Background and Purpose: We report on workflow and process-based performance measures and their effect on clinical outcome in Solitaire FR Thrombectomy for Acute Revascularization (STAR), a multicenter, prospective, single-arm study of Solitaire FR thrombectomy in large vessel anterior circulation stroke patients.
Background and Purpose: The Capillary Index Score (CIS) is a simple angiography-based scale for assessing viable tissue in the ischemic territory. We retrospectively applied it to Interventional Management of Stroke (IMS) trials I and II to evaluate the predictive value for good outcomes.
Background and Purpose: In acute ischemic stroke patients treated by intravenous thrombolysis, a diffusion-weighted imaging (DWI) Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is an independent factor of functional outcomes. Our aim was to assess the impact of pretreatment DWI-ASPECTS on outcomes after endovascular therapy, with a specific emphasis on recanalization.
Background and Purpose: High revascularization rates in large-vessel occlusion strokes treated by mechanical thrombectomy are not always associated with good clinical outcomes. We evaluated predictors of functional dependence despite successful revascularization among patients with acute ischemic stroke treated with thrombectomy.
Atherosclerotic stenosis of the internal carotid artery accounts for 10% to 15% of all strokes. For symptomatic patients with significant extracranial carotid stenosis, prior trials have found better outcomes after carotid endarterectomy (CEA) compared with best medical therapy.1-5 Numerous studies have assessed endovascular treatment (angioplasty with or without stenting) as an alternative to CEA.6-10 More recently, randomized trials comparing stenting with CEA for symptomatic carotid stenosis found that stenting was associated with a higher risk of stroke but lower rates of myocardial infarction, access site hematoma, and cranial nerve palsy.
BACKGROUND: Intracranial artery dissections (IADs) are an important cause of stroke or subarachnoid hemorrhage (SAH). Outcome of IAD in the anterior circulation or presentation without SAH is rarely investigated and might be different.
Abstract: Clinical prediction and decision rules use evidence-based medicine to assist clinicians in diagnosing and treating illness. Although widespread in modern medical practice, there are relatively few clinical rules for neurosurgical conditions. This article reviews the background of how clinical prediction and decision rules are derived, validated, evaluated, and used in practice. It also summarizes a list of clinical rules published for neurosurgical illnesses and analyzes each rule for how it was derived and whether it was validated and/or evaluated compared with similar rules. It reports on whether the implementation of each rule was studied and grades the overall quality of each report.
Case series identifying chronic traumatic encephalopathy (CTE) in former athletes and military veterans have been, and continue to be, reported. Recently, there have also been substantial descriptions of the neuropathological similarities and differences between CTE and other neurodegenerative diseases such as Alzheimer disease (AD). Finally, there is growing evidence that neurodegenerative diseases, including Parkinson disease (PD), afflict those with a history of head trauma and blast exposure at higher rates than the general population.
Over the past century, craniotomy and resection of both the tumor resection and its dural base has become the preferred approach for the majority of symptomatic patients with skull base meningiomas.
The concept of flow diversion seems intuitive for the treatment of vascular disease. Flow diversion is stenting in a way that truly reconstructs the parent vessel, encouraging flow within the true vessel lumen and restricting it from surrounding pathology. This technique is possible because of the tightly braided nature of flow-diverting stents (30%-35% metal surface area coverage).
Residual and recurrent aneurysms are difficult quandaries for patients and clinicians because curative occlusion is not achieved and a decision about retreatment must be made, weighing the risks of rupture from a partially treated aneurysm against the risks of further intervention, which can be exponentially more challenging than an untreated aneurysm.
The clinical significance of remnants or recurrences of treated intracranial aneurysms is not a new concern for vascular neurosurgeons. However, in the endovascular era of aneurysm treatment, there has been more focus on this problem. It should be noted, first and foremost, that not all aneurysm remnants are created equally.
The anterior communicating artery (ACoA) is a common location for both ruptured and unruptured aneurysms. As with the treatment of all intracranial aneurysms, microsurgical clip occlusion has long represented the traditional and time-tested method of treatment. However, with the evolution of endovascular technology and improvements in catheter design that allowed easier access to the ACoA complex, coiling for lesions in this location became safer, with early series demonstrating good results.
OBJECT: The authors review their ventriculoperitoneal (VP) shunt revisions over a 3-year period to determine the rate of intraventricular hemorrhage (IVH) and subsequent need for re-revision.
OBJECT: Although stereotactic radiosurgery (SRS) has been accepted as a therapeutic option for arteriovenous malformations (AVMs) in children and adolescents, substantial data are still lacking regarding the outcomes of SRS for AVMs in this age group, especially long-term complications. This study aimed to clarify the long-term outcomