Asian Journal of Neurosurgery最新文献_第4页

Microneurosurgery for Ruptured Aneurysm of Distal Intracranial Vertebral Artery: A Case Report 颅内椎动脉远端动脉瘤破裂的显微神经外科手术：病例报告

Asian Journal of Neurosurgery Pub Date : 2024-05-09 DOI: 10.1055/s-0044-1786704

Tushar V. Soni, Shreyansh Patel, Varshesh Shah, Sandip Singh, Nirav Shah

{"title":"Microneurosurgery for Ruptured Aneurysm of Distal Intracranial Vertebral Artery: A Case Report","authors":"Tushar V. Soni, Shreyansh Patel, Varshesh Shah, Sandip Singh, Nirav Shah","doi":"10.1055/s-0044-1786704","DOIUrl":"https://doi.org/10.1055/s-0044-1786704","url":null,"abstract":"The International Subarachnoid Aneurysm Trial led to a shift from clipping to endovascular coiling as the primary therapy for cerebral aneurysm particularly in the management of posterior circulation aneurysm. However, endovascular therapy is often unavailable in low-resource settings, emphasizing the importance of maintaining surgical skill sets in resource-poor countries. This article presents a detailed case report on the successful microneurosurgical management of a 65-year-old female with a history of headache and weakness with past history of hypertension and a right posterior cerebral artery territory infarct who was diagnosed with a ruptured aneurysm situated within the intracranial vertebral artery. Patient was operated with the far lateral approach and clipping of the aneurysm. This case report elucidates the intricate surgical techniques employed, and the challenges neurosurgeons encountered in treating posterior circulation intracranial aneurysms, particularly those with ruptured complications. The aneurysms' intricate anatomy and increased rupture risk necessitate a meticulous microneurosurgical approach. The severity of subarachnoid hemorrhage from ruptured aneurysms increases morbidity and mortality rates.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994575","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 Rare Case of Panton-Valentine Leukocidin-Related Cervical Empyema 潘顿-瓦伦丁白细胞介素相关性颈椎水肿的罕见病例

Asian Journal of Neurosurgery Pub Date : 2023-12-29 DOI: 10.1055/s-0043-1776307

Hung Le, Dung Le Thuy Nguyen, My Nu Tra Ton, Duy Phan, Anh Hoang Ngoc Tran, Van Tri Truong

引用次数: 0

Predicting Morphological Changes to Vessel Walls Adjacent to Unruptured Cerebral Aneurysms Using Computational Fluid Dynamics 利用计算流体力学预测未破裂脑动脉瘤邻近血管壁的形态变化

Asian Journal of Neurosurgery Pub Date : 2023-12-15 DOI: 10.1055/s-0043-1771367

Kento Sasaki, Fuminari Komatsu, Kyosuke Miyatani, Riki Tanaka, Yasuhiro Yamada, Yoko Kato, Yuichi Hirose

{"title":"Predicting Morphological Changes to Vessel Walls Adjacent to Unruptured Cerebral Aneurysms Using Computational Fluid Dynamics","authors":"Kento Sasaki, Fuminari Komatsu, Kyosuke Miyatani, Riki Tanaka, Yasuhiro Yamada, Yoko Kato, Yuichi Hirose","doi":"10.1055/s-0043-1771367","DOIUrl":"https://doi.org/10.1055/s-0043-1771367","url":null,"abstract":"Abstract Objective This study compared intraoperative findings with preoperative computed tomography angiography (CTA) and computational fluid dynamics (CFD) analysis of perianeurysmal findings for the indication of possible vessel wall thinning. Materials and Methods Participants comprised 38 patients with unruptured middle cerebral artery aneurysms treated by surgical clipping at our hospital between May 2020 and April 2021. We defined parent artery radiation sign (PARS) as the presence of each of the following three findings in CFD analysis based on preoperative CTA: (1) impingement of the stream line on the outer parent vessel wall of the aneurysm; (2) radiation of wall shear stress vectors outwards from the same site; and (3) increased wall pressure compared with the surrounding area. CFD analysis showing PARS was compared with intraoperative findings. Results In all nine cases with PARS, no morphological abnormalities were found in the same area on CTA. However, intraoperative findings showed thinning of the parent artery wall in one of the nine cases and formation of a very small mass in three cases, differing from CTA findings. All nine patients underwent additional clipping and/or wrapping and coating at the site of PARS. Conclusion Detecting thinning of the vessel wall or the presence of a microaneurysm may be difficult in endovascular therapy, which is based on the visualization of the vessel lumen. CFD analysis suggests the necessity of confirming findings for the vessel wall around an aneurysm by direct manipulation, as the presence of PARS may indicate partial thinning of the vessel wall or formation of a microaneurysm.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000685","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

Surgical Outcome of Basal Ganglia Hemorrhage: A Retrospective Analysis of Nearly 3,000 Cases over 10 Years 基底节出血的手术效果：10年间近3000例病例的回顾性分析

