World Neurosurgery: X最新文献

{"title":"Neurocysticercosis in a Nigerian woman -missed diagnosis of a neglected disease and surgical management","authors":"Omotayo Abimbola Ojo ,&nbsp;Chiazor Udochukwu Onyia ,&nbsp;Badirat Olukemi Lawal ,&nbsp;Nicholas Awodele Awolola","doi":"10.1016/j.wnsx.2024.100380","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100380","url":null,"abstract":"<div><p>Neurocysticercosis is a rarely diagnosed but significant clinical problem from infestation with taenia solium. It occurs as a result of ingestion of infested pork and the mode of transmission is usually feco-oral. It is commonly associated with non-specific neurologic manifestations expected of intracranial space-occupying lesions with its most common neurological presentation being seizures. However, its diagnosis without seizure is rarely reported. We report a recent experience in this regard and outcome of this disease which was inadvertently managed surgically. A good history and high index of suspicion especially in developing and low socioeconomic region is helpful for diagnosis in the presence of appropriate radiological findings. Prognosis is good when treatment is tailored to well selected cases. Treatment options include medical with or without surgical removal of encapsulated cyst. A high index of suspicion will be helpful in making appropriate diagnosis and proper management of this disease.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100380"},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259013972400111X/pdfft?md5=e04aaf7606f642f63ad10a6074a4d651&pid=1-s2.0-S259013972400111X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140539515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing surgical outcomes: Craniotomy versus decompressive craniectomy in acute subdural hematoma - A systematic review and meta-analysis","authors":"Abdullah Nadeem ,&nbsp;Tasmiyah Siddiqui ,&nbsp;Taruba Rais ,&nbsp;Rabbia Munsab ,&nbsp;Ashna Habib ,&nbsp;Eesha Khan Afridi ,&nbsp;Fariha Shariq","doi":"10.1016/j.wnsx.2024.100368","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100368","url":null,"abstract":"<div><h3>Introduction</h3><p>Acute subdural hematomas (SDH) pose a significant health risk, often resulting from traumatic head injuries. The choice between surgical interventions, craniotomy, and decompressive craniectomy, remains a subject of debate. This meta-analysis aims to compare outcomes and guide clinical decision-making.</p></div><div><h3>Methods</h3><p>Following PRISMA guidelines, a comprehensive literature search was conducted in databases such as Ovid Medline, PubMed, and Cochrane, up to December 2023. Selection criteria included studies comparing craniotomy and decompressive craniectomy for acute SDH. Data extraction utilized the Newcastle–Ottawa Quality Assessment Tool, and statistical analysis employed the random-effects model.</p></div><div><h3>Results</h3><p>The meta-analysis included 17 studies and 6848 patients. Craniotomy demonstrated a significant reduction in mortality rates (RR 0.80, 95% CI 0.73–0.89, <em>P</em> &lt; 0.0001). GCS scores favored craniotomy for severe cases. GOS outcomes showed a trend favoring craniotomy, particularly in good recovery (RR 1.34, 95% CI 1.04–1.74, <em>P</em> = 0.03). Additional factors explored included co-existing sub-epidural hematoma, mydriasis, extracranial injuries, residual SDH, revision rates, and intracranial pressure.</p></div><div><h3>Conclusion</h3><p>The meta-analysis suggests that craniotomy may be a favorable surgical strategy for acute SDH, displaying a significant decrease in mortality rates and a lower risk of raised intracranial pressure. However, the nuanced nature of outcomes emphasizes the need for a tailored approach, considering broader clinical contexts. Future research should address limitations and provide a basis for well-informed clinical decision-making.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100368"},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000991/pdfft?md5=95ca356c2c61228b8cb362146b8bbab2&pid=1-s2.0-S2590139724000991-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140539516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why are clinical trials of deep brain stimulation terminated? An analysis of clinicaltrials.gov","authors":"Akash Mishra ,&nbsp;Sabrina L. Begley ,&nbsp;Harshal A. Shah ,&nbsp;Brandon A. Santhumayor ,&nbsp;Ritesh A. Ramdhani ,&nbsp;Albert J. Fenoy ,&nbsp;Michael Schulder","doi":"10.1016/j.wnsx.2024.100378","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100378","url":null,"abstract":"<div><h3>Background</h3><p>Although deep brain stimulation (DBS) has established uses for patients with movement disorders and epilepsy, it is under consideration for a wide range of neurologic and neuropsychiatric conditions.</p></div><div><h3>Objective</h3><p>To review successful and unsuccessful DBS clinical trials and identify factors associated with early trial termination.