Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Trehalose: A promising new treatment for traumatic brain injury? A systematic review of animal evidence","authors":"Mohammad Ghorbani ,&nbsp;MohammadAli Abouei Mehrizi ,&nbsp;Mahboobeh Tajvidi ,&nbsp;Mohmmad Amin Habibi ,&nbsp;Mohammad Mohammadi ,&nbsp;Saeid Esmaeilian ,&nbsp;Paria Torabi ,&nbsp;Elham Rahmanipour ,&nbsp;Mahyar Daskareh ,&nbsp;Aynaz Mohammadi","doi":"10.1016/j.inat.2023.101947","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101947","url":null,"abstract":"<div><h3>Background</h3><p>TBI is a major global health issue due to its high morbidity and mortality rates. Persistent neurodegeneration following secondary brain injuries is a significant concern. Trehalose, a naturally occurring disaccharide, has shown potential therapeutic effects in preclinical TBI models. This study systematically reviews the preclinical and clinical data on trehalose as a potential TBI treatment.</p></div><div><h3>Methods</h3><p>We conducted a systematic review of trehalose’s role in TBI treatment following PRISMA guidelines. Our search spanned from the inception of PubMed, EMBASE, SCOPUS, and Web of Science until August 2023. Google Scholar was also manually searched. The quality of the studies was assessed using SYRCLE’s risk of bias tool for animal studies.</p></div><div><h3>Results</h3><p>Out of sixty-six records reviewed, four animal studies were included. These studies indicated that trehalose enhanced motor and cognitive functions, reduced oxidative damage and inflammation, regulated metal dyshomeostasis, increased neurotrophic factors and synaptic proteins, and improved autophagy and mitochondrial function in mouse/rat TBI models. However, a significant risk of bias was noted.</p></div><div><h3>Conclusion</h3><p>Trehalose demonstrates potential as a TBI treatment. However, more rigorous, and comprehensive research is needed to confirm its safety and efficacy in humans.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101947"},"PeriodicalIF":0.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221475192300230X/pdfft?md5=18d81bec42efcd5437337fe0ee80c266&pid=1-s2.0-S221475192300230X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090301","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":"Coiling of an iatrogenic aneurysm of the distal posterior inferior cerebellar artery via a Marathon microcatheter","authors":"Xin Wang,&nbsp;Jinlu Yu","doi":"10.1016/j.inat.2023.101950","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101950","url":null,"abstract":"<div><p>Iatrogenic distal posterior inferior cerebellar artery (PICA) aneurysms are rare, and parent artery occlusion (PAO) via Marathon microcatheters can be an option for coiling. We reported such a case. A 60-year-old woman with an epidermoid cyst of the posterior fossa suffered subarachnoid hemorrhage after open surgery for the removal of an epidermoid cyst and fell into a coma. Digital subtraction angiography confirmed a distal PICA iatrogenic dissecting aneurysm. Due to the PICA being tortuous, routine microcatheters that deliver coils cannot access the aneurysm. However, a Marathon microcatheter over a Synchro 10 guidewire was able to successfully access the aneurysm. An Axium Prime coil was advanced easily into a Marathon microcatheter. After the coil was detached in the Marathon microcatheter, the Synchro 10 guidewire was able to push the detached coil through the Marathon microcatheter tip into the dissecting aneurysm, and then another coil was deployed to complete PAO. Postoperatively, due to acute hydrocephalus, an Ommaya catheter with a reservoir was deployed into the lateral ventricle to aspirate cerebrospinal fluid. One week postoperatively, a computed tomography scan showed acute infarction of the cerebellar hemisphere with no mass effect. During follow-up, no rebleeding occurred. Six months later, the patient did not wake up and was declared to be in a vegetative state. By reporting this case, it was found that for iatrogenic distal PICA aneurysms, PAO is feasible with an Axium Prime coil deployed via a Marathon microcatheter.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101950"},"PeriodicalIF":0.