Journal of cerebrovascular and endovascular neurosurgery最新文献

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Discrepancy in vessel tortuosity measurements of anterior circulation cerebral artery between digital subtraction angiography and magnetic resonance angiography. 数字减影血管造影术和磁共振血管造影术对前循环大脑动脉血管迂曲度测量的差异。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-09-01 Epub Date: 2025-03-28 DOI: 10.7461/jcen.2025.E2024.11.005
Jae Ho Kim, Hyeondong Yang, Nak-Hoon Son, Chang Ki Jang, Jae Whan Lee, Kwang-Chun Cho
{"title":"Discrepancy in vessel tortuosity measurements of anterior circulation cerebral artery between digital subtraction angiography and magnetic resonance angiography.","authors":"Jae Ho Kim, Hyeondong Yang, Nak-Hoon Son, Chang Ki Jang, Jae Whan Lee, Kwang-Chun Cho","doi":"10.7461/jcen.2025.E2024.11.005","DOIUrl":"10.7461/jcen.2025.E2024.11.005","url":null,"abstract":"<p><strong>Objective: </strong>Tortuosity in blood vessels is a common angiographic feature that plays a crucial role in hemodynamics and is implicated in systemic diseases such as arterial hypertension and diabetes mellitus. Although studies exist on the relationship between vessel tortuosity and intracranial aneurysms, standard imaging modalities and parameters representing vessel tortuosity are controversial. This study compared vessel tortuosity based on angle measurements using magnetic resonance angiography (MRA) and digital subtraction angiography (DSA).</p><p><strong>Methods: </strong>A retrospective analysis of 85 patients with 63 males (75.3%) with unruptured anterior circulation aneurysms between December 2021 and December 2022 was conducted using MRA and DSA. The vessel angles of several segments in the carotid siphon, internal carotid artery bifurcation, and the inflow angles to intracranial aneurysms were measured to evaluate the discrepancy between MRA and DSA.</p><p><strong>Results: </strong>No significant difference was observed in vessel and inflow angles between MRA and DSA, except the internal carotid artery-middle cerebral artery (ICA-MCA) angle, which shows a significant difference (MRA; 50.26˚ (interquartile range (IQR), 33.49-70.57), DSA; 50.75˚ (IQR, 34.91-62.24), p-value=0.035). Conclusions: We found a discrepancy between MRA and DSA in measuring the ICA-MCA angle. Further studies are required to address observed discrepancies between imaging modalities and improve the accuracy of hemodynamic analysis in clinical settings.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"212-218"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733760","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
A rare case of Fahr's disease with posterior circulation (basilar tip) aneurysm- pathophysiology, management, and complications. Fahr病合并后循环(基底尖)动脉瘤1例-病理、生理、处理及并发症。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-09-01 Epub Date: 2025-05-21 DOI: 10.7461/jcen.2025.E2024.09.006
Monirah Zeya, Vikrant Setia, Anita Jagetia
{"title":"A rare case of Fahr's disease with posterior circulation (basilar tip) aneurysm- pathophysiology, management, and complications.","authors":"Monirah Zeya, Vikrant Setia, Anita Jagetia","doi":"10.7461/jcen.2025.E2024.09.006","DOIUrl":"10.7461/jcen.2025.E2024.09.006","url":null,"abstract":"<p><p>Fahr's disease is an uncommon condition characterized by a gradual decline in cognitive, psychiatric, and motor functions, linked to idiopathic calcification in the basal ganglia, typically inherited in an autosomal dominant fashion. Acute presentation is most often as a seizure disorder; however, we present a case of an acute presentation in which the cause of the deterioration was an aneurysmal subarachnoid haemorrhage. The association between Fahr's disease and intracranial aneurysms is exceedingly rare, with only five cases documented in the literature to date. This report represents the sixth such case. Furthermore, all previously reported aneurysms were confined to the anterior circulation; thus, this is the first documented instance of Fahr's disease presenting with an aneurysm in the posterior circulation. The case here presented to the emergency service with the complaint of severe headache. Computed tomography (CT) of the head showed bilateral basal ganglia calcification and subarachnoid haemorrhage. Digital subtraction angiography (DSA) revealed a basilar tip aneurysm. The aneurysm was treated with Neqstent assisted coiling via jailing technique. Intraoperative aneurysmal haemorrhage occurred just after inserting the first coil. Heparin was reversed, blood pressure decreased and aneurysm was packed with further coils till the bleeding stopped. External