Neurologia medico-chirurgica最新文献_第7页

A Combination Technique of N-butyl-2-cyanoacrylate and Minimal Coils with Flow Control for Parent Artery Occlusion of a Giant Internal Carotid Artery Aneurysm: A Technical Note. N-丁基-2-氰基丙烯酸酯与带流量控制的微型线圈的组合技术用于巨大颈内动脉瘤的母动脉闭塞：技术说明。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-09-15 Epub Date: 2024-07-27 DOI: 10.2176/jns-nmc.2024-0046

Taketo Hanyu, Takashi Izumi, Takafumi Tanei, Masahiro Nishihori, Shunsaku Gotoh, Yoshio Araki, Kinya Yokoyama, Ryuta Saito

{"title":"A Combination Technique of N-butyl-2-cyanoacrylate and Minimal Coils with Flow Control for Parent Artery Occlusion of a Giant Internal Carotid Artery Aneurysm: A Technical Note.","authors":"Taketo Hanyu, Takashi Izumi, Takafumi Tanei, Masahiro Nishihori, Shunsaku Gotoh, Yoshio Araki, Kinya Yokoyama, Ryuta Saito","doi":"10.2176/jns-nmc.2024-0046","DOIUrl":"10.2176/jns-nmc.2024-0046","url":null,"abstract":"Parent artery occlusion for large or giant internal carotid artery aneurysms remains a necessary procedure in the era of flow diverters. Endovascular parent artery occlusion is currently performed using detachable balloons or coils, which are difficult to obtain or costly. At our institution, we have devised a technique for combining n-butyl-2-cyanoacrylate and coils with flow control to solve this problem. Patients who underwent parent artery occlusion for large or giant internal carotid artery aneurysms with a follow-up period of more than 12 months were included. Imaging outcomes were evaluated for complete or incomplete aneurysmal occlusion and with or without aneurysmal shrinkage. The clinical outcome was based on changes in the modified Rankin Scale. Ten patients (ten aneurysms) were included. Their average age and average follow-up period were 68.4 years and 36 months, respectively. Complete occlusion and favorable clinical outcome were observed in all cases. The parent artery occlusion using a combination of coils and n-butyl-2-cyanoacrylate with flow control technique is effective for both imaging and clinical outcomes.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"347-351"},"PeriodicalIF":2.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment Outcomes of PED for Unruptured Aneurysms of Internal Carotid Artery: Comparison of PED-Flex and PED-Shield. PED治疗颈内动脉未破裂动脉瘤的疗效：PED-Flex 和 PED-Shield 的比较。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-08-15 Epub Date: 2024-06-19 DOI: 10.2176/jns-nmc.2024-0034

Saki Kawamoto, Tomohiko Ozaki, Katsunori Asai, Tomoki Kidani, Nobuyuki Izutsu, Shin Nakajima, Yonehiro Kanemura, Naoki Nishizawa, Koji Kobayashi, Yosuke Fujimi, Toshiyuki Fujinaka