Asian Journal of Neurosurgery Pub Date : 2023-12-14 DOI: 10.1055/s-0043-1776049

D. Hazra, G. Chandy, Amit Ghosh

{"title":"Surgical Outcome of Basal Ganglia Hemorrhage: A Retrospective Analysis of Nearly 3,000 Cases over 10 Years","authors":"D. Hazra, G. Chandy, Amit Ghosh","doi":"10.1055/s-0043-1776049","DOIUrl":"https://doi.org/10.1055/s-0043-1776049","url":null,"abstract":"Abstract Background Basal ganglia hemorrhage (BGH) is a severe neurologic condition associated with significant morbidity and mortality, and its optimal management remains a topic of debate. Our study assessed the surgical outcomes of BGH patients at the 3-month mark using the modified Rankin Scale (mRS). Methods This retrospective observational study was conducted over 10 years at an advanced neuro-specialty hospital in Eastern India, including patients who underwent decompressive craniotomy and hematoma evacuation. Variables were systematically coded and analyzed to evaluate the postoperative outcome with age (in years), preoperative motor (M) status, and hematoma volume. Results This study enrolled 2,989 patients with a mean age of 59.62 (standard deviation: 9.64) years, predominantly males ( n = 2,427; 81.2%). Hypertension (1,612 cases) and diabetes mellitus (1,202 cases) were the most common comorbidities. Common clinical presentations included ipsilateral weakness (1,920 cases) and/or altered mental status (1,670 cases). At the 3-month mark postsurgery, 2,129 cases (71.2%) had a favorable outcome based on mRS, while 389 cases (13.0%) had an unfavorable outcome. The regression equation showed that age was inversely related to the percentage of individuals achieving a favorable outcome. It also revealed that the preoperative motor score was positively correlated with favorable outcomes. Hematomas smaller than 60 mL had better outcomes, with 1,311 cases (69.1%) classified as good outcomes and 337 cases (17.8%) as bad outcomes. Fatal outcomes related to the illness were observed in 471 patients (15.8%) within the study population. Conclusion Surgery for BGH showed a substantial improvement in outcomes, particularly in patients with M5/M4 motor status. The preoperative motor score (M status) emerged as a crucial predictor of favorable neurological outcomes. Age and hematoma volume, however, were found to be nondefinitive factors in determining good outcomes.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139002662","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

Erratum: Ventriculoperitoneal Shunt Surgery in Brunei Darussalam: A Population-Based Perspective 勘误：文莱达鲁萨兰国的脑室腹腔分流手术：基于人口的视角

Asian Journal of Neurosurgery Pub Date : 2023-10-12 DOI: 10.1055/s-0043-1776296

Merlin Boban, John Mathew, Ady Thien

引用次数: 0

Analysis of the Variations in the Morphology, Topography of the Pterion, and Their Implications in Neurosurgery: An Osteometric Study. 翼管形态和地形的变异分析及其对神经外科的影响：骨测量学研究。

Asian Journal of Neurosurgery Pub Date : 2023-08-31 eCollection Date: 2023-09-01 DOI: 10.1055/s-0043-1772759

Navita Aggarwal, Noopinder Kaur, Apurba Patra, Monika Gupta

{"title":"Analysis of the Variations in the Morphology, Topography of the Pterion, and Their Implications in Neurosurgery: An Osteometric Study.","authors":"Navita Aggarwal, Noopinder Kaur, Apurba Patra, Monika Gupta","doi":"10.1055/s-0043-1772759","DOIUrl":"10.1055/s-0043-1772759","url":null,"abstract":"Objective Pterion is an \"H\" shaped formation of sutures located in the temporal fossa of the skull. It is an important anatomical landmark and a craniometric point. The thinness of the skull and its inner relation with the middle meningeal artery make this anatomical landmark clinically significant. Variations in the pterion are imperative, especially for neurosurgeons in order to have the most suitable craniometric point to be minimally invasive. Materials and Methods One hundred pterions were studied to report the variations in the type and location of the pterion. Murphy's classification was used to classify the pterion into four types on the basis of bone articulation-sphenoparietal, frontotemporal, stellate, and epipteric. Results All four types of pterions were observed, sphenoparietal being the most common. No significant gender difference was observed in terms of type and laterality of various pterions. The mean distance between the center of pterion to the superolateral point of zygomaticotemporal (PZT) suture and the anterolateral point of the frontozygomatic (PFZ) suture were 3.91 ± 3.79 cm and 3.68 ± 3.79 mm, respectively. Correlation analysis showed a strong positive relation between PZT and PFZ sutures. Conclusion Accurate data on the morphology and morphometry of bony anatomical points are crucial, while performing intracranial surgery using them as recognizable landmarks. The morphometric parameters may help in determining the soundness of the pterion as an identifiable landmark for performing interventions like burr hole and other neurosurgical procedures in this area.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88341562","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}

引用次数: 0

Purely Intramuscular Giant Epidermoid Cyst of the Temporalis Muscle. 颞肌纯肌内巨大表皮样囊肿

Asian Journal of Neurosurgery Pub Date : 2023-08-31 eCollection Date: 2023-09-01 DOI: 10.1055/s-0043-1772766