</p></div><div><h3>Methods</h3><p>The ClinicalTrials.gov database was screened for all studies related to DBS. Information regarding condition of interest, study aim, trial design, trial success, and, if applicable, reason for failure was collected. Trials were compared and logistic regression was utilized to identify independent factors associated with trial termination.</p></div><div><h3>Results</h3><p>Of 325 identified trials, 79.7% were successful and 20.3% unsuccessful. Patient recruitment, sponsor decision, and device issues were the most cited reasons for termination. 242 trials (74.5%) were interventional with 78.1% successful. There was a statistically significant difference between successful and unsuccessful trials in number of funding sources (<em>p</em> = 0.0375). NIH funding was associated with successful trials while utilization of other funding sources (academic institutions and community organizations) was associated with unsuccessful trials. 83 trials (25.5%) were observational with 84.0% successful; there were no statistically significant differences between successful and unsuccessful observational trials.</p></div><div><h3>Conclusion</h3><p>One in five clinical trials for DBS were found to be unsuccessful, most commonly due to patient recruitment difficulties. The source of funding was the only factor associated with trial success. As DBS research continues to grow, understanding the current state of clinical trials will help design successful future studies, thereby minimizing futile expenditures of time, cost, and patient engagement.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001091/pdfft?md5=9b38253d2c0f218d35128c73598ec5f7&pid=1-s2.0-S2590139724001091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140349905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laminectomy for acute transverse sacral fractures with compression of the cauda equina: A neurosurgical perspective","authors":"Devin A. Nikjou ,&nbsp;Chani M. Taggart ,&nbsp;Salvatore C. Lettieri ,&nbsp;Michael R. Collins ,&nbsp;Owen T. McCabe ,&nbsp;Layne A. Rousseau ,&nbsp;Iman Feiz-Erfan","doi":"10.1016/j.wnsx.2024.100374","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100374","url":null,"abstract":"<div><h3>Introduction</h3><p>Optimal management of transverse sacral fractures (TSF) remains inconclusive. These injuries may present with neurological deficits including cauda equina syndrome. We present our series of laminectomy for acute TSF with cauda equina compression.</p></div><div><h3>Methods</h3><p>This was a retrospective chart review of all patients that underwent sacral laminectomy for treatment of cauda equina compression in acute TSF at our institution between 2007 through 2023.</p></div><div><h3>Results</h3><p>A total of 9 patients (5 male and 4 female) underwent sacral laminectomy to decompress the cauda equina in the setting of acute high impact trauma. Surgeries were done early within a mean time of 5.9 days. All but one patient had symptomatic cauda equina syndrome. In one instance surgery was applied due to significant canal stenosis present on imaging in a patient with diminished mental status not allowing proper neurological examination. Torn sacral nerve roots were repaired directly when possible. All patients regained their neurological function related to the sacral cauda equina on follow up. The rate of surgical site infection (SSI) was 33%.</p></div><div><h3>Conclusion</h3><p>Acute early sacral laminectomy and nerve root repair as needed was effective in recovering bowel and bladder function in patients after high impact trauma and TSF with cauda equina compression. A high SSI rate may be reduced by delaying surgery past 1 week from trauma, but little data exists at this time for clear recommendations.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100374"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001054/pdfft?md5=2681ddf7645d0c5976d42878c89f12de&pid=1-s2.0-S2590139724001054-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140348333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of reasons for medical malpractice litigation due to anterior cervical discectomy and fusion","authors":"Haad Arif ,&nbsp;Jacob Razzouk ,&nbsp;Daniel Bohen ,&nbsp;Omar Ramos ,&nbsp;Olumide Danisa ,&nbsp;Paul Cheng ,&nbsp;Wayne Cheng","doi":"10.1016/j.wnsx.2024.100371","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100371","url":null,"abstract":"<div><h3>Background</h3><p>Anterior cervical discectomy and fusions (ACDF) are among the most common cervical spine operations, with over 137,000 surgeries performed annually. Understanding reasons underlying malpractice pertaining to ACDF may inform physicians of practices to improve delivery of patient care and mitigate malpractice. The aim of our study was to analyze the causes and outcomes for lawsuits pertaining to ACDF.</p></div><div><h3>Methods</h3><p>The Westlaw Edge and Verdict Search databases were queried for malpractice claims utilizing the keywords “anterior cervical discectomy and fusion” and “ACDF”. Inclusion criteria was based on relevance of case grievance(s) to ACDF. Data collected included date of case hearing, plaintiff demographics, defendant specialty, verdict ruling, location of filed claim, monetary award, and sustained injuries.