{"title":"Treatment Outcomes of PED for Unruptured Aneurysms of Internal Carotid Artery: Comparison of PED-Flex and PED-Shield.","authors":"Saki Kawamoto, Tomohiko Ozaki, Katsunori Asai, Tomoki Kidani, Nobuyuki Izutsu, Shin Nakajima, Yonehiro Kanemura, Naoki Nishizawa, Koji Kobayashi, Yosuke Fujimi, Toshiyuki Fujinaka","doi":"10.2176/jns-nmc.2024-0034","DOIUrl":"10.2176/jns-nmc.2024-0034","url":null,"abstract":"There is a lack of data regarding the safety and effectiveness of implanting the Pipeline Embolization Device with Shield technology (PED-Shield) compared with the previous generation of Pipeline (PED-Flex). This retrospective single-center study aimed to compare treatment outcomes between the PED-Shield and PED-Flex for treating unruptured internal carotid artery aneurysms. The PED-Flex was used in 62 procedures (67 aneurysms, 59 patients) and the PED-Shield in 53 procedures (59 aneurysms, 58 patients). The mean aneurysm diameter was significantly lower in the PED-Shield group than in the PED-Flex group (11.9 ± 7.0 mm vs. 15.2 ± 6.9 mm, p < 0.001). At the 12-month follow-up, the complete angiographic occlusion rate was 72.1% and 72.3% in the PED-Flex and PED-Shield groups, respectively (p = 0.9808). Limited to aneurysms larger than 10 mm, 70.6% and 68.0%, respectively (p = 0.8175). The incidence of more than three high signal intensity areas on diffusion-weighted imaging after treatment was significantly lower in the PED-Shield group than in the PED-Flex group (27.7% vs. 67.7%; p < 0.001). Limited to aneurysms larger than 10 mm, 41.1% and 69.6%, respectively (p < 0.0117). Symptomatic ischemic complications occurred within 30 days of four PED-Flex procedures (6.5%) and one PED-Shield procedure (2.0%) (p = 0.2315). Limited to aneurysms larger than 10 mm, 1.8% and 3.2%, respectively (p = 0.6677). The incidence of mRS score worsening at 6 months was 3.2% and 1.9% in the PED-Flex and PED-Shield groups, respectively (p = 0.6534). The PED-Shield can achieve outcomes equivalent to or better than the PED-Flex. Further large-scale studies are warranted to confirm our findings.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"316-322"},"PeriodicalIF":2.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Historical Development of Diagnostic Criteria for NF2-related Schwannomatosis. NF2 相关许旺瘤病诊断标准的历史发展。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-08-15 Epub Date: 2024-06-19 DOI: 10.2176/jns-nmc.2024-0067

Ryota Tamura, Masahiro Yo, Masahiro Toda

{"title":"Historical Development of Diagnostic Criteria for NF2-related Schwannomatosis.","authors":"Ryota Tamura, Masahiro Yo, Masahiro Toda","doi":"10.2176/jns-nmc.2024-0067","DOIUrl":"10.2176/jns-nmc.2024-0067","url":null,"abstract":"NF2-related schwannomatosis (NF2; previously termed neurofibromatosis type 2) is a tumor-prone disorder characterized by development of multiple schwannomas and meningiomas. The diagnostic criteria of NF2 have been regularly revised. Clinical criteria for NF2 were first formulated at the National Institutes of Health Consensus Conference in 1987 and revised in 1990. Revised criteria were also proposed by the Manchester group in 1992 and by the National Neurofibromatosis Foundation (NNFF) in 1997. The 2011 Baser criteria improved the sensitivity of diagnostic criteria, particularly for patients without bilateral vestibular schwannomas. Revisions to the Manchester criteria were published in 2019, with replacement of \"glioma\" by \"ependymoma,\" removal of \"neurofibroma,\" addition of an age limit of 70 years for development of vestibular schwannomas, and introduction of molecular criteria, which led to the most widely used criteria. In 2022, the criteria were reviewed and updated by the international committee of NF experts. In addition to changes in diagnostic criteria, the committee recommended the use of \"schwannomatosis\" as an umbrella term for conditions that predispose to schwannomas. Each type of schwannomatosis was classified by the gene containing the disease-causing pathogenic variant. Molecular data from NF2 patients led to further clarification of the diagnostic criteria for NF2 mosaic phenotypes. Given all these changes, the diagnostic criteria of NF2 may be confusing. Herein, to help healthcare professionals who diagnose NF2 conditions in the clinical setting, we review the historical development of diagnostic criteria.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"299-308"},"PeriodicalIF":2.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Concepts and Long-term Outcomes of Thalamic Deep Brain Stimulation in Patients with Severe Tourette Syndrome: A Single-center Experience. 严重抽动秽语综合征患者丘脑深部脑刺激的手术概念和长期疗效：单中心经验。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-08-15 Epub Date: 2024-06-19 DOI: 10.2176/jns-nmc.2023-0254

Takashi Morishita, Yuki Sakai, Hitoshi Iida, Hideaki Tanaka, Galih I Permana, Hiromasa Kobayashi, Saori C Tanaka, Hiroshi Abe