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002335/pdfft?md5=00f5b528c962b21e0e6362f78ef58da9&pid=1-s2.0-S2214751923002335-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139109031","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 unique variant of abducens nerve duplication in a case of a large vestibular schwannoma","authors":"Ufuk Erginoglu,&nbsp;Mario Wolak Junior,&nbsp;Cagdas Ataoglu,&nbsp;Abdullah Keles,&nbsp;Mustafa K. Baskaya","doi":"10.1016/j.inat.2023.101946","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101946","url":null,"abstract":"<div><p>Vestibular schwannomas (VS) are slow-growing benign tumors commonly found in the cerebellopontine angle, potentially compressing brain structures and cranial nerves, including the abducens nerve (AN), responsible for lateral gaze. Although large VSs may compress the AN, postsurgical AN palsy is rare, and the clinical significance of AN variations, particularly in VS cases, remains unclear. We report a unique case of a 29-year-old female with a large left vestibular schwannoma. The patient underwent a left-sided microsurgical two-stage excision with an uneventful recovery (House-Brackmann facial grade I). During surgery, a rare variant of the AN was identified. This AN originated as two separate trunks and merged 3 mm distal to its origin in the same segment. To the best of our knowledge, arising and merging in the cisternal segment of AN variation has not been reported previously. Recognizing AN variations is vital for successful skull base surgeries, especially in preserving both branches during vestibular schwannoma surgery and ensuring ocular function.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101946"},"PeriodicalIF":0.4,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002293/pdfft?md5=27cb01dc8bfc8c366f407565cb8a4058&pid=1-s2.0-S2214751923002293-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090297","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":"Neurobrucellosis after a cranioplasty: A case report and literature review","authors":"Changdong Li ,&nbsp;Yipeng Jiang ,&nbsp;Zhihong Wang","doi":"10.1016/j.inat.2023.101941","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101941","url":null,"abstract":"<div><h3>Background</h3><p>Brucellosis is a zoonotic infectious disease. Neurobrucellosis occurs when <em>Borrelia burgdorferi</em> infects the nervous system and is a complication of brucellosis. Infection is a common post-cranioplasty complication, although co-infection with <em>B. burgdorferi</em> is rare. In this article, we report a case of neurobrucellosis caused by <em>B. burgdorferi</em> infection after cranioplasty in a female patient with traumatic brain injury and review the literature.</p></div><div><h3>Case Description</h3><p>A 37-year-old woman with traumatic brain injury underwent emergency clot removal and decompression craniectomy. Three-dimensional titanium mesh cranioplasty was performed 4 years later. Unfortunately, only 1 year later, the skull repair material had to be removed because of a localized scalp infection in the area of the skull repair. Cranioplasty was performed 5 months later with polyetheretherketone material. The patient remained free of symptoms until July 27, 2022, when the patient was readmitted for a headache. The final diagnosis of neurobrucellosis was made after relevant examinations, tests, and subcutaneous puncture of aspirated pus for bacterial cultures and special genus tests. Following the standard protocol, the patient was treated effectively.</p></div><div><h3>Conclusion</h3><p>Neurobrucellosis occurs after a patient contracts a neurological infection through contact with the excrement of an infected animal or ingestion of food from an infected or diseased animal. Any postoperative complications of specific infections can cause physical pain and a heavy financial burden on the patient because of the special and expensive materials used for cranial repair. Therefore, we recommend screening patients from areas at epidemiological risk for relevant diseases before undergoing cranioplasty.