Abstract:
BACKGROUND:This study aimed to clarify the risk factors of treatment for unruptured cerebral aneurysms (UCAs) in elderly patients by comparing the morbidity at discharge between surgical clipping and endovascular coiling in nonelderly (<65 years) and elderly (≥65 years) patients based on a national database in Japan. METHODS:A total of 36,017, including 15,671 patients with UCA after exclusion of unknown location, were registered in the Diagnosis Procedure Combination, the nationwide database, from 2010 to 2015 in Japan. Outcome of Barthel Index at discharge was investigated and multivariate logistic regression analysis identified risk factors for morbidity of Barthel Index <90 at discharge in nonelderly and elderly patient groups. RESULTS:Risk factors for morbidity at discharge were basilar artery aneurysm compared with internal carotid artery (ICA), diabetes mellitus (odds ratio [OR], 2.0-2.5; 95% confidence interval [CI], 1.6-3.7), antiplatelet drug, and anticoagulation drug; however, highest hospital volume compared with lowest was an inverse risk factor in both age groups. Endovascular coiling (OR, 0.4; 95% CI, 0.3-0.5) was a significantly inverse risk in the elderly group. Anterior communicating artery aneurysm compared with ICA was a significant risk (OR, 1.6; 95% CI, 1.0-2.6) in the nonelderly group; on the other hand, anterior communicating artery aneurysm (OR, 0.7; 95% CI, 0.5-0.95) and middle cerebral artery aneurysm (OR, 0.6; 95% CI, 0.5-0.8) compared with ICA were significantly inverse risks in the elderly group. CONCLUSIONS:Endovascular coiling after control of diabetes mellitus was recommended for the treatment of UCA in elderly patients. The ICA location of aneurysm in the elderly should be paid attention as the treatment risk.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Ikawa F,Michihata N,Akiyama Y,Iihara K,Matano F,Morita A,Kato Y,Iida K,Kurisu K,Fushimi K,Yasunaga Hdoi
10.1016/j.wneu.2019.08.252subject
Has Abstractpub_date
2019-12-01 00:00:00pages
e89-e98eissn
1878-8750issn
1878-8769pii
S1878-8750(19)32420-9journal_volume
132pub_type
杂志文章abstract:BACKGROUND:Patients with an aneurysmal subarachnoid hemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome. OBJECTIVE:The objective of this study was to assess the actual clinical outcome of WFNS grade I aSAH patients, and ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.157
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Indications for reconstruction of the common carotid artery (CCA) include trauma, iatrogenic injury, neoplastic growth (such as invasive neck carcinomas), postoperative infection, and cervical carotid aneurysm. Although various techniques and conduits have been described, the clinical scenario may preclude t...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.05.215
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Acute ischemic stroke in pregnancy is a cause of maternal and fetal morbidity. Optimal treatment strategies for stroke in this population are undefined. Thrombolysis is recommended by guidelines should the benefit outweigh uterine bleeding risk. Alternately, data regarding mechanical thrombectomy (MT) is ext...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.095
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Rhabdoid meningioma (RM) is a rare subtype of meningioma, classified as World Health Organization grade III with a poor prognosis. Here we present our experience on RM and review relevant literature in an attempt to investigate the clinical features, treatment, and prognosis of these tumors. METHODS:Twelve ...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.08.002
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the clinical and radiologic outcome of stand-alone anterolateral lumbar interbody fusion (ALLIF) using self-locked cages in comparison with extended posterior lumbar interbody fusion (PLIF) for symptomatic adjacent-segment degeneration (ASD) after posterior lumbar fusion. METHODS:This retrospecti...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.165
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Complete aneurysm obliteration is the goal of aneurysm treatment. In selected cases, a neck remnant may be left to preserve a critical branch. Literature on ophthalmic artery sacrifice in the treatment of cerebral aneurysms and subsequent risk of vision loss is limited. CASE DESCRIPTION:Herein, we describe ...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.04.196
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Addition of fusion to decompression for stenosis with grade 1 degenerative spondylolisthesis is a controversial topic, and the question remains if fusion provides any benefit to the patient that warrants the increased health care utilization and perioperative morbidity. There is no consensus on indications f...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.11.001
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:The treatment of hypothalamus-invading craniopharyngiomas, based on pediatric experience, is subtotal resection (STR) with radiotherapy. This strategy sometimes leads to uncontrollable tumor progression. In adults, with the use of endoscopic endonasal surgery (EES), does removing the hypothalamic part of the ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.037
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:There is a lack of studies highlighting the outcome by different scores or parameters after surgery for recurrent disc herniations of the lumbar spine at the initial herniation site. This study assessed the quality of life after surgical treatment of recurrent herniations with different standardized validated o...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.02.028
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcomes and complications of patients with adult spinal deformity treated in a primary versus revision fashion with long fusions to the sacropelvis. METHODS:A retrospective review was performed of a multicenter consecutive series of patients with adult spinal deformity requiring fusion to th...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2013.02.059
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:In this study, we considered the treatment of cognitive characteristics of Parkinson's subtypes under resting magnetic resonance imaging scans, and used magnetic resonance imaging to analyze brain activity characteristics of patients with Parkinson's subtypes at rest. METHODS:In this study, patients with neu...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.002
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Intracranial hematomas associated with abnormal collateral vessels are observed in certain populations of adult patients with moyamoya disease (MMD). Of these, intraventricular hematomas resulting from rupture of intraventricular aneurysms, which are formed along an abnormal peripheral choroidal artery, are ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.05.222