{"title":"Surgical Concepts and Long-term Outcomes of Thalamic Deep Brain Stimulation in Patients with Severe Tourette Syndrome: A Single-center Experience.","authors":"Takashi Morishita, Yuki Sakai, Hitoshi Iida, Hideaki Tanaka, Galih I Permana, Hiromasa Kobayashi, Saori C Tanaka, Hiroshi Abe","doi":"10.2176/jns-nmc.2023-0254","DOIUrl":"10.2176/jns-nmc.2023-0254","url":null,"abstract":"Tourette syndrome (TS) is a developmental neuropsychiatric disorder that is characterized by tic movements. Deep brain stimulation (DBS) may be a treatment option for severe cases refractory to medical and behavioral therapies. In this study, we reviewed the surgical techniques used for DBS in patients with severe TS and its clinical outcomes and sought to determine the optimal surgical procedure and current issues based on our experience and the literature. A total of 14 patients, consisting of 13 men and 1 woman, who underwent centromedian thalamic DBS and were followed up for a mean duration of 2.3 ± 1.0 years, participated in this study. The mean Yale Global Tic Severity Scale severity score significantly improved from 41.4 ± 7.0 at baseline to 19.8 ± 11.4 at 6 months (P = 0.01) and 12.7 ± 6.2 at the last follow-up (P < 0.01). Moreover, the mean Yale Global Tic Severity Scale impairment score significantly improved from 47.1 ± 4.7 at baseline to 23.1 ± 11.1 at 6 months (P < 0.01) and 7.6 ± 2.9 at the last follow-up (P < 0.01). However, there were problems with continuous postoperative monitoring (three cases were lost to follow-up) and surgery-related adverse events, including one case each of lead misplacement and a delayed intracerebral hemorrhage due to severe self-injurious tics. This study aimed to highlight not only the clinical efficacy of DBS for TS but also its challenges. Clinicians should understand the three-dimensional brain anatomy so that they can perform precise surgical procedures, avoid adverse events, and achieve favorable outcomes of DBS for TS.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"289-298"},"PeriodicalIF":2.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends and Progress in Neuroendovascular Treatment in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) 4. Main Report. 日本神经内血管治疗的趋势和进展：日本神经内血管治疗登记处（JR-NET）4.主要报告。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-08-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2024-0011

Nobuyuki Sakai, Satoru Fujiwara, Kazutaka Uchida, Koji Iihara, Hirotoshi Imamura, Akira Ishii, Yuji Matsumaru, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Yasushi Matsumoto, Hidenori Oishi, Naoto Kimura, Masayuki Ezura, Tatsufumi Nomura, Shinzo Ota, Akio Hyodo, Fuminori Shimizu

{"title":"Trends and Progress in Neuroendovascular Treatment in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) 4. Main Report.","authors":"Nobuyuki Sakai, Satoru Fujiwara, Kazutaka Uchida, Koji Iihara, Hirotoshi Imamura, Akira Ishii, Yuji Matsumaru, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Yasushi Matsumoto, Hidenori Oishi, Naoto Kimura, Masayuki Ezura, Tatsufumi Nomura, Shinzo Ota, Akio Hyodo, Fuminori Shimizu","doi":"10.2176/jns-nmc.2024-0011","DOIUrl":"10.2176/jns-nmc.2024-0011","url":null,"abstract":"We reported the main results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 4, a nationwide surveillance of therapy (NET) in Japan from January 2015 to December 2019. JR-NET 4 registered consecutive patients who underwent NETs by Japan Society of Neuroendovascular Therapy (JSNET) -certified specialists. The primary endpoint was functional independence (mRS score of 0-2) at 30 days post-NET, with secondary endpoints focusing on technical success and major adverse events within 30 days.A total of 63,230 patients and 60,354 NET procedures from 166 participating centers were analyzed. During the study period, NET cases have consistently increased, with an increase in the proportion of elderly patients. A significant trend shift was observed in the distribution of NET procedures, with endovascular treatment for acute ischemic stroke that showed a dramatic increase in 5 years. This trend aligns with key randomized clinical trials from 2015 that presented the efficacy of this treatment. Clinical outcomes at 30 days posttreatment revealed that endovascular treatment for acute ischemic stroke and other NETs maintained safety and effectiveness despite varying prevalence of functional independence between target diseases. The study also observed a steady increase in emergency treatment cases, reflecting the increase in acute ischemic stroke, a time-sensitive medical condition.This comprehensive surveillance highlights the trend of NET practices in Japan, driven by clinical evidence and advancements in treatment devices. Although these findings were specific to Japan, they offer valuable insights into the broader trends in NETs and acute stroke care.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"309-315"},"PeriodicalIF":2.4,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Internal Neurolysis for Trigeminal Neuralgia: A Preliminary Single-institution Experience in Japan. 治疗三叉神经痛的内神经溶解术：日本单一机构的初步经验。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2023-0285

