Abstract:
OBJECTIVE:Spinal dural arteriovenous fistulas (SDAVFs) are rare vascular spinal malformations. According to the reported data, surgery seems to result in better occlusion rates than endovascular treatment. However, the post-treatment evolution of neurological symptoms stratified by the treatment remains unknown. The main objective of the present study was to compare the clinical outcomes for patients according to the treatment method. METHODS:The data from 63 patients with SDAVFs from 2000 to 2017 at 4 academic neurosurgical departments were retrospectively analyzed. Preoperative and postoperative examination neurological status was assessed using the Aminoff-Logue scale (ALS), which evaluates gait and micturition disturbances. Initial occlusion, late recurrence, and complications of the 2 techniques were also reviewed. RESULTS:Patients who had undergone surgery and embolization improved clinically on the ALS (P = 0.0009), and no significant differences were found between the 2 techniques. Subgroup analysis using the ALS showed that patients who had undergone surgery and embolization without late recurrence improved (P < 0.0001 and P = 0.0334, respectively) and that patients who had undergone surgery or embolization with late recurrence did not improve. The initial occlusion rate was in favor of surgery, with 91.3% versus 70% for endovascular treatment (P = 0.050). The late recurrence rate was higher for embolization (21.4% vs. 9.1% for surgery; P = 0.28). CONCLUSIONS:Surgery can be proposed as first-line treatment of SDAVFs after multidisciplinary discussion between neurosurgeons and neuroradiologists. The development of late recurrence negatively affects the neurological outcome of patients.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Bretonnier M,Hénaux PL,Gaberel T,Roualdes V,Kerdiles G,Le Reste PJ,Morandi Xdoi
10.1016/j.wneu.2019.04.005subject
Has Abstractpub_date
2019-07-01 00:00:00pages
e943-e949eissn
1878-8750issn
1878-8769pii
S1878-8750(19)30996-9journal_volume
127pub_type
杂志文章abstract:BACKGROUND:Osteoblastoma is a benign bone-forming tumor, sometimes locally invasive, that may involve any bone. The highest incidence is between 20 and 30 years of age, and there are no cases described in the elderly. METHODS:We report a case of an elderly patient with a lesion in the lumbar spine in which osteoblasto...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.180
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abstract:OBJECTIVE:To report a single-center experience with endovascular treatment of ruptured proximal posterior inferior cerebellar artery (PICA) aneurysms. METHODS:Between January 2007 and December 2016, among 1403 patients with aneurysmal subarachnoid hemorrhage, 15 with ruptured proximal PICA aneurysms underwent endovasc...
journal_title:World neurosurgery
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journal_title:World neurosurgery
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pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 临床试验,杂志文章
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更新日期:2017-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-08-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2020-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-03-01 00:00:00
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更新日期:2020-01-01 00:00:00
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更新日期:2020-01-01 00:00:00
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更新日期:2019-06-01 00:00:00