Abstract:
BACKGROUND:We describe the histopathology of an unruptured giant calcified left middle cerebral artery (MCA) fusiform aneurysm initially treated with endovascular flow diversion. The flow diversion construct underwent postoperative in-stent thrombosis, necessitating surgical resection of the aneurysm to eliminate mass effect. METHODS:A 75-year-old woman with a known left MCA aneurysm presented to the emergency department with moderate right hemibody weakness. Owing to the clinical and radiographic progression of the aneurysm, the patient was offered treatment. She was initially offered open surgical management of the lesion but declined it, indicating that she would consider only endovascular treatment. The patient underwent endovascular reconstruction of the aneurysmal segment with an overlapping pipeline construct. Postoperatively, the patient experienced in-stent thrombosis of the pipeline construct. The thrombosed aneurysm exerted a progressive local mass effect, necessitating en bloc surgical resection of the aneurysm and stent construct. The aneurysm was submitted for pathological analysis, which demonstrated chronologically older thrombus outside the flow diversion construct. RESULTS:Postsurgical imaging demonstrated a left MCA territory stroke. The patient gradually gained strength in her right hemibody. The histopathological analysis indicated that the degrees of platelet activation and clot formation in this case were dependent on the aggregate surface area of the thrombus and surface area of the pipeline device used in the reconstruction. CONCLUSIONS:This technical report with histopathological analysis provides useful insight into the mechanism of aneurysmal thrombosis after flow diversion. It also raises new questions regarding the roles of thrombus formation, platelet aggregation, and stent construct surface area in the maintenance of vessel patency.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Sack J,Cheung V,Amaro D,Wali AR,Santiago-Dieppa DR,Pannell JS,Khalessi AAdoi
10.1016/j.wneu.2017.04.070subject
Has Abstractpub_date
2017-07-01 00:00:00pages
348-354eissn
1878-8750issn
1878-8769pii
S1878-8750(17)30565-Xjournal_volume
103pub_type
杂志文章abstract:BACKGROUND:Despite advances in skull base surgery, achieving effective surgical management of jugular foramen schwannomas (JFSs) that avoids postoperative cranial nerve (CN) deficits remains a challenge. Subtotal resection followed by radiosurgery (rather than radical resection) is increasingly being viewed as a better...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.10.042
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Spontaneous regression in intracranial germ cell tumors (GCTs) is an extremely rare phenomenon with only 9 cases reported. The mechanism and natural history of this phenomenon are still equivocal. METHODS:A 12-year-old boy presented with a lesion in the suprasellar region with involvement of basal ganglia a...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.06.220
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:The amount of blood detected on brain computed tomography scan is frequently used in prediction models for delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). These models, which include coarse grading scales to assess the amount of blood, have only moderate predictive...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.170
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:For the diagnosis and surgical treatment of diseases around the cavernous sinus (CS), radiologists should achieve complete mastery of the sectional anatomy of the CS, and neurosurgeons need to understand the stereoscopic orientation of the CS and circumjacent structures. However, despite the complicated stru...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.03.049
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Optimal vision and ergonomics are important factors contributing to achievement of good results during neurosurgical interventions. The operating microscope and the endoscope have partially filled the gap between the need for good surgical vision and maintenance of a comfortable posture during surgery. Recen...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.083
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Attainment of basic microsurgical skills in neurosurgery presents a departmental challenge worldwide. Models for teaching are either not readily available or expensive and are incompatible with a resident's busy schedule, requiring lengthy and proper setup. We present a model and a set of measurable tasks, b...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.060
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:Chiari 1 malformation is a structural abnormality of the hindbrain and posterior fossa characterized by herniation of the cerebellar tonsils through the foramen magnum. Although asymptomatic in some cases, hindbrain herniation can be associated with disruption of cerebrospinal fluid flow dynamics at the cran...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.03.218
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Spinal arteriovenous malformations (AVM) are an abnormal interconnection of vasculature in the spine than can lead to significant neurologic deficit if left untreated. OBJECTIVE:The objective of this study was to characterize how patients with spinal AVM initially presented, what treatment options were used...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.010
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Giant intracranial aneurysms (GIAs) can be approached via microsurgical and endovascular techniques. Use of flow diversion devices has yielded favorable outcomes, and indications for cerebral revascularization have dramatically decreased. OBJECTIVE:To evaluate the safety and validity of using internal maxil...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.014
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To evaluate safety and effectiveness of the application of piezosurgery in en bloc laminectomy for the treatment of multilevel thoracic ossification of ligamentum flavum (MTOLF). METHODS:Forty-one cases who had MTOLF and underwent en bloc laminectomy from January 2012 to January 2017 were reviewed and divide...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.200
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The Timed Up and Go (TUG) test, as a measure of objective functional impairment in lumbar degenerative disk disease (DDD), complements patient-reported outcome measures (PROMs) of subjective functional impairment. METHODS:Prospective 2-center study on consecutive patients scheduled for surgical treatment fo...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2016.11.039
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:Resection of epidural thoracic spine tumors is uniquely challenging owing to the dangers posed by the surrounding anatomy and the unforgiving nature of the thoracic spinal cord. We assessed the preoperative and postoperative risk factors for 30-day morbidity and mortality in patients undergoing resection of t...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.195
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:High-mobility group box 1 (HMGB1) was shown to be a major extracellular mediator involved in relayed neuro-inflammation in animals after subarachnoid hemorrhage (SAH). It is of interest to examine the effect of rhinacanthin-C (RCT-C, C25H30O5) on pro-inflammatory cytokines/HMGB1 in an SAH-related early brain ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.08.071
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Rete mirabile is a very rare vascular malformation and superior cerebellar artery (SCA) rete mirabile is not reported previously. We report a new case of rete mirabile of SCA initially detected by magnetic resonance imaging and transfemoral cerebral angiography. CASE DESCRIPTION:This report illustrates the ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.244
更新日期:2019-10-01 00:00:00
abstract::From their origins as cardiovascular research tools, endovascular techniques have evolved to provide a minimally invasive means of diagnosis and therapy for individuals suffering from occlusive artery disease. The techniques were pioneered by William Harvey, whose work set the stage for all subsequent endovascular exp...