Kenichi Amagasaki, Kyoko Tatebayashi, Kazuaki Naemura

{"title":"Internal Neurolysis for Trigeminal Neuralgia: A Preliminary Single-institution Experience in Japan.","authors":"Kenichi Amagasaki, Kyoko Tatebayashi, Kazuaki Naemura","doi":"10.2176/jns-nmc.2023-0285","DOIUrl":"10.2176/jns-nmc.2023-0285","url":null,"abstract":"Internal neurolysis (IN) is a surgical procedure in which the trigeminal fibers are separated between the pons and porus trigeminus to relieve trigeminal neuralgia (TN). Recent investigations revealed that the number of nerve bundles made by IN varies, and immediate postoperative hypesthesia exceeded 90% and pain control rate at 1 year was 77%-93.5%. We present the preliminary experience of 18 patients who underwent IN for TN between June 2020 and June 2022. The Barrow Neurological Institute pain scale (BNI-PS) was recorded preoperatively and in June 2023, and the Barrow Neurological Institute hypesthesia scale (BNI-HS) was recorded preoperatively, immediate postoperatively and in June 2023. Intraoperatively, the number of bundles made by IN was reviewed. Preoperative BNI-PS ranged between VI and V. Two patients experienced BNI-HS II due to percutaneous procedure prior to IN. Intraoperatively, 3 bundles were made by IN in 7 patients, 4 bundles in 5, and 5 bundles in 6. Immediate postoperative BNI-HS I was recorded in 6 patients and II in 12 (66.7%). The last follow-up revealed that BNI-PS I and II were recorded in 13 patients (72.2%) and BNI-HS I and II in 6 patients, respectively. Our results demonstrated that the rates of immediate postoperative hypesthesia (66.7%) and pain control (72.2%) at 1 year or later were below those of previous reports. Therefore, we are currently combing to make at least 6 bundles. Detailed surgical technique and cardiac reflex alerts during the procedure are described.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"261-265"},"PeriodicalIF":2.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effective Smartphone Application Use for Postoperative Management of Moyamoya Disease. 有效使用智能手机应用程序对 Moyamoya 病进行术后管理。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2024-0025

Haruto Uchino, Toshiya Osanai, Masaki Ito, Kota Kurisu, Taku Sugiyama, Miki Fujimura