ventricular drainage was performed to address subarachnoid hemorrhage (SAH) and intraventricular hemorrhage. The exact mechanisms underlying Fahr's disease are not fully understood, but it is believed to play a role in the development of aneurysms due to mineral deposits in blood vessels. For patients experiencing unexplained recurrent episodes of loss of consciousness, brain computed tomography angiography (CTA) should be performed to rule out an aneurysm, even if they have a known diagnosis of Fahr's disease, to prevent misattributing these episodes to epilepsy. Additionally, vessel wall magnetic resonance imaging (MRI) should be conducted preoperatively in cases of aneurysms linked to Fahr's disease or vasculitis to improve management planning.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"276-282"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113144","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
Preoperative embolization of brain, head, and neck tumors: Single center experience and literature review. 术前栓塞脑、头颈部肿瘤:单中心经验及文献回顾。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-09-01 Epub Date: 2025-06-20 DOI: 10.7461/jcen.2025.E2024.12.005
Jimmy Achi-Arteaga, José Guillermo Flores-Vazquez, Irving Fuentes-Calvo, Jimena Gonzalez-Salido, Xavier Wong-Achi
{"title":"Preoperative embolization of brain, head, and neck tumors: Single center experience and literature review.","authors":"Jimmy Achi-Arteaga, José Guillermo Flores-Vazquez, Irving Fuentes-Calvo, Jimena Gonzalez-Salido, Xavier Wong-Achi","doi":"10.7461/jcen.2025.E2024.12.005","DOIUrl":"10.7461/jcen.2025.E2024.12.005","url":null,"abstract":"<p><strong>Objective: </strong>The management of highly vascularized tumors in the brain, head, and neck regions poses significant challenges. This review aims to provide practical insights into using preoperative embolization to improve surgical outcomes and guide healthcare centers with limited expertise in this technique.</p><p><strong>Methods: </strong>A literature review was conducted using PubMed, Scopus, and Web of Science databases with keywords related to preoperative embolization and highly vascularized tumors, detailing its definition, indications, diagnostic considerations, procedural aspects, clinical and surgical implications, and associated complications. The findings are supported by data from 309 patients with brain, head, and neck tumors treated with preoperative embolization at Hospital Clínica Kennedy in Guayaquil, Ecuador, from 2015 to 2023. Cases without embolization or those below the clavicular border were excluded. Illustrations and photographs, based on the authors' surgical experience, are included with informed consent.</p><p><strong>Results: </strong>Preoperative embolization has proven effective in reducing morbidity, enhancing surgical outcomes, and palliating symptoms in inoperable cases by decreasing tumor size. While complications are rare, they can be minimized with careful planning. Despite its efficacy, the lack of randomized controlled trials due to the rarity of hypervascular tumors limits the ability to establish standardized practices. Conclusions: Preoperative embolization is a valuable tool in managing highly vascularized tumors. However, further research and uniform reporting are essential to optimize outcomes and develop clear guidelines for this critical procedure.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"195-211"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328234","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 for reocclusion after mechanical thrombectomy plus rescue treatment in acute athereosclerotic steno-occlusion with successful recanalization. 机械取栓加抢救治疗急性动脉粥样硬化狭窄再通成功后再闭塞的预后因素。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-09-01 Epub Date: 2025-05-14 DOI: 10.7461/jcen.2025.E2025.02.003
Kyungryong Baek, Joonwon Lee, Kyung-Wan Kim, Seung Hwan Kim, Hyungon Lee, Sung-Chul Jin
{"title":"Prognostic factors for reocclusion after mechanical thrombectomy plus rescue treatment in acute athereosclerotic steno-occlusion with successful recanalization.","authors":"Kyungryong Baek, Joonwon Lee, Kyung-Wan Kim, Seung Hwan Kim, Hyungon Lee, Sung-Chul Jin","doi":"10.7461/jcen.2025.E2025.02.003","DOIUrl":"10.7461/jcen.2025.E2025.02.003","url":null,"abstract":"<p><strong>Objective: </strong>Treatment failure usually occurs within 24 hours after mechanical thrombectomy (MT) for acute intracranial atherosclerotic steno-occlusion (ICAS) and is an unexpected event that adversely influences the clinical outcome. We retrospectively evaluated the factors influencing reocclusion after MT plus rescue treatment in acute ICAS patients with successful recanalization.