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:To identify deficiencies leading to readmissions to the University of Florida Neurosurgery Service by using the Institute for Healthcare Improvement STate Action on Avoidable Rehospitalizations Readmissions diagnostic tool and to report the opinions of patients, their families, and health care providers. MET...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.02.028
更新日期:2014-09-01 00:00:00
abstract::Terminal myelocystocele is a rare type of neural tube malformation, consisting of a skin-covered lumbosacral mass, highly associated with other complex abdominal malformations within the OIES complex (omphalocele, imperforate anus, exstrophy of the cloaca and spinal defects). We present a case of a premature female wi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.135
更新日期:2020-12-19 00:00:00
abstract:BACKGROUND:Although previous studies have reported the expression of JAK1, STAT3, and phosphorylated STAT3 in hypertrophied ligamentum flavum (LF), the role of the Janus kinase-signal transducer and activator of transcription (JAK/STAT) signaling pathway in hypertrophied LF has not been fully elucidated. The aim of thi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.024
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Transforaminal lumbar interbody fusion (TLIF) is an effective treatment of upper lumbar intervertebral disk herniation. However, its clinical efficacy for adjacent segment disk degeneration (ASDD) remains undefined. Therefore, the biomechanical evaluation of ASDD caused by TLIF after pedicle screw fixation (...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.195
更新日期:2018-11-29 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:It remains controversial which bypass methods are optimal for treating adult moyamoya angiopathy patients. This study aimed to analyze the literature about whether different bypass methods affect differently outcome results of adult moyamoya patients with symptoms or hemodynamic instability. METHODS:A syste...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2016.07.009
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Approximately 60 cases of schwannoma unrelated to the cranial nerve have been reported, and only 12 arose from the tentorium. We present a case of tentorial schwannoma extending into the pons and midbrain without cranial nerve involvement, which was almost totally resected with an occipital transtentorial ap...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.11.049
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To review the clinic value and severity assessment of serum substance P (SP) concentration in children with different degrees of traumatic brain injury (TBI) through analyzing correlations with outcomes. METHODS:One hundred thirty-nine children with TBI who were diagnosed and treated at Nanjing Medical Unive...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.009
更新日期:2020-12-09 00:00:00
abstract:INTRODUCTION:Treatment of hydrocephalus related to myelomeningocele (MM) is debated. Endoscopic third ventriculostomy (ETV) has been proposed with contrasting results. We report our experience in the management of hydrocephalus related to MM and the advantages of ETV. MATERIAL AND METHODS:From 1994 to 2012, we treated...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.07.071
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Telemedicine has seen substantial growth in the past 20 years, related to technologic advancements and evolving reimbursement policies. The risks and opportunities of neurosurgical telemedicine are nuanced. METHODS:We reviewed general and peer-reviewed literature as it relates to telemedicine and neurosurge...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.01.075
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:Although the endoscopic transpterygoid approach has been popularized, there are no studies about anatomy-specific morbidities of this approach. The objective of this study is to investigate the surgical morbidities associated with the endoscopic transpterygoid approach for resection of anatomic structures. M...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.12.023
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Extracranial to intracranial (EC-IC) high-flow bypass using radial artery or saphenous vein (SV) graft has remained vital for complex aneurysms. If an Allen test is positive, the radial artery cannot be harvested because of poor palmer collateral circulation. The valves are thought to be one of causes of SV g...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.12.009
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Hiccups are a well-known short-term phenomenon in daily life. If they persist or become intractable, they may be a primary symptom of a disease. Recent studies identified the medulla oblongata as the neuroanatomic center of the hiccup reflex arc. In previous cases, an isolated lesion at the dorsal side of th...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.06.013
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Data on traumatic intraventricular hemorrhage (IVH) are currently limited, and therefore, the condition is not fully understood. The aim of this study was to determine the epidemiology of traumatic IVH and its effects on outcome in patients with blunt head trauma. METHODS AND MATERIALS:Using a nationwide tr...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2018.02.183
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Quantitative measurements of intracranial vessel walls are reliable in 3-T high-resolution magnetic resonance imaging (HR-MRI). However, few reports have assessed the arterial wall after endovascular treatment (EVT) by 3-T HR-MRI. This study aimed to quantitatively analyze vessel walls in vertebrobasilar arte...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.161
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Hemifacial spasm (HFS) associated with Chiari I malformation (CIM) is rare. This study aimed to analyze the frequency of HFS associated with CIM in our department and further to investigate the clinical characteristics, treatment strategies, and outcomes of these cases. METHODS:Twenty-eight of 831 patients w...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.033
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:Intracranial arterial dissection (IAD) is a rare cerebrovascular disease that is likely underdiagnosed because of the inherent difficulty of visualizing the subtle radiographic signs of the pathologic small intracranial arteries. No widespread consensus exists on the treatment of IAD, and thus it is often man...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.153
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To retrospectively evaluate influence of intraoperative positioning (semisitting vs. lateral decubitus) and surgeon's learning curve with regard to functional outcome of patients with vestibular schwannoma. METHODS:This study included 544 patients (median age 57 years) and spanned 3 decades: 1991-1999 (n = 1...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.107
更新日期:2020-12-28 00:00:00