{"title":"Effective Smartphone Application Use for Postoperative Management of Moyamoya Disease.","authors":"Haruto Uchino, Toshiya Osanai, Masaki Ito, Kota Kurisu, Taku Sugiyama, Miki Fujimura","doi":"10.2176/jns-nmc.2024-0025","DOIUrl":"10.2176/jns-nmc.2024-0025","url":null,"abstract":"Continuous and careful management is necessary after revascularization surgery for moyamoya disease (MMD). The postoperative information has been shared in person or by telephone and emails among doctors; however, this is not always efficient. We aimed to describe the feasibility of remote diagnosis and text chats using a smartphone application on postoperative MMD management. Twenty consecutive patients who underwent combined direct and indirect revascularization for MMD were prospectively investigated in this study. In ten patients, the operator viewed postoperative images uploaded on a smartphone screen using the Join application (Allm Inc., Tokyo, Japan). The doctors shared the radiological findings and treatment plans using the group text chat function and performed postoperative management. We evaluated the intermodality agreements of radiological findings between the smartphone screen and conventional viewer. Postoperative courses were compared between the two patient groups that used or did not use the application. All postoperative images were uploaded to the cloud server and the operator viewed them remotely on the smartphone screen without restriction of location. Detected abnormal findings were cerebral hyperperfusion (CHP), CHP-related watershed shift phenomenon, fluid-attenuated inversion recovery cortical hyperintensity, high signal intensity on diffusion-weighted imaging, CHP-related crossed cerebellar diaschisis, and hypoperfusion. Radiological agreement between the modalities was good in all cases, and additional findings were not obtained on the conventional viewer. The postoperative courses of the Join group were as good as those of the control group. Remote radiological diagnosis and text chat using a smartphone application were feasible and useful for efficient and safe postoperative MMD management.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"272-277"},"PeriodicalIF":2.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Usefulness of the 3.1-mm-diameter 4K Rigid Endoscope for Intracerebral Hematoma Evacuation. 直径 3.1 毫米的 4K 硬质内窥镜在脑内血肿清除术中的实用性

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2023-0147

Hiroto Okubata, Masaaki Taniguchi, Naoki Irizato, Hidekazu Nakata, Tomofumi Takenaka, Shogo Fukuya, Katsunori Asai, Akihiro Tateishi, Kazumi Yamamoto, Akatsuki Wakayama

引用次数: 0

Epilepsy in Patients with Gliomas. 胶质瘤患者的癫痫。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2023-0299

Takuro Ehara, Fumiharu Ohka, Kazuya Motomura, Ryuta Saito

引用次数: 0

Clinical Characteristics and Outcomes of Aneurysmal Subarachnoid Hemorrhage Patients Who Live Alone. 独居动脉瘤性蛛网膜下腔出血患者的临床特征和预后。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-07-15 Epub Date: 2024-06-05 DOI: 10.2176/jns-nmc.2024-0024

Joji Inamasu, Masashi Fujisawa, Mizuto Sato, Takahiro Miyata

{"title":"Clinical Characteristics and Outcomes of Aneurysmal Subarachnoid Hemorrhage Patients Who Live Alone.","authors":"Joji Inamasu, Masashi Fujisawa, Mizuto Sato, Takahiro Miyata","doi":"10.2176/jns-nmc.2024-0024","DOIUrl":"10.2176/jns-nmc.2024-0024","url":null,"abstract":"It has been shown that living alone is one of the risk factors for unfavorable outcomes in ischemic stroke patients, mostly due to delay in receiving appropriate treatment. A single-center retrospective observational study was conducted to evaluate whether living alone was associated with unfavorable outcomes in aneurysmal subarachnoid hemorrhage (SAH) patients. Among 451 SAH patients admitted to our institution between January 2013 and December 2022, 43 patients who lived alone had sustained SAH at home (group A) and 329 patients who lived with family had sustained SAH at home (group F). The mortality rate (46.5% vs. 29.8%, p = 0.04) and a tendency for having unfavorable outcomes were higher in group A than in group F. The incidence of concomitant hydrocephalus was significantly higher in the former (37.2% vs. 21.3%, p = 0.03). Group A was further classified to the Able to Call (n = 15, group AC) and Unable to Call (n = 28, group UC) subgroups based on their ability to call for help by themselves. Group AC tended to have favorable outcomes (27% vs. 4%, p = 0.04). Treatment to obliterate a ruptured aneurysm had particularly been challenging in group UC, in which the accurate time of onset often remained unidentifiable: Their overall mortality was as high as 57% and their capability to undergo surgical/interventional treatment was only 67%. Perioperative complications resulting from delayed presentation had been common. Considering the present finding that most of those who lived alone could not call for help, further effort is warranted to facilitate early detection of those patients.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"266-271"},"PeriodicalIF":2.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0