</p></div><div><h3>Results</h3><p>Fifty cases were included in this study after excluding 1933 cases. Of the 50 cases, 34 (68%) resulted in a defendant outcome, 8 (16%) resulted in a plaintiff outcome, and 8 (16%) resulted in settlement. Plaintiff verdicts resulted in an average monetary payment of $9.70 million, while settlements resulted in an average payment of $2.06 million. Reasons for litigation were divided into 10 categories, most commonly improper postoperative management (20%), hardware failure (18%), intraoperative error (14%), off-label use of implants (14%), and insufficient informed consent (12%).</p></div><div><h3>Conclusions</h3><p>Malpractice claims due to ACDF are associated with higher frequencies of plaintiff verdicts and higher monetary costs compared to other spinal surgery procedures. There does not appear to be supporting evidence that spinal cord neuromonitoring is mandatory for ACDF procedures from a medicolegal standpoint.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100371"},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001029/pdfft?md5=a6c31dd9d72b3b0fdde8b16056788d3e&pid=1-s2.0-S2590139724001029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140349904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty as a predictor of poor outcomes in patients with chronic subdural hematoma (cSDH): A systematic review of literature","authors":"Bhavya Pahwa ,&nbsp;Syed Faraz Kazim ,&nbsp;John Vellek ,&nbsp;Daniel J. Alvarez-Crespo ,&nbsp;Smit Shah ,&nbsp;Omar Tarawneh ,&nbsp;Alis J. Dicpinigaitis ,&nbsp;Ramesh Grandhi ,&nbsp;William T. Couldwell ,&nbsp;Meic H. Schmidt ,&nbsp;Christian A. Bowers","doi":"10.1016/j.wnsx.2024.100372","DOIUrl":"10.1016/j.wnsx.2024.100372","url":null,"abstract":"<div><h3>Objective</h3><p>In recent years, frailty has been reported to be an important predictive factor associated with worse outcomes in neurosurgical patients. The purpose of the present systematic review was to analyze the impact of frailty on outcomes of chronic subdural hematoma (cSDH) patients.</p></div><div><h3>Methods</h3><p>We performed a systematic review of literature using the PubMed, Cochrane library, Wiley online library, and Web of Science databases following PRISMA guidelines of studies evaluating the effect of frailty on outcomes of cSDH published until January 31, 2023.</p></div><div><h3>Results</h3><p>A comprehensive literature search of databases yielded a total of 471 studies. Six studies with 4085 patients were included in our final qualitative systematic review. We found that frailty was associated with inferior outcomes (including mortality, complications, recurrence, and discharge disposition) in cSDH patients. Despite varying frailty scales/indices used across studies, negative outcomes occurred more frequently in patients that were frail than those who were not.</p></div><div><h3>Conclusions</h3><p>While the small number of available studies, and heterogenous methodology and reporting parameters precluded us from conducting a pooled analysis, the results of the present systematic review identify frailty as a robust predictor of worse outcomes in cSDH patients. Future studies with a larger sample size and consistent frailty scales/indices are warranted to strengthen the available evidence. The results of this work suggest a strong case for using frailty as a pre-operative risk stratification measure in cSDH patients.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100372"},"PeriodicalIF":0.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001030/pdfft?md5=ac8cbfe41a141690aa6ae4e260e977ee&pid=1-s2.0-S2590139724001030-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Andexanet alfa therapy showed No increased rate of thromboembolic events in spontaneous intracranial hemorrhage patients: A multicenter electronic health record study","authors":"John Vellek ,&nbsp;Omar H. Tarawneh ,&nbsp;Syed Faraz Kazim ,&nbsp;Oluwafemi P. Owodunni ,&nbsp;Sophia Arbuiso ,&nbsp;Smit Shah ,&nbsp;Alis J. Dicpinigaitis ,&nbsp;Meic H. Schmidt ,&nbsp;Rohini G. McKee ,&nbsp;Richard Miskimins ,&nbsp;Fawaz Al-Mufti ,&nbsp;Christian A. Bowers","doi":"10.1016/j.wnsx.2024.100367","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100367","url":null,"abstract":"","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100367"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259013972400098X/pdfft?md5=7a1dab968cbcbd78a692d09f871e1fe8&pid=1-s2.0-S259013972400098X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High brain natriuretic peptide levels are associated with vulnerable plaque in cervical carotid artery","authors":"Nozomi Sasaki,&nbsp;Taku Hiramatsu,&nbsp;Yoshihito Hasegawa,&nbsp;Motoshi Sawada","doi":"10.1016/j.wnsx.2024.100369","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100369","url":null,"abstract":"","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100369"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001005/pdfft?md5=694f7564397ee5a030375693bef8cd8b&pid=1-s2.0-S2590139724001005-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140328271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive