Abstract:
BACKGROUND:The number of patients treated with novel oral anticoagulants (NOACs) is increasing. Despite growing clinical relevance, guidelines on the perioperative management of neurosurgical patients treated with NOACs are still lacking. The aim of this study was to analyze the occurrence of postoperative bleeding events and factors that might influence bleeding rates in these patients. METHODS:Out of 1353 consecutive patients undergoing cranial neurosurgical procedures, 30 (2.2%) received NOACs preoperatively. The rates of perioperative and postoperative intracranial bleeding events, rate of postoperative thromboembolic events, hematologic findings, morbidity, and mortality were reviewed. A subanalysis of factors influencing the bleeding risk of these patients and the bleeding rate depending on the preoperative discontinuation time of NOACS, with cutoff of 24 and 48 hours, was performed as well. RESULTS:The rate of perioperative bleeding was 13.3% (n = 4 of 30). Postoperative bleeding led to death in 2 patients. The median discontinuation time was significantly shorter in the patients experiencing a bleeding event compared to those without a bleeding event (1.5 days [range 0-3 days] vs. 11 days [range, 0-120 days]). The rate of perioperative thromboembolic events was 3.3% (n = 1), and overall mortality was 13.3% (n = 4). CONCLUSIONS:The postoperative bleeding rate in patients undergoing cranial surgery treated with NOACs was 13.3%. A shorter preoperative discontinuation time seems to have a significant effect on bleeding rate. Further studies evaluating the management and postsurgical outcomes of these patients are warranted.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Croci DM,Kamenova M,Guzman R,Mariani L,Soleman Jdoi
10.1016/j.wneu.2017.06.105subject
Has Abstractpub_date
2017-09-01 00:00:00pages
841-848eissn
1878-8750issn
1878-8769pii
S1878-8750(17)30997-Xjournal_volume
105pub_type
杂志文章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 treatmen...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.056
更新日期:2020-10-17 00:00:00
abstract:BACKGROUND:Every year, there are an estimated 22.6 million new neurosurgical consultative cases worldwide, of which 13.8 million require surgery. In 2016, the global neurosurgical workforce was estimated and mapped as open-access information to guide neurosurgeons, affiliates, and policy makers. We present a subsequent...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.067
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Spinal neuronavigation improves accuracy of pedicle screw placement but may increase operative time, and its use in oncologic operations remains relatively unstudied. We compared the use of two-dimensional (2D) fluoroscopy and three-dimensional (3D) spinal neuronavigation relative to operative time in instrum...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.016
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Use of distal nerve transfer for improving upper limb function has been well described for patients with tetraplegic spinal cord injury and brachial plexus injuries but has not previously been described for Brown-Séquard type spinal cord injury. We describe our experience with 2 cases of combined Brown-Séqua...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.10.169
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND IMPORTANCE:Lesions located lateral to the lower brainstem, such as proximal posterior inferior cerebellar artery (PICA) aneurysms, are surgically challenging. We report a case of a patient with a left proximal PICA aneurysm that was successfully clipped via a so-called "extended" suboccipital subtonsilla...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.019
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The foramen of Luschka is a natural aperture between the fourth ventricle and the subarachnoid space at the cerebellopontine angle. Membranous closure of this foramen is referred to as primary obstruction. Available information about this variant and its role in the development of the cysts of the posterior ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.037
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Idiopathic spinal cord herniation is a rare condition that involves spinal cord herniation through a defect in the ventral dura. CASE DESCRIPTION:We present a case of a 61-year-old woman who initially presented in 2016 with an approximately 1-year history of burning right lower extremity pain and gait insta...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.219
更新日期:2019-09-01 00:00:00
abstract::The reach to expose the peritrigonal/atrial territories poses special challenges. The highly functional overlying cortices and white matter tracts, such as the optic radiations lateral to the ventricle, postcentral gyrus laterally and more superficially, and the thalamus anteroinferiorly, constrain the surgical corrid...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.08.150
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Thalamic glioma is a type of midline glioma with poor outcomes. In the present study, we investigated the clinical and molecular features of thalamic gliomas in Chinese patients. METHODS:The data from 26 patients with thalamic glioma who had undergone surgery at Shanghai Huashan Hospital from January 2011 to...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.061
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The benefit of endovascular treatment (EVT) for acute ischemic stroke patients with mild deficits is unknown. We sought to evaluate the natural history of patients with a low National Institute of Health Stroke Score (NIHSS) and an intracranial occlusion. METHODS:We included patients with a computed tomogra...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.080
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Scalp arteriovenous malformation (SAVM) is primarily treated by surgery and reports on endovascular treatment are scarce. We report the results of an endovascular-first approach in the treatment of SAVM. We also have proposed a simple dichotomized classification using the angiographically determined morpholo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.092
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Paragangliomas are uncommon neuroendocrine tumors, rarely occurring in the lumbar spine. Primary lumbar paragangliomas are prominently vascularized, can present variably, and pose both diagnostic and surgical challenges. We report on a large case series with long-term follow-up and intraoperative footage to ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.05.144
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The neurosurgical boot camp has been fully incorporated into U.S. postgraduate education. This is the first implementation of the neurosurgical boot in a developing country. To advance neurosurgical education, we developed a similar boot camp program, in collaboration with Bolivian neurosurgeons, to determin...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.046