</p><p><strong>Methods: </strong>From January 2013 to December 2020, 60 patients with ICAS who underwent MT plus rescue treatment with successful recanalization were included in our study. We classified the patients into a patency group (n=47, 78.3%) and a reocclusion group (n=13, 21.7%) based on CT angiography data obtained the day after MT plus rescue treatment.</p><p><strong>Results: </strong>Intravenous tissue plasminogen activator (IV t-PA) in the patency group (n=18/47 (38.3%)) significantly differed from that in the reocclusion group (n=1/13 (7.7%)) (p=0.045). The number of thrombectomy attempts in the reocclusion group was significantly greater than that in the patency group (median [interquartile range], 2 [1-3] vs. 1 [0-1.5], p=0.004). According to the univariate logistic regression analysis, the only prognostic factor for reocclusion was the number of thrombectomy attempts (odds ratio (OR), 1.655 [1.046-2.619], p=0.032). Conclusions: In our study of ICAS patients who achieved successful recanalization after MT plus rescue treatment, the number of thrombectomy attempts was an independent prognostic factor for reocclusion after MT. Accordingly, for highly suspicious ICAS lesions, additional attempts at the MT should be carefully performed to prevent reocclusion.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"228-237"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001995","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
Noninferiority of coiling versus coiling with particles in middle meningeal artery embolization: A technical note and case series. 在脑膜中动脉栓塞术中,卷绕术与颗粒卷绕术的非劣效性:技术说明和病例系列。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-09-01 Epub Date: 2025-04-17 DOI: 10.7461/jcen.2025.E2024.07.001
Ryan W Sindewald, Arvin R Wali, Nikhil K Murthy, Michael G Brandel, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander A Khalessi, David R Santiago-Dieppa
{"title":"Noninferiority of coiling versus coiling with particles in middle meningeal artery embolization: A technical note and case series.","authors":"Ryan W Sindewald, Arvin R Wali, Nikhil K Murthy, Michael G Brandel, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander A Khalessi, David R Santiago-Dieppa","doi":"10.7461/jcen.2025.E2024.07.001","DOIUrl":"10.7461/jcen.2025.E2024.07.001","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the possibility of using coils as a standalone treatment for middle meningeal artery embolization.</p><p><strong>Methods: </strong>Four patients (3 females, 1 male, median age 77.5) with bilateral subdural hematomas were treated with bilateral MMA embolization. One hematoma of each patient was treated with coils and PVA, and the other was treated exclusively with coils. New or resolved symptoms, radiographic imaging demonstrating hematoma change, and complications were recorded and compared between the two treatment modalities. Minimum follow-up time was three months.</p><p><strong>Results: </strong>All patients demonstrated symptomatic and radiographic improvement at three month follow-up. None of the patients in this cohort received surgical evacuation of the hematoma prior to or after embolization. One patient had previously been treated for hydrocephalus with a VP shunt. There were no postoperative complications. In the hematomas treated with a combination of coils and particles, three showed complete resolution with one showing interval improvement on imaging. All hematomas treated with coils alone demonstrated complete resolution after three months. Conclusions: Middle meningeal artery embolization with coils alone has demonstrated noninferior results to embolization with a combination of particle embolisate and coils in this small cohort.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"238-245"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045173","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
The efficacy and safety of stent-assisted coil embolization with the semi-jailing technique in patients with unruptured intracranial aneurysm. 支架辅助半监禁线圈栓塞治疗颅内未破裂动脉瘤的疗效和安全性。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-09-01 Epub Date: 2025-07-16 DOI: 10.7461/jcen.2025.E2025.01.003
Wint Shwe Yee Phyo, Manabu Shirakawa, Hidetoshi Matsukawa, Kazutaka Uchida, Shuntaro Kuwahara, Kensaku Senda, Takanori Miyazaki, Shinichi Yoshimura
