Abstract:
BACKGROUND:The use of anticoagulants and older age are the main risk factors for chronic subdural hematoma (CSDH). Because the age of the population and use of anticoagulants are increasing, a growing number of CSDH cases is expected. To address this issue, we analyzed the impact of anticoagulants on postsurgical outcome in patients in the intensive care unit (ICU). METHODS:Demographic data, coagulation parameters, surgical details, radiologic appearance of hematoma, Glasgow Coma Scale (GCS) score on admission, and Glasgow Outcome Scale (GOS) score on discharge were retrieved and retrospectively analyzed in 98 patients with CSDH treated in the neurosurgical ICU using correlation coefficient tests and multivariate analysis test. RESULTS:Overall outcome was good (GOS score 4 and 5) in 55.1% of patients. Overall mortality was 9.1%. There was a correlation between GCS score on admission and GOS score. There was no correlation between hematoma thickness/radiologic appearance and impaired coagulation. Disturbance in thrombocyte function (usually resulting from aspirin intake) correlated with improved outcome, whereas warfarin-related coagulopathy correlated with poor recovery. Nevertheless, patients with thrombocytopathy presented with better initial GCS scores. Neither hematoma size nor recurrence rate affected the outcome. CONCLUSIONS:The size of CSDH was not associated with poor outcome and is not necessarily determined by the use of anticoagulants. Coagulopathy does not rule out a good outcome, but the impact of anticoagulation on treatment results in CSDH varies between the main groups of drugs (warfarin vs. antiplatelet drugs). Patients in good neurologic condition on ICU admission have better chances of recovery.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Szczygielski J,Gund SM,Schwerdtfeger K,Steudel WI,Oertel Jdoi
10.1016/j.wneu.2016.05.049subject
Has Abstractpub_date
2016-08-01 00:00:00pages
426-433eissn
1878-8750issn
1878-8769pii
S1878-8750(16)30323-0journal_volume
92pub_type
杂志文章abstract:BACKGROUND:Intracranial meningiomas are most common among patients in their fifth to seventh decade of life and rare in children and young adults. They constitute 1.5% of all neoplasms in patients age <20 years, but account for 13.5% of all neoplasms in patients age 20-34 years. They are often associated with hereditar...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.161
更新日期:2018-01-01 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:Spinal cord herniation (SCH) is rare, is mostly idiopathic, and occurs predominantly in the thoracic spine. SCH is less common in the cervical spine and has been reported after posterior cervical spine surgery associated with the development of pseudomeningoceles. Two cases of SCH have been reported after an...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.078
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Unfavorable anatomy can preclude traditional anterograde endovascular interventions. Transcirculation approaches, which consist of primary catheterization of a target artery from the contralateral side or opposite cerebral circulation, can provide alternative pathways for successful treatment of these patien...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2019.11.078
更新日期:2020-02-01 00:00:00
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 eve...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.105
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:The effect of frailty on outcomes after angiogram-negative subarachnoid hemorrhages (ANSAH) is currently unknown. We investigated frailty's effects on ANSAH outcomes, including mortality and in-hospital complications. METHODS:Patients from 2014 to 2018 with non-traumatic subarachnoid hemorrhage and cerebral...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.003
更新日期:2020-02-01 00:00:00
abstract::Traumatic brain injury (TBI) represents a major public health concern worldwide, with no significant change in its epidemiology over the last 30 years. After TBI, the primary injury induces irreversible brain damage, which is untreatable. The subsequent secondary injury plays a critical role in the clinical prognosis ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.082
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Carotid free-floating thrombus (CFFT) is defined as a blood clot attached to the arterial wall with surrounding blood flow at its distal component. Although rare, it is a clinically significant cause of embolic stroke. CFFT within a stent has not been previously reported. CASE DESCRIPTION:We report a 64-yea...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.06.100
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Abnormalities of the posterior arches of the upper and middle cervical spine that can cause myelopathy are rare, and no reports of such defects at the thoracic spinal level have been published. CASE DESCRIPTION:A 29-year-old male patient reported right arm weakness and pain for 1 year. Magnetic resonance im...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.088
更新日期:2016-09-01 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:Recurrent trigeminal neuralgia after successful microvascular decompression is not rare. CASE DESCRIPTION:A 72-year-old woman who presented with typical right trigeminal neuralgia had been successfully treated by microvascular decompression with transposition of the superior cerebellar artery. However, she ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.200
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:The sellar spine is a rare, bony growth that typically arises from the dorsum sellae. Few cases have been described in the literature thus far, and most are asymptomatic and incidentally found. We describe the case of a 19-year-old female in whom a sellar spine was noted to be associated with pituitary gland...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.046
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Approximately 2%-10% of all central nervous system tumors are primary spinal cord tumors (SCTs). Spinal cord glioblastoma is a rare tumor type accounting for 1%-3% of all SCTs and 7.5% of all spinal cord gliomas. Notably, the small-cell variant of spinal cord glioblastoma is even rarer with only 2 previously...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.07.007
