Journal of Cerebrovascular Sciences最新文献_第2页

Microsurgery for anterior communicating artery aneurysms: One size does not fit all 前交通动脉瘤的显微外科治疗:一种方法不适合所有

Journal of Cerebrovascular Sciences Pub Date : 2022-01-01 DOI: 10.4103/jcvs.jcvs_22_22

Adesh Shrivastava, S. Nair, Rakesh Mishra

引用次数: 0

Indocyanine green fluorescence video angiography – An indispensable tool for avoiding vascular complications during microsurgical clipping of ruptured intracranial aneurysms and improving surgical outcome: A preliminary study 吲哚菁绿荧光视频血管造影——显微手术切除颅内动脉瘤破裂时避免血管并发症和改善手术效果不可缺少的工具:初步研究

Journal of Cerebrovascular Sciences Pub Date : 2022-01-01 DOI: 10.4103/jcvs.jcvs_14_22

A. Acharya, Sarvpreet Singh Grewal

{"title":"Indocyanine green fluorescence video angiography – An indispensable tool for avoiding vascular complications during microsurgical clipping of ruptured intracranial aneurysms and improving surgical outcome: A preliminary study","authors":"A. Acharya, Sarvpreet Singh Grewal","doi":"10.4103/jcvs.jcvs_14_22","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_14_22","url":null,"abstract":"Background: The surgical complications in aneurysmal microsurgical clipping are attributable primarily to vascular compromise and retraction injury. The vascular complications almost 50% of these. ICG-VA gives us intraoperative real-time high definition functional imaging of the cerebrovascular tree, thereby allowing immediate quality assessment and control of aneurysm obliteration and parent vessel optimisation. Here we report our preliminary data of an ongoing series of patient study. Objective: This study aims at evaluating the role of ICG VA in avoiding vascular complications during microsurgical clipping of ruptured intracranial aneurysms and ascertaining normative data for ICG dye administration. Materials and Methods: The study aimed at determining the utility of microscope incorporated (Leica M530 OHX microscope) ICG VA in ruptured aneurysm surgery. We used ICG-VA in 17 patients of ruptured aneurysm with WFNS grade 1 and 2 as an adjunct to surgery. We studied multiple patient characteristics, intraoperative ICG peak flow and washout time of dye, and changes made in the operative decisions, and outcome of the surgeries. Results: ICG-VA helped in intraoperative decision making for 5 out of 17 patients. In one patient, inadequate clipping with residual neck was confirmed with ICG-VA and the clip was adjusted. In three patient's perforator/additional vessel compromise was found hence needed clip readjustment, whereas in two patients ICG-VA demonstrated residual filling of large neck sac and 2nd clip was applied in tandem. Conclusion: ICG VA is a conclusively simple adjunctive tool for the early detection and prevention of vascular compromise of multiple vessels and perforators during ruptured aneurysm surgery.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116480016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Syndromic association of spinal arteriovenous malformations: CLOVES syndrome 脊髓动静脉畸形的综合征相关性:CLOVES综合征

Journal of Cerebrovascular Sciences Pub Date : 2022-01-01 DOI: 10.4103/jcvs.jcvs_21_22

M. Mahajan, Daljit Singh, H. Sahni, Sumit Bhandari, D. Vishwakarma

引用次数: 0

Optico-chiasmatic hypothalamic cavernomas - A report of three cases and review of literature 视交叉下丘脑海绵状瘤:附3例报告及文献复习

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_8_22

Roopesh Kumar, A. Karthikayan, Adhithyan Rajendran

{"title":"Optico-chiasmatic hypothalamic cavernomas - A report of three cases and review of literature","authors":"Roopesh Kumar, A. Karthikayan, Adhithyan Rajendran","doi":"10.4103/jcvs.jcvs_8_22","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_8_22","url":null,"abstract":"Optochiasmatic hypothalamic cavernous malformations (CMs) are exceedingly rare lesions and can manifest with visual deficits of varying magnitudes. They also can result in sudden-onset visual loss due to apoplexy. Magnetic resonance imaging can delineate the lesions and differentiate it from other common lesions like glioma or craniopharyngioma. Preoperative visual assessment including perimetry and optical coherence tomogram has to be performed whenever possible to assess the degree of deficits and also for prognostication. Microsurgical excision improves the visual deficits in majority of instances as documented by earlier reports and has to be undertaken as an emergency in apoplexy. Various corridors can be used to reach the lesion including anterolateral, midline transbasal anterior interhemispheric approach, and transnasal endoscopic approaches. The aim should be to achieve a gross total excision with minimal manipulation of surrounding white matter tracts to improve the visual outcome. There is a limited role for stereotactic radiosurgery. In the present study, we report three cases of CMs involving optic chiasm and hypothalamus including a case of apoplexy managed by gross total microsurgical resection with good outcome and also review the relevant literature on the natural history and management strategies","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130934944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Microsurgery of complex intracranial aneurysms 复杂颅内动脉瘤的显微外科治疗