Dimble Raju, Shamshuddin Patel, Sayan Das, Prasad Krishnan

引用次数: 0

Spontaneous Vertebral Artery Arteriovenous Fistula with Neurofibromatosis Type I and Its Management with Covered Stent. 神经纤维瘤病Ⅰ型自发性椎动脉动静脉瘘及其覆膜支架治疗。

Asian Journal of Neurosurgery Pub Date : 2023-08-31 eCollection Date: 2023-09-01 DOI: 10.1055/s-0043-1771327

Batuk Diyora, Anup Purandare, Kavin Devani, Prakash Palave

引用次数: 0

A Prospective Study of the Effect and Safety of Atorvastatin on the Recurrence of Chronic Subdural Hematoma after Burr Hole Surgery. 阿托伐他汀对毛细孔手术后慢性硬膜下血肿复发的影响和安全性的前瞻性研究

Asian Journal of Neurosurgery Pub Date : 2023-08-31 eCollection Date: 2023-09-01 DOI: 10.1055/s-0043-1771372

Duangkamol Bumpetch, Bunpot Sitthinamsuwan, Sarun Nunta-Aree

{"title":"A Prospective Study of the Effect and Safety of Atorvastatin on the Recurrence of Chronic Subdural Hematoma after Burr Hole Surgery.","authors":"Duangkamol Bumpetch, Bunpot Sitthinamsuwan, Sarun Nunta-Aree","doi":"10.1055/s-0043-1771372","DOIUrl":"10.1055/s-0043-1771372","url":null,"abstract":"Introduction Chronic subdural hematoma (CSDH) is a common neurosurgical condition. Recent studies showed efficacy of atorvastatin in reducing the requirement of surgical treatment. This study aimed to evaluate the efficacy and safety of atorvastatin in reducing the recurrence of CSDH after burr hole surgery. Methods This prospective study included patients with CSDH who underwent burr hole surgery. Atorvastatin at 20 mg per day was administered to all patients for 4 weeks postoperatively. The major outcome was the recurrence rate of CSDH at 8 weeks following the operation. Results Seventy-three patients who completed the 4-week course of atorvastatin were included. The mean age was 73.9 years. The most common cause of CSDH was falling. The mean hematoma volume was 106.3 mL. There was no adverse effect of atorvastatin in all of 73 patients. During the 8-week postoperative period, recurrent CSDH was found in 2 of 73 (2.7%) patients. In a comparison of the recurrence rate of CSDH between patients with use of atorvastatin from the present and previous studies (2.6-4.8%), and patients without use of atorvastatin from previous studies (9.8-19%), a marked reduction in recurrent CSDH after burr hole surgery was found in patients with use of atorvastatin. Conclusion An administration of atorvastatin of 20 mg daily for 4 weeks following burr hole surgery is safe and may be helpful in reducing the recurrence rate of CSDH after burr hole surgery.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82688985","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}

引用次数: 0

Prognostic Factors of Mortality and Functional Outcome for Acute Subdural Hematoma: A Review Article. 急性硬膜下血肿的死亡率和功能预后因素：综述文章。

Asian Journal of Neurosurgery Pub Date : 2023-08-31 eCollection Date: 2023-09-01 DOI: 10.1055/s-0043-1772763

Nathan Beucler

{"title":"Prognostic Factors of Mortality and Functional Outcome for Acute Subdural Hematoma: A Review Article.","authors":"Nathan Beucler","doi":"10.1055/s-0043-1772763","DOIUrl":"10.1055/s-0043-1772763","url":null,"abstract":"Acute subdural hematoma (ASDH) is the most frequent intracranial traumatic lesion requiring surgery in high-income countries. To date, uncertainty remains regarding the odds of mortality or functional outcome of patients with ASDH, regardless of whether they are operated on. This review aims to shed light on the clinical and radiologic factors associated with ASDH outcome. A scoping review was conducted on Medline database from inception to 2023. This review yielded 41 patient series. In the general population, specific clinical (admission Glasgow Coma Scale [GCS], abnormal pupil exam, time to surgery, decompressive craniectomy, raised postoperative intracranial pressure) and radiologic (ASDH thickness, midline shift, thickness/midline shift ratio, uncal herniation, and brain density difference) factors were associated with mortality (grade III). Other clinical (admission GCS, decompressive craniectomy) and radiologic (ASDH volume, thickness/midline shift ratio, uncal herniation, loss of basal cisterns, petechiae, and brain density difference) factors were associated with functional outcome (grade III). In the elderly, only postoperative GCS and midline shift on brain computed tomography were associated with mortality (grade III). Comorbidities, abnormal pupil examination, postoperative GCS, intensive care unit hospitalization, and midline shift were associated with functional outcome (grade III). Based on these factors, the SHE (Subdural Hematoma in the Elderly) and the RASH (Richmond Acute Subdural Hematoma) scores could be used in daily clinical practice. This review has underlined a few supplementary factors of prognostic interest in patients with ASDH, and highlighted two predictive scores that could be used in clinical practice to guide and assist clinicians in surgical indication.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87106126","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}

引用次数: 0