{"title":"The efficacy and safety of stent-assisted coil embolization with the semi-jailing technique in patients with unruptured intracranial aneurysm.","authors":"Wint Shwe Yee Phyo, Manabu Shirakawa, Hidetoshi Matsukawa, Kazutaka Uchida, Shuntaro Kuwahara, Kensaku Senda, Takanori Miyazaki, Shinichi Yoshimura","doi":"10.7461/jcen.2025.E2025.01.003","DOIUrl":"10.7461/jcen.2025.E2025.01.003","url":null,"abstract":"<p><strong>Objective: </strong>The stent-assisted coiling (SAC) is a well-known procedure for wide neck intracranial aneurysms. To date, the impact of the semi-jailing technique (SJT) on outcomes in patients with SAC remains unknown. This study aims to evaluate the efficacy and safety of SAC using open- or closed-cell stents in patients with unruptured intracranial aneurysms.</p><p><strong>Methods: </strong>The data of patients treated with SAC between December 2013 and May 2022 was retrospectively investigated. Clinical, aneurysmal, outcomes were compared between patients with and without SJT. The primary outcome was 1-year complete occlusion defined as the Raymond-Roy occlusion classification class I. Safety outcomes included permanent deficits and mortality. Subgroup analysis was also performed regarding open-cell or closed-cell stents.</p><p><strong>Results: </strong>Among 320 patients with SAC, 220 patients undertook SJT (68.8%). The median age of patients was 61.0 years (interquartile range, 50.3-71.0 years) and 73 were male (22.8%). 1-year complete occlusion was obtained in 221 patients (69.1%). Permanent deficits and mortality were observed in 3 (0.9%) and 1 (0.3%) patient, respectively. Compared to non-SJT, SJT was significantly related to 1-year complete occlusion (73.2% vs. 60.0%, adjusted odds ratio 1.85, 95% confidence interval 1.11-3.09, p=0.02). Safety outcomes showed no significant difference between SJT and non-SJT. Conclusions: The results of this study showed the efficacy and safety of SJT in unruptured intracranial aneurysm patients treated with SAC.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"219-227"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639104","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
Intraosseous dural arteriovenous fistula draining into the diploic veins treated with transarterial embolization: A case report. 经动脉栓塞治疗硬脑膜内动静脉瘘引流至双静脉1例。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-08-21 DOI: 10.7461/jcen.2025.E2024.10.002
Midori Ichihashi, Hidesato Takezawa, Manato Sakamoto, Kengo Kishida, Shigeomi Yokoya, Hideki Oka
{"title":"Intraosseous dural arteriovenous fistula draining into the diploic veins treated with transarterial embolization: A case report.","authors":"Midori Ichihashi, Hidesato Takezawa, Manato Sakamoto, Kengo Kishida, Shigeomi Yokoya, Hideki Oka","doi":"10.7461/jcen.2025.E2024.10.002","DOIUrl":"10.7461/jcen.2025.E2024.10.002","url":null,"abstract":"<p><p>This study presents the rare case of an intraosseous dural arteriovenous fistula (DAVF) draining into the diploic veins in the left frontal bone with high-flow feeder, successfully treated with transarterial Onyx embolization. A 59-year-old male exhibited mild right hemiparalysis and aphasia without prior head trauma, surgery, or venous sinus thrombosis. Imaging identified DAVF, fed by the bilateral superficial temporal arteries, left middle meningeal artery, and left occipital artery, draining retrogradely solely through the diploic veins into the superior sagittal sinus, causing cortical venous reflux (CVR). Treatment involved Onyx embolization under flow control, preventing Onyx (Medtronic, Irvine, CA, USA) migration and achieving complete DAVF occlusion, resolving the neurological deficits. This case highlights the clinical significance of diagnosing and managing DAVF draining exclusively into the diploic veins, emphasizing the effectiveness of Onyx embolization in such cases.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884676","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
Comparison of mechanical thrombectomy alone versus post-IV t-PA thrombectomy in acute large artery occlusion within 4.5 hours of symptom onset. 急性大动脉闭塞4.5小时内机械取栓与静脉注射后t-PA取栓的比较
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-08-21 DOI: 10.7461/jcen.2025.E2025.04.004
Joonwon Lee, Hyungon Lee, Kyung-Wan Kim, Seung Hwan Kim, Yunhyeok Choi, Sung-Chul Jin