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_6_22

B. Misra, Harshad R Purandare

引用次数: 0

Outcome of microsurgical clipping of anterior communicating aneurysms: A single-centre experience 显微外科夹闭前交通动脉瘤的疗效:单中心经验

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_10_22

M. N. Kumar, R. Prasad, Senthil Kumar, A. Pravallika

引用次数: 0

Do intra operative brain conditions during clipping for ruptured intra cranial aneurysms affect the outcome? Being devil's advocate 颅内动脉瘤破裂夹闭术中脑内状况是否影响预后?唱反调

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_11_22

Navneet Singla, K. Reddy, A. Aggarwal, R. Chhabra, H. Bhagat

{"title":"Do intra operative brain conditions during clipping for ruptured intra cranial aneurysms affect the outcome? Being devil's advocate","authors":"Navneet Singla, K. Reddy, A. Aggarwal, R. Chhabra, H. Bhagat","doi":"10.4103/jcvs.jcvs_11_22","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_11_22","url":null,"abstract":"Introduction: For a disease like aneurysmal subarachnoid haemorrhage (aSAH) which continues to have high morbidity and mortality, prognostication is imperative. This gives realistic goals to both the health-care worker and the patient. Unfavourable brain conditions during surgery like dural bulge, brain swelling, petechial haemorrhages, need for ventricular tap are conventionally thought to be harbingers of poor outcomes. But is it really so? Methods: Fifty-four consecutively operated patients of aSAH were studied. Clinical grade at admission (H and H, World Federation of Neurosurgical Societies (WFNS)), Dural bulge, brain swelling, petechial haemorrhages, need for ventricular tap, and brain pulsatility were studied for outcome parameters like Glasgow outcome scale (GOS) at 1 and 3 months and development of focal deficits. Results: H and H and WFNS grades had a significant correlation with GOS. We found that the need for augmentation duraplasty had a significant association with the outcome and appearance of focal deficits. However, unfavourable brain conditions like--dural bulge, brain swelling, petechial haemorrhages, need for ventricular tap, absence of brain pulsatility during surgery did not have a significant impact on the outcome. Conclusions: Clinical grading by far remains the best predictor of outcome. Intra-operative brain conditions did not have a bearing on the outcome. The mechanism by which poor grade patients exhibit poor outcomes remains elusive. At least in the present study, it was not by way of manifesting as unfavourable brain conditions. A word of caution--further large studies are required before definite conclusions can be drawn.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114890371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Statistical corner: Building own functions in R 统计角:在R中构建自己的函数

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_22_21

Mikko J. Pyysalo

引用次数: 0

Thrombolysis beyond the time window in takayasu's arteritis: A challenging experience 在takayasu动脉炎的时间窗之外的溶栓:一个具有挑战性的经验

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_20_21

Madhavi Karri, Balakrishnan Ramasamy, E. Swamiappan, S. Perumal, K. Kannan

{"title":"Thrombolysis beyond the time window in takayasu's arteritis: A challenging experience","authors":"Madhavi Karri, Balakrishnan Ramasamy, E. Swamiappan, S. Perumal, K. Kannan","doi":"10.4103/jcvs.jcvs_20_21","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_20_21","url":null,"abstract":"Takayasu's arteritis (TA) is chronic inflammatory vasculopathy preferentially affecting the aorta and its major branches. It is one of the potential causes of stroke in young adults. Here, we report a young female who presented to us with an acute-onset right hemiparesis with motor aphasia after 10 h of symptoms onset. Her National Institute of Health Stroke Scale (NIHSS) score at admission was 12. The stroke imaging showed acute infarct in the left middle cerebral artery territory with arterial spin labelling perfusion sequence showing diffusion perfusion mismatch with good penumbra. She underwent intravenous thrombolysis with tenecteplase, based on imaging findings and despite being out of window period. She had an excellent clinical recovery and was discharged with oral anticoagulant and azathioprine. After 3 months of stroke and recovery, follow-up was unremarkable with minimal residual deficits with an NIHSS score of 4 and Modified Rankin Scale of 1. Hence, appropriate early interventions in acute stroke in TA individuals are highly beneficial and timely considered for a good outcome and better quality of life.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124378964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-Operative ischaemic stroke as a sequelae of unnoticed small internal carotid artery intimal flap 术后缺血性卒中作为未被注意的颈内动脉小内膜瓣的后遗症

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_5_22

Amit Sharma, A. Jagetia, A. Srivastava, Daljit Singh

引用次数: 0