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Myelocystoceles, which are classified as closed neural tube defects, are usually covered by skin and rarely complicated by hydrocephalus. We encountered an unusual case of a terminal myelocystocele with hydrocephalus with clinical characteristics of a myelomeningocele. CASE DESCRIPTION:Severe hydrocephalus ...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.07.247
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:The AOSpine Subaxial Cervical Spine Injury Classification System was introduced to improve communication, clinical management, and research. Here, the system was studied in relation to injury severity along with admission and long term neurologic follow-up. METHODS:A retrospective study was performed in suba...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.092
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Ankylosing spondylitis (AS) is an inflammatory disease that involves above all the spine and the pelvis. In the spine, the inflammatory processes cause the formation of syndesmophytes between the vertebral bodies and the ossification of ligaments, with bony overgrowth. In this setting, dysphagia is a rare bu...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.04.031
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Vestibular schwannomas and meningiomas account for the great majority of lesions arising in the cerebellopontine angle. In this report, we present a case of glioneuronal heterotopia, also known as glioneuronal hamartoma, arising from cranial nerve VIII, which is an extremely uncommon lesion. Important radiol...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.03.185
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To assess the prognostic profile, clinical outcome, treatment-associated morbidity, and treatment burden of elderly patients with glioblastoma (GBM) undergoing microsurgical tumor resection as part of contemporary treatment algorithms. METHODS:We retrospectively identified patients with GBM ≥65 years of age ...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2019.09.097
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:In selected cases, embolization can be indicated for very small unruptured intracranial aneurysms. Previous studies reported high intraprocedural rupture rates. Recent improvements of endovascular devices and availability of small, soft platinum coils may lead to improved safety and efficacy profiles. METHOD...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.070
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:We reviewed our clinical experience of patients with moyamoya disease (MMD) who gave birth and assessed characteristics of those experiencing neurologic deterioration. METHODS:The patients were classified into patients diagnosed with MMD during pregnancy and puerperium (group 1) and those diagnosed before p...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.11.094
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Development of immunologically smart implants, integrated to biological systems, is a key aim to minimize the inflammatory response of the host to biomaterial implants. METHODS:The aim of this study is to investigate the influence of titanium alloy and stainless steel implants on immunological responses in r...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.08.016
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Occipital artery pseudoaneurysms are extremely rare pathologies that manifest after traumatic injury; only 11 cases have been reported in the literature. Because of their low incidence and vague symptoms, the initial diagnosis can be difficult. However, for correctly diagnosed occipital artery pseudoaneurysm...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.01.095
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Tuberculous meningitis (TBM) is an endemic infectious disease in developing countries, and it can become a serious illness in children. Treatment of TBM is more difficult and prone to failure than treatment of pulmonary tuberculosis. TBM causes hydrocephalus, cerebral edema, increased intracranial pressure, ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.007
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Cement leakage is the most common complication of vertebroplasty and kyphoplasty. So far, the reported risk factors remain conflicting because of limited data and lack of uniform measurement and evaluation. Here, we performed a systematic review and meta-analysis of potential risk factors for cement leakage ...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2017.01.124
更新日期:2017-05-01 00:00:00
abstract::A previously healthy 44-year-old woman presented with a first-time seizure. Magnetic resonance imaging (MRI) revealed a right frontal intraaxial mass extending from the orbitofrontal gyri and gyrus rectus to the head of the caudate (Video 1). The mass demonstrated heterogeneous signal intensity on precontrast T1-weigh...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2019.12.160
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The balloon occlusion test (BOT) is a well-accepted technique for the treatment of large or complex aneurysms. However, this procedure may not be feasible for small arteries such as the posterior inferior cerebellar artery (PICA). We report our experience with endovascular treatment of a fusiform PICA aneury...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.05.002
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Meningeal hemangiopericytoma (HPC) is a rare, aggressive central nervous system tumor that tends to invade locally and to metastasize, and has a high rate of recurrence. METHODS:This study presents a retrospective review of patients managed for intracranial HPC at Rome University Hospital. RESULTS:A total o...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2013.11.009
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this s...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.114
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Bow hunter's syndrome (BHS) or rotational vertebral artery occlusion is a rare syndrome of vertebrobasilar insufficiency due to compression or occlusion of the contralateral vertebral artery with cervical axial rotation. Compression at the C2-C3 level, the junction between the axial and subaxial spine, has n...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.07.129
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Microvascular anastomosis is an essential procedure in neurosurgery, but the opportunity to perform the surgery has gradually decreased for neurosurgeons. Therefore, training is necessary for obtaining and maintaining the skills required for the procedure. We describe the detailed anatomy of cervical and fem...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.071
更新日期:2018-12-01 00:00:00