Journal of Cerebrovascular Sciences最新文献_第3页

Adenosine in facilitating aneurysm clipping: An institutional experience 腺苷促进动脉瘤夹闭:一个机构经验

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_3_22

G. Manoharan, R. Prasad, Senthil Kumar, K. Arvind

{"title":"Adenosine in facilitating aneurysm clipping: An institutional experience","authors":"G. Manoharan, R. Prasad, Senthil Kumar, K. Arvind","doi":"10.4103/jcvs.jcvs_3_22","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_3_22","url":null,"abstract":"Introduction: Intracranial aneurysms are the one of most complicated conditions confronted by a neurosurgeon. Even though endovascular procedure is preferred, open surgery and clipping of the aneurysm still remains gold standard procedure for many aneurysms. Proximal control of the parent vessel remains one of the most critical steps in clipping the aneurysms and this can be achieved by various ways such as temporary clipping and transient cardiac standstill using adenosine. Temporary clipping is associated with complications such as infarct and injury to the vessel, whereas temporary hypotension using adenosine provides a way for successful clipping of the aneurysm. Here, we present our experience with adenosine in patients undergoing clipping of aneurysms in our institution between 2017 and 2020. Methodology: It is a retrospective cohort study conducted on patients undergoing craniotomy and clipping of aneurysms and in those where adenosine is not contraindicated. Patients are divided into Group A where adenosine is not used and Group B where adenosine is used. Results: In Group B, where adenosine is used, clipping was easier, with less incidence of intraoperative ruptures, less usage of Temporary clip (TC) and less incidence of infarct, reduce clipping time with no side effects. Conclusion: Adenosine-induced transient cardiac arrest and hypotension are a safe and effective method in facilitating aneurysm clipping.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"8 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":"116857465","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

A concise operative atlas of microvascular decompression – Different intraoperative scenarios and technical nuances 微血管减压简明手术图谱-术中不同场景和技术差异

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_21_21

Roopesh Kumar, A. Karthikayan

引用次数: 0

Clinical Significance of Serial Measurements of Interleukin-6 and High-Sensitivity C-Reactive Protein as Early Predictor of Poor Neurological Outcome in Aneurysmal Subarachnoid Haemorrhage 白细胞介素-6和高敏c反应蛋白系列检测作为动脉瘤性蛛网膜下腔出血神经预后不良的早期预测指标的临床意义

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_4_22

Amit Sharma, Ruhi Mamualiya, Rahul Inganal, Daljit Singh, B. Mahajan

{"title":"Clinical Significance of Serial Measurements of Interleukin-6 and High-Sensitivity C-Reactive Protein as Early Predictor of Poor Neurological Outcome in Aneurysmal Subarachnoid Haemorrhage","authors":"Amit Sharma, Ruhi Mamualiya, Rahul Inganal, Daljit Singh, B. Mahajan","doi":"10.4103/jcvs.jcvs_4_22","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_4_22","url":null,"abstract":"Introduction: The inflammatory events are implicated in the pathophysiology of subarachnoid haemorrhage (SAH) and secondary brain injury. The goal of this study was to determine the role of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) as an early predictor of the poor neurological outcome at 6 months in individuals with SAH. Methods: In this prospective, observational study of consecutive patients with aneurysmal SAH included over 1 year. Peak IL-6 and hsCRP were used as an indicator of the inflammatory response. Initial IL-6 and hs-CRP levels were collected within 12 h from admission and then for the next consecutive 7 days. The primary outcome was neurological status at 6-month follow-up assessed with the Modified Rankin Scale (0–6) with a score with or higher than 3 labelled as poor outcome. Logistic regression analyses were used to evaluate the associations between the peak serum IL-6 and hs-CRP levels and the neurological outcome. Results: The median peak levels of both markers were significantly higher in the poor outcome group on all 7 days. A significant correlation was seen between peak IL-6 and poor Hunt and Hess grade (P = 0.006), infarction (0.033) and systemic infection (0.03), whereas peak hsCRP had a correlation with rebleed (P = 0.017) and clipping (P = 0.032). Significant risk factors for the poor outcome were poor Hunt and Hess grade (P < 0.000) and high Fisher grades (P = 0.021) and peak IL-6 levels (P = 0.014) on regression analysis. Conclusion: The serial measurements of inflammatory markers IL-6 and hsCRP may be used to predict the neurological outcome in aSAH patients. The peak IL-6 levels correlated significantly with poor neurological outcome. Although hsCRP was elevated in patients with the poor outcome, it was statistically non-significant, suggesting a non-specific inflammatory stress response.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"87 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":"122748796","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