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101941"},"PeriodicalIF":0.4,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002244/pdfft?md5=1a46f891bdb3cb5b53450fdee5fb2240&pid=1-s2.0-S2214751923002244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139050449","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":"Case Reports: Two Different Onset Types of Chronic Encapsulated Intracerebral Hematoma related to cerebrospinal fluid perfusion identified prior to and following surgery","authors":"Jota Tega ,&nbsp;Koichiro Suzuki ,&nbsp;Takaaki Amamoto ,&nbsp;Toshiyuki Enomoto ,&nbsp;Hiromasa Kobayashi ,&nbsp;Takashi Morishita ,&nbsp;Koichiro Takemoto ,&nbsp;Yoshihisa Kawano ,&nbsp;Hiroshi Abe","doi":"10.1016/j.inat.2023.101945","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101945","url":null,"abstract":"<div><p>Hypertensive intracerebral hemorrhage rarely develops into chronic encapsulated intracerebral hematoma (CEIH). We encountered 2 cases of CEIH, one with initial CEIH and the other with CEIH following minimally invasive endoscopic surgery for hypertensive intracerebral hemorrhage. Case 1 was a 46-year-old man with Glasgow Coma Scale (GCS) 12 (E4V3M5), complete hemiplegia, and motor aphasia who was brought to our hospital. A head computed tomography scan showed a left putaminal hemorrhage, and he was treated conservatively. However, because the hematoma enlarged and cerebral herniation appeared, we performed endoscopic hematoma removal. His paralysis improved and he transferred to a convalescent hospital with modified Rankin Scale 2. Case 2 was an 84-year-old man with GCS 9 (E3V2M4), right conjugate deviation, and complete hemiplegia who was brought to our hospital. We performed endoscopic hematoma removal. Because of gradual regrowth of the hematoma and cerebral herniation, endoscopic hematoma removal was performed again on day 12 after surgery. His consciousness improved postoperatively, and he was transferred to a convalescent hospital. The pathogenesis of CEIH is still not known, and we newly suggest the involvement of pia mater collapse and cerebral spinal fluid accumulation. We report the effectiveness of minimally invasive endoscopic surgery and reconsider the mechanism of CEIH based on a literature review.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101945"},"PeriodicalIF":0.4,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002281/pdfft?md5=8db98a1a8a5098049f63235522fd54e8&pid=1-s2.0-S2214751923002281-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090298","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":"Cavernous angioma of the cauda equina: A case report","authors":"Annelies Mondelaers ,&nbsp;Thomas Vermeulen ,&nbsp;Eline De Smet ,&nbsp;Maarten Vanloon ,&nbsp;Tomas Menovsky","doi":"10.1016/j.inat.2023.101942","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101942","url":null,"abstract":"<div><p>Cavernous angiomas are benign vascular malformations that are occasionally found in the central nervous system. They comprise about 3% of all subdural spinal cord tumors, with only 24 cases of cavernomas of the cauda equina described in the literature.</p><p>This paper reports the case of a 55-year-old man who presented with back pain radiating to both legs. The patient followed several sessions of physiotherapy with only short pain relief. A lumbar magnetic resonance imaging showed a lesion with diameter of 12 mm located at the L1/L2 level under the conus medullaris. The patient underwent L2 and partially L1 laminectomy with complete resection of the lesion. The pathohistological examination was consistent with a cavernous angioma of the cauda equina. Full recovery of the patient was obtained without any neurological deficit.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101942"},"PeriodicalIF":0.4,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002256/pdfft?md5=82b4a8de78765b53858565dcaacb81a9&pid=1-s2.0-S2214751923002256-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090299","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":"Coexistence of intracranial dysraphic cyst and aneurysm: A qualitative systematic review and multiple management portraits","authors":"Francesco Calvanese ,&nbsp;Anna Maria Auricchio ,&nbsp;Anni Pohjola ,&nbsp;Rahul Raj ,&nbsp;Mika Niemelä","doi":"10.1016/j.inat.2023.101948","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101948","url":null,"abstract":"<div><h3>Background</h3><p>The coexistence of intracranial aneurysms and dysraphic cysts is a rare manifestation. The response triggered by the cyst and its proinflammatory content could play a role in the rupture or growth of a neighboring aneurysm.</p></div><div><h3>Methods</h3><p>We performed a systematic review according to the PRISMA guidelines searching PubMed, Medline, Google Scholar and Embase. Additionally, we report a case of one patient with both a dermoid cyst and an ipsilateral anterior cerebral artery aneurysm, illustrating a progressive formation of the vascular lesion during the follow-up of the cyst.