evaluation of career trajectories of the American Association of Neurological Surgeons William P. Van Wagenen fellows","authors":"Tritan Plute ,&nbsp;Othman Bin-Alamer ,&nbsp;Arka N. Mallela ,&nbsp;Justiss A. Kallos ,&nbsp;D. Kojo Hamilton ,&nbsp;Ian F. Pollack ,&nbsp;L. Dade Lunsford ,&nbsp;Robert M. Friedlander ,&nbsp;Hussam Abou-Al-Shaar","doi":"10.1016/j.wnsx.2024.100365","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100365","url":null,"abstract":"<div><h3>Objective</h3><p>To elucidate the current academic, demographic, and professional factors influencing the career trajectories of the American Association of Neurological Surgeons (AANS) William P. Van Wagenen (VW) fellows while also identifying trends that may influence future fellow selection.</p></div><div><h3>Methods</h3><p>Fifty-five VW fellows were identified from 1968 to 2022 from the AANS website, along with corresponding institutions, countries, and continents of study. Additional variables such as age at selection, accruing additional degrees, neurosurgical subspecialty, the number of publications at the time of selection, funding, and h-index were collected from various publicly available sources.</p></div><div><h3>Results</h3><p>Eighty-five percent of VW fellows were male and had a mean age of 34 ± 2.4 years. Ninety-one percent of fellows chose to study in Europe, and 40% had earned additional degrees. Univariate linear regression demonstrated a positive relationship between the year of selection and both age at selection (<em>p</em> = 0.0094) and the number of publications at hire (<em>p</em> &lt; 0.001), while logistic regression revealed that more recently selected fellows were less likely to study in Europe (<em>p</em> = 0.037) and be of the white race (<em>p</em> = 0.0047). Logistic regression also exhibited a positive trend between the year of selection and both the likelihood that the VW fellow was currently enrolled in another fellowship (<em>p</em> = 0.019) and possessed additional degrees (<em>p</em> = 0.0019). Females were shown to have fewer publications at hire compared to males (<em>p</em> = 0.04).</p></div><div><h3>Conclusions</h3><p>Most Van Wagenen fellows are academically productive members of the neurosurgical community. Increased attention is likely to be placed on both academic, research, and individualized factors when selecting future fellows.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100365"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724000966/pdfft?md5=40f88537e0208a4cfbb17dd793952d82&pid=1-s2.0-S2590139724000966-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140339257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel predictor of ischemic complications in the treatment of ruptured middle cerebral artery aneurysms: Neck-branching angle","authors":"Tomofumi Takenaka ,&nbsp;Hajime Nakamura ,&nbsp;Shuhei Yamada ,&nbsp;Tomoki Kidani ,&nbsp;Akihiro Tateishi ,&nbsp;Shingo Toyota ,&nbsp;Toshiyuki Fujinaka ,&nbsp;Takuyu Taki ,&nbsp;Akatsuki Wakayama ,&nbsp;Haruhiko Kishima","doi":"10.1016/j.wnsx.2024.100370","DOIUrl":"https://doi.org/10.1016/j.wnsx.2024.100370","url":null,"abstract":"<div><h3>Objective</h3><p>The risk factors of procedural cerebral ischemia (CI) in ruptured middle cerebral artery (MCA) aneurysms are unclear. This study proposed the neck-branching angle (NBA), a simple quantitative indicator of the aneurysm neck and branch vessels, and analyzed its usefulness as a predictor of procedural CI in ruptured MCA aneurysms.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed 128 patients with ruptured saccular MCA aneurysms who underwent surgical or endovascular treatment between January 2014 and June 2021. We defined the NBA as the angle formed by the MCA aneurysm neck and M2 superior or inferior branch vessel line. The superior and inferior NBA were measured on admission via three-dimensional computed tomography angiography on admission. We divided the patients into clipping (106 patients) and coiling (22 patients) groups according to the treatment. Risk factors associated with procedural CI were analyzed in each group.</p></div><div><h3>Results</h3><p>Both groups showed that an enlarged superior NBA was a significant risk factor for procedural CI (clipping, P &lt; 0.0005; coiling group, P = 0.007). The receiver operating characteristic curve showed the closed thresholds of the superior NBA with procedural CI in both groups (clipping group, 128.5°, sensitivity and specificity of 0.667 and 0.848, respectively; coiling group, 130.9°, sensitivity and specificity of 1 and 0.889, respectively).</p></div><div><h3>Conclusion</h3><p>The NBA can estimate the procedural risk of ruptured MCA aneurysms. In addition, an enlarged superior NBA is a risk factor for procedural CI in both clipping and coiling techniques.</p></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"23 ","pages":"Article 100370"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590139724001017/pdfft?md5=9e30926572d772d31784ba672ce57bb3&pid=1-s2.0-S2590139724001017-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}