Combined Sub-temporal and Pterional Exposure for Clipping of Posterior Cerebral Artery Aneurysm 颞下翼点联合暴露夹持大脑后动脉动脉瘤

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_1_22

G. Menon, A. Varsha, Vinod Kumar, Ajay Hegde

引用次数: 0

Spontaneous thrombosis of internal carotid artery with occlusion of giant cavernous carotid aneurysm and malignant hemispheric infarct – Cure or curse? 颈内动脉自发性血栓形成伴巨海绵状动脉瘤闭塞和恶性半球性梗死——治愈还是诅咒?

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_23_21

G. Menon, A. Pradhan, Ajay Hegde

引用次数: 1

Torcular herophili dural arteriovenous fistula of the brain – Balloon-assisted flow-controlled embolisation with venous sinus preservation 脑圆形嗜herophili硬脑膜动静脉瘘-球囊辅助血流控制栓塞与静脉窦保存

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_9_22

S. Paramasivam, Kannah Elangovan

{"title":"Torcular herophili dural arteriovenous fistula of the brain – Balloon-assisted flow-controlled embolisation with venous sinus preservation","authors":"S. Paramasivam, Kannah Elangovan","doi":"10.4103/jcvs.jcvs_9_22","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_9_22","url":null,"abstract":"Dural arteriovenous fistulas (DAVF) are rare acquired vascular malformations of the brain with varied clinical presentations based on the location and pattern of venous drainage. Aggressive management of DAVF is predominantly endovascular with open surgical obliteration reserved for a few selected cases. DAVF around the trocular herophili are challenging as we need to preserve the superficial and deep venous channels for the normal drain drainage. We describe a case of complex DAVF centered around torcula herophili and left transverse sinus with complete obliteration of left sigmoid sinus and stenosis of the left transverse sigmoid sinus. The DAVF had retrograde venous drainage through the superficial and deep venous sinuses, cortical veins, competing with normal venous drainage of the brain with significant venous hypertension and cognitive impairment. Our goal was complete obliteration of all the feeders with preservation of the venous sinuses and reduction of venous hypertension to achieve cognitive improvement. Endovascular embolisation by transarterial route was done with flow control on the venous side using dimethyl sulfoxide compatible balloon. We have described the technical challenges and strategy to achieve complete obliteration of all the feeders around the sinus, with preservation of torcula using balloon inflation. Venous system flow was restored to the normal pattern and anti-coagulated for 24 h. Endovascular embolisation is the mainstay treatment for DAVF. To achieve cure, strategising the approach and extent of obliteration based on anatomy and venous drainage pattern of the brain is essential. Torcular DAVF pose a specific challenge, at it is the confluence of the superficial and deep venous system. Transvenous Balloon-assisted embolisation is a safe and effective method to achieve complete obliteration of DAVF with preservation of the venous sinuses.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"17 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":"114461302","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

Practicality of aneurysm clipping over coiling in semi-urban and rural India 在印度的半城市和农村地区，动脉瘤切开术的实用性

Journal of Cerebrovascular Sciences Pub Date : 2021-07-01 DOI: 10.4103/jcvs.jcvs_12_22

J. Dil

引用次数: 0

Pseudo-hyperdense MCA sign: The value of comparing CT densities of vessels on both sides 伪MCA高密度征:比较两侧血管CT密度的价值

Journal of Cerebrovascular Sciences Pub Date : 2021-01-01 DOI: 10.4103/jcvs.jcvs_5_21

P. Krishnan

引用次数: 0

A giant spontaneous dural arteriovenous fistula of the spheno-parietal sinus clinically masquerading as carotico-cavernous fistula: A case report 蝶顶窦巨大自发性硬脑膜动静脉瘘临床伪装为颈海绵状瘘1例

Journal of Cerebrovascular Sciences Pub Date : 2021-01-01 DOI: 10.4103/jcvs.jcvs_9_21

D. Mahakul, Rahul Inganal, Daljit Singh

引用次数: 0

Surgical nuances of clip reconstruction of recurrent middle cerebral artery aneurysms: A technical note 复发性大脑中动脉瘤夹片重建的手术细节:技术注意事项

Journal of Cerebrovascular Sciences Pub Date : 2021-01-01 DOI: 10.4103/jcvs.jcvs_17_21

Aravind Sabesan, Y. Kato, T. Kawase, Yasuhiro Yamada, Riki Tanaka

引用次数: 0