the metaplasia of arachnoid cells. Over 50 cases of AO have been reported, with predisposing factors including spinal trauma, hemorrhage, vascular abnormalities, and infection. The administration of oi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.178
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Intracranial and intraspinal clear cell meningiomas (CCMs) are rarely reported because of their extremely low incidence, and the current understanding of CCM is poor. The purpose of this study was to analyze the incidence and the clinical, radiologic, pathologic, and prognostic features of intracranial and in...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.173
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Cluster Headache (CH) is most painful primary headache sometimes lead to poor quality of life and associated disability. So far not have treatment way to cured the CH. in this study, we introduce the novel and effective surgery for CH. METHOD:Six patients with CH, the diagnosis of CH matched on criteria of ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.059
更新日期:2020-12-17 00:00:00
abstract:OBJECTIVE:Diffusion tensor imaging (DTI) tractography provides useful information that can be used to optimize surgical planning and help avoid injury during subcortical dissection of eloquent tracts. The objective is to provide a safe, timely, and affordable algorithm for preoperative DTI language reconstruction for i...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.163
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Anatomical barriers (e.g., pedicles, narrow foramina) can hinder direct access to, and removal of, disc fragments that have migrated far downward. Using transforaminal full-endoscopic lumbar discectomy (FELD), we devised a modified technique, the suprapedicular retrocorporeal approach, for herniations in whic...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.08.038
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Various authors have described the morphology of the alar ligaments; however, there are no reports of a cadaveric study focusing on their attachments onto the dens. The purpose of this study was to use fresh cadaveric specimens to describe in detail different attachment patterns of the alar ligaments onto the...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.186
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To provide anatomic evidence of preoperative assessment of oblique lumbar interbody fusion (OLIF) for Chinese patients. METHODS:From the hospital picture archiving and communication system, 400 lumbar magnetic resonance imaging studies of adults performed between November 2016 and January 2017 were selected....
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.244
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Although the incidence of intracerebral hemorrhage (ICH) has appeared to be increasing over the years, its prognosis remains dismal. No consensus has yet been reached regarding the management of ICH; however, minimally invasive surgery should limit, if not avoid, intraoperative parenchymal damage. Therefore,...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.136
更新日期:2019-02-01 00:00:00
abstract::Endoscopy for hydrocephalus caused by infectious diseases presents clear challenges to the surgeon. Hydrocephalus caused by tuberculous meningitis is a good model to explore many of the issues that should be considered in the management of these patients. Tuberculous hydrocephalus may be communicating or noncommunicat...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.02.002
更新日期:2013-02-01 00:00:00