{"title":"Comparison of mechanical thrombectomy alone versus post-IV t-PA thrombectomy in acute large artery occlusion within 4.5 hours of symptom onset.","authors":"Joonwon Lee, Hyungon Lee, Kyung-Wan Kim, Seung Hwan Kim, Yunhyeok Choi, Sung-Chul Jin","doi":"10.7461/jcen.2025.E2025.04.004","DOIUrl":"10.7461/jcen.2025.E2025.04.004","url":null,"abstract":"<p><strong>Objective: </strong>Intravenous tissue plasminogen activator (IV t-PA) is commonly used as bridging therapy before mechanical thrombectomy (MT) in acute ischemic stroke. However, in practice, some patients undergo MT only after IV t-PA has been fully administered. This study aimed to compare clinical and radiological outcomes of MT only versus IV t-PA followed by MT within 4.5 hours of symptom onset.</p><p><strong>Methods: </strong>We retrospectively reviewed 190 patients with acute large artery occlusion treated with MT between January 2018 and December 2020. After excluding 53 patients ineligible for IV t-PA. A total of 137 patients were enrolled and categorized into two groups: MT only (n=82, 59.8%) and post-IV t-PA MT (n=55, 40.2%). The primary outcome was successful recanalization; the secondary outcome was a good clinical outcome at 90 days (3-month modified Rankin Scale (mRS) score of 0-2).</p><p><strong>Results: </strong>The successful recanalization rates did not significantly differ between the MT-only and post-IV t-PA MT groups (92.7% vs. 89.1%, p=0.466). Good outcomes at 90 days were not statistically different between both groups (58.5% vs. 61.8%, p=0.701). Multivariable analysis identified baseline National Institutes of Health Stroke Scale (NIHSS) score (adjusted odds ratio (OR) 0.873; 95% confidence intervals (CI), 0.806-0.946; p<0.001) and door-to-puncture time (adjusted OR 0.987; 95% CI, 0.978-0.997; p=0.009) as independent predictors of outcome.</p><p><strong>Conclusions: </strong>In our study, MT alone yielded comparable outcomes to IV t-PA followed by MT in patients treated within 4.5 hours. Direct MT may be a reasonable treatment strategy.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884675","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
Acute intraparenchymal hemorrhage caused by rupture of a traumatic pseudoaneurysm of the middle meningeal artery. 由外伤性脑膜中动脉假性动脉瘤破裂引起的急性脑实质出血。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-08-11 DOI: 10.7461/jcen.2025.E2025.04.001
Myoung Soo Kim
{"title":"Acute intraparenchymal hemorrhage caused by rupture of a traumatic pseudoaneurysm of the middle meningeal artery.","authors":"Myoung Soo Kim","doi":"10.7461/jcen.2025.E2025.04.001","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.04.001","url":null,"abstract":"","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818866","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
Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds. 颅内压阈值对蛛网膜下腔出血预后的影响。
Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-07-23 DOI: 10.7461/jcen.2025.E2025.04.003
Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng
{"title":"Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds.","authors":"Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng","doi":"10.7461/jcen.2025.E2025.04.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.04.003","url":null,"abstract":"<p><strong>Objective: </strong>Subarachnoid hemorrhage (SAH) is a severe neurological condition often associated with elevated intracranial pressure (ICP), which can impact patient outcomes. The present study aimed to evaluate the prognostic significance of ICP thresholds in predicting prognosis in SAH patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, including patients diagnosed with SAH who underwent ventriculostomy between January 2019 and December 2024. Prognostic factors were estimated from various clinical-radiographic characteristics and ICP using the Cox regression model. Additional analyses were performed to evaluate the relationship between ICP thresholds and hazard ratio by dose-response analysis.</p><p><strong>Results: </strong>A total of 110 SAH patients were included in the study. The analysis demonstrated a significant association between elevated ICP and poor outcomes (Hazard ratio (HR) 1.06, 95% CI 1.03-1.09). In multivariable analysis, ICP value was significantly associated with prognosis when the model was adjusted with pupillary light reflex (HR 1.04, 95% CI 1.01-1.08). In addition, SAH patients were divided into two groups based on the ICP cutoff value of 24 mmHg. Consequently, the group with ICP values of 24 mmHg or higher was strongly associated with poor prognosis (p-value of log-rank test=0.01).</p><p><strong>Conclusions: </strong>Our study demonstrates that elevated ICP, particularly beyond the threshold of 24 mmHg, is strongly associated with poor outcomes in SAH patients. These findings support the inclusion of ICP thresholds in prognostic assessment and underscore the need for vigilant ICP monitoring and early intervention in the neurocritical care setting.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692847","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
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