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Xanthogranuloma is a chronic inflammatory mass characterized by cholesterol crystal deposition, which is rarely seen in the sellar region. The objective of this study is to identify the clinical features and cause of sellar xanthogranulomas. METHODS:We retrospectively analyzed manifestation, radiographic, a...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.021
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The caroticoclinoid bar (CCB) is implicated in both transcranial and endonasal surgery. Its morphology reflects differences in the microsurgical anatomy of the parasellar area while its manipulation during an anterior or middle clinoidectomy can result in ICA injury. Although safe surgical access to the para...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.01.017
更新日期:2019-01-21 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:Reducing complications from unruptured aneurysms (UAs) treatment is important. We clarify the criteria for achieving safe and complete treatment for UAs ≤10 mm by clipping or coil embolization. METHODS:This study included 59 newly treated UAs in the past 2 years. We prospectively decided on criteria to recom...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.005
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:The relationship between urgent decompression and neurologic recovery for traumatic spinal cord injury (TSCI) remains controversial. This meta-analysis was conducted to determine the beneficial effects of surgery within 8 hours for patients with TSCI. METHODS:A systematic search in EMBASE, MEDLINE, Cochrane ...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.wneu.2020.04.230
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Intracranial hemorrhage can be a devastating complication of endovascular thrombectomy (ET) after acute ischemic stroke increasing disability and mortality. Patients with low platelet count were excluded from major ET trials. This study explores the association between platelet count and intracranial hemorrh...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.036
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Arteriovenous malformations (AVMs) represent a complex pathologic entity in terms of their associated angioarchitecture and blood flow dynamics. METHODS:Using existing imaging data, we generated a patient's giant AVM to scale. RESULTS:A series of 3-dimensional (3D) models were generated and blood flow dyna...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.095
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The cause of postoperative heterotopic ossification (HO) after cervical disc replacement (CDR) is unclear. The aim of the present study was to investigate the incidence of HO, its clinical significance, and whether the degree of preoperative degeneration was associated with its occurrence. METHODS:Patients ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.244
更新日期:2019-05-01 00:00:00
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:This report describes 2 techniques for controlling otherwise difficult-to-control hemorrhage from choanoid bony foramina. METHODS:Medical records of 3 patients in whom vigorous and difficult-to-control bleeding from choanoid cranial foramina was successfully halted are reviewed. RESULTS:In 2 patients, vigor...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.128
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Carotid artery ligation (CAL) is used to treat large and complex intracranial aneurysms. However, little is known about long-term survival and causes of death in patients who undergo the procedure. This study was intended to evaluate if patients who have undergone CAL have long-term excess mortality and what ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.01.023
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:Malformations in the craniocervical junction (CCJ) are rare in the pediatric population but often need surgical treatment. We present a pediatric case series of patients treated with a 2-stage surgical approach with a halo vest and occipitocervical fusion and review complications and outcomes. METHODS:A retr...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.079
更新日期:2020-11-20 00:00:00
abstract:BACKGROUND:Stiff neck or nuchal rigidity is a significant clinical sign of neurologic disease. It is commonly associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumors. It may also occur as a result of tonsillar impaction following pressure in the infratentorial compartment from an expanding poste...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.230
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Pituitary carcinomas are rare and challenging clinical entities. Because of the paucity of cases, there is limited information in the literature on how best to diagnose and treat pituitary carcinomas. METHODS:We review the literature and describe a woman who presented with an adrenocorticotropic hormone (AC...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.04.018
更新日期:2013-02-01 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:Surgical treatment of ruptured blood blister-like aneurysms (BBAs) arising from the internal carotid artery (ICA) is challenging. We retrospectively reviewed the results of our surgical strategies tailored for each aneurysm site. METHODS:All ruptured ICA BBAs treated between 2003 and 2015 were reviewed. Aneu...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.018
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:In his 1938 monograph, Cushing tabulated 313 meningioma cases treated throughout his career at the Johns Hopkins and the Peter Bent Brigham Hospitals. Of these, 18 patients were treated at the Johns Hopkins Hospital. Cushing provided basic demographic, perioperative, and outcomes data in his tables, but the ...
journal_title:World neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.wneu.2011.08.021
更新日期:2013-07-01 00:00:00