</p></div><div><h3>Results</h3><p>Out of 103 papers fulfilling the inclusion criteria for the systematic review, 79 articles were selected for eligibility. Finally, a total of 9 cases, including our own case, were considered for the review. We found that all aneurysms were in the anterior circulation and all cysts were supratentorial. The aneurysms or parent vessels were in proximity or in contact with the dysraphic lesion, presenting a strong adherence to its capsule. The 3 dermoids presented with cysts rupture and showed simultaneous or delayed subarachnoid aneurysmal hemorrhage. Two epidermoid cysts were diagnosed after aneurysm rupture, while the others due to focal mass effect, as in the case of the neurenteric cyst.</p></div><div><h3>Conclusions</h3><p>Coexistence of intracranial aneurysm and disraphic cyst is a rare finding with multiple possible presentations. In managing patients harboring disraphic cyst, the presence of the aneurysm should be ruled out during the standard workup. A coexistence of these pathologies could affect their natural histories, and this could justify a more active management protocol.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101948"},"PeriodicalIF":0.4,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002311/pdfft?md5=f93e21c444853f29f7004e236183765a&pid=1-s2.0-S2214751923002311-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139050450","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":"Differential diagnosis of a primary skull bone tumor – Characteristics of an purely intraosseous extradural meningioma. Case report and literature review","authors":"Franz Jooji Onishi ,&nbsp;Ana Camila Gandolfi ,&nbsp;Rafi Felicio B. Dauar","doi":"10.1016/j.inat.2023.101940","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101940","url":null,"abstract":"<div><h3>Objective</h3><p>This case report aims to describe a rare occurrence of a purely intraosseous meningioma, presenting as a lytic bone lesion in the skull.</p></div><div><h3>Case Report</h3><p>We present the case of a 67-year-old female patient who presented with a persistent headache and underwent diagnostic imaging, including CT scan and MRI. Surgical resection with wide margins and cranial reconstruction was performed, followed by histopathological examination of the tumor.</p></div><div><h3>Discussion</h3><p>The radiological investigation revealed an infiltrative and lytic heterogeneous lesion in the left parietal bone. Whole-body PET-CT scan showed no signs of primary involvement. The patient underwent successful surgery, and the histopathological examination confirmed the diagnosis of a grade I meningothelial meningioma with adjacent hyperostosis. Primary intraosseous meningiomas are exceedingly rare and challenging to diagnose due to their mimicry of other benign and malignant skull lesions. Surgical resection with wide margins is recommended, and histopathological examination with immunohistochemistry aids in confirming the diagnosis. Long-term surveillance is necessary due to the potential for recurrence and malignant transformation.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101940"},"PeriodicalIF":0.4,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002232/pdfft?md5=687e941976747e63d48f030672543232&pid=1-s2.0-S2214751923002232-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033343","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":"Clinical predictors and surgical outcomes following surgical treatment in patients with cervical spondylotic myelopathy, Addis Ababa, Ethiopia: A prospective study","authors":"Sura Daniel Elias,&nbsp;Azarias Kassahun Admasu","doi":"10.1016/j.inat.2023.101934","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101934","url":null,"abstract":"<div><h3>Background</h3><p>CSM is the most common cause of spinal dysfunction in adults older than 55 years of age and surgery is the mainstay of treatment for patients with CSM.The objective of our study was to assess the outcome of patients operated for CSM by using m-JOA and Recovery rate using Hirabayashi formula and evaluate clinical factors predicting surgical outcomes in patients undergoing decompressive surgeries.</p></div><div><h3>Methodology</h3><p>Adult CSM patients fulfilling inclusion and exclusion criteria were enrolled at two hospitals. Patients were followed prospectively for a minimum of 06 month, with mJOA score, recovery rate (using Hirabayashi formula) and Postoperative complications assessments. Possible clinical predictive factors were also assessed.