journal_title:World neurosurgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.wneu.2020.01.072
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Nontraumatic carotid artery injury with active extravasation, or carotid blowout syndrome (CBS), is relatively rare and highly difficult to treat because it is difficult to approach the lesions owing to anatomic factors. It also involves quick progression and a risk of cerebral embolization caused by thrombi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.076
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:This study sought to determine whether implantation of a newly designed nonfusion intracorporeal enhancement (NICE) system is an effective and safe way to treat osteoporotic vertebral compression fracture (OVCF). METHODS:Thirteen patients with OVCF (10 women, 3 men; mean age 69 years, T11-L4) were included. ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.039
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:The impact of obesity on spine surgery has been studied extensively, but only a few investigations have been focused on minimally invasive spinal fusion techniques and complication rates in normal-weight, preobese, or obese patients. Obesity was found to be a risk factor for intraoperative complications. Publ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.075
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Symptomatic cerebral vasospasm has been reported in a low percentage of patients with moderate or severe traumatic brain injury (TBI) as defined by Glasgow Coma Scale (GCS) score. We present a case of mild TBI (GCS score 14) complicated by early and severe symptomatic cerebral vasospasm. CASE DESCRIPTION:A ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.03.039
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To analyze the outcomes of use of a lumboperitoneal shunt (LPS) to treat all-cause communicating hydrocephalus (ACCH). METHODS:We analyzed the outcomes of adult patients with ACCH treated with an LPS between June 2015 and June 2018, using Keifer's hydrocephalus score (KHS), postoperative symptom improvement ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.070
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Infection and skin fistula are well-known complications after cranioplasty leading to reconstruction exposure and usually requiring new surgical procedure with poor condition for cutaneous closure. We describe 2 cases using muscle forehead flap (MFF) to treat skin fistula and cranioplasty exposure. CASE DES...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.10.184
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Chronic subdural hematoma (CSDH) is a common intracranial hematoma. The number of patients who undergo anticoagulant therapy including a direct oral anticoagulant (DOAC) is expected to increase. Recently, idarucizumab, the antidote for dabigatran, which is a DOAC, has been developed. We successfully treated ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.10.043
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Recurrent chronic subdural hematoma (CSDH) is not rare. Some studies have demonstrated the role of dexamethasone in the medical management of chronic subdural hematoma. However, no systematic study in the treatment of recurrent CSDH has been published. The aim of our study is to evaluate the efficacy and safe...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.135
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Although extreme lateral interbody fusion (XLIF) largely provides successful indirect decompression, some patients have recurrent same-level pain and functional disability. Identifying risk factors for this failure would facilitate better patient selection and improve outcomes. The aim of this study is to ide...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2017.07.045
更新日期:2017-10-01 00:00:00
abstract::Surgical treatment of large paraclinoid aneurysms remains technically challenging due to the adjacent bony anatomy and neurovascular structures. Endovascular retrograde suction decompression using a double-lumen balloon catheter facilitates clip ligation of the aneurysm. Video 1 demonstrates a large paraclinoid aneury...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.03.109
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To test whether robot-assisted surgery can improve prognosis of small-volume thalamic hemorrhage and to provide a surgical basis for treatment of small-volume thalamic hemorrhage. METHODS:This retrospective study included patients with thalamic hemorrhage and hematoma volume of 5-15 mL treated from December ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.224
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Subcallosal artery (ScA) infarction is a well-recognized but uncommon complication of surgical treatment of anterior communicating artery aneurysms. CASE DESCRIPTION:An elderly man presented with massive subarachnoid hemorrhage due to left posterior communicating artery aneurysm with thick clots in the ante...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.052
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:Surgical robotics present new and unique opportunities for the training and practice of neurosurgery, beyond the promise of the minimally invasive paradigm. METHODS:Robotic systems have been developed that simulate the sight, sound, and touch of surgery allowing surgical training to evolve past an apprentice...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.04.005
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:Primary orbitofrontal cholesterol granuloma (OFCG) is rare. We present 4 cases of OFCG and a systematic literature review to examine patient characteristics, presentation, treatment, and outcome. METHODOLOGY:Our institutional records were reviewed for OFCG cases. A systematic literature review was perform...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.11.095
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Pituitary ependymoma is exceptionally rare. Its etiology, clinical presentation, radiologic feature, and treatment strategy are still a matter of debate. Only 7 human cases with limited data were reported in the English literature, and now we described another case of pituitary ependymoma. We also systematic...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2017.10.134
更新日期:2018-02-01 00:00:00