</p></div><div><h3>Results</h3><p>There were 38 men and 19 women (mean age, 50.63 yr) enrolled in our study. 48 patients had anterior cervical procedure, 9 patients had posterior procedures.The mean mJOA scores at 6 months (13.33) and 1 year(14.74) after surgery were significantly higher than the mean preoperative mJOA (10.44) (P value = 0.01). 42(73.4 %)patients had recovery, 7 patients (11.9 %) remained the same while 8 (13.6 %) patients worsened. Average recovery rate was 36.59 ± 37.12 % in younger patients(&lt;65yrs) and 2.4 ± 47.10 % in the group older than 65 years (P value = 0.043). Rate of recovery in patients with symptom duration of &lt; 1 year was found to be better than those presented with symptom duration of &gt; 1 year(39.11 % vs 15.54 %) with p-value = 0.035. Six patients had new neurologic deficit in the immediate postoperative period.</p></div><div><h3>Conclusions</h3><p>Surgical treatment of CSM was associated with significant improvement in mJOA and recovery rate at 6 and 12 months. Age and duration of symptom were highly predictive of surgical. Our study showed a high rate of immediate post op neurologic deterioration but other complications in our study were comparable with those in previously reported CSM series.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101934"},"PeriodicalIF":0.4,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002177/pdfft?md5=948c3d88ec6024cc931d3c1582dc7e32&pid=1-s2.0-S2214751923002177-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138558926","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":"Application of hybrid operating room in the surgical treatment for intracranial aneurysm","authors":"Yan Zhao,&nbsp;Xinyu Yang,&nbsp;Dasen Gong,&nbsp;Wei Wei,&nbsp;Shuyuan Yue,&nbsp;Jianning Zhang","doi":"10.1016/j.inat.2023.101935","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101935","url":null,"abstract":"<div><h3>Background</h3><p>Intracranial aneurysms are associated with a high mortality rate in the event of a rupture and significant morbidity during subsequent treatment. Hybrid treatment approaches for vascular diseases have been incorporated into modern operating rooms as guides for surgical interventions now. The current study evaluates the feasibility and effectiveness of hybrid operating room system and its application in the surgical treatment of intracranial aneurysms.</p></div><div><h3>Aims</h3><p>To evaluate the feasibility and effectiveness of hybrid operating room system and its application in the surgical treatment for aneurysms.</p></div><div><h3>Methods</h3><p>76 patients with 84 intracranial aneurysms were surgically treated in Hybrid operating room with intraoperative angiography between March 2018 and March 2021. Aneurysm clipping was performed in 76 (94.7 %) cases; Aneurysm trapping with extracranial-intracranial (EC-IC) bypass in 4 (5.3 %) cases. Patient demographics, aneurysm size, location, Hunt and Hess score, were recorded. 69 (90.8 %) patients were followed up 6–12 months post operation.</p></div><div><h3>Results</h3><p>Intraoperative angiography demonstrated 5 (6.9%) unexpected aneurysm neck residuals leading to adjustment; 6 (8.3%) parent vessel stenosis in which 5 returned to normal after adjustment. Four giant paraclinoid aneurysms trapping with EC-IC bypass showed total successful vessel reconstruction and complete aneurysm exclusion (100%). The postoperative outcome was evaluated with the modified Rankin Scale (mRS). 53 (76.8%) patients showed good outcome (mRS 0), 11 (15.9%) showed mild neurological defect (mRS 1–2), 3 (4.3%) showed poor outcome (mRS 5), and 2 (2.9%) patients died (mRS 6, Hunt-Hess grade V before surgery). <strong>Conclusion:</strong> Hybrid operating room provides new concepts in the surgically treatment of intracranial aneurysms, especially valuable for the complex aneurysms. The combination of intraoperative imaging of angiography and clipping surgery may offer the opportunity of radical clipping and reduced complications for aneurysm patients.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101935"},"PeriodicalIF":0.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214751923002189/pdfft?md5=1f36c177765e622d2e091b81e1e10748&pid=1-s2.0-S2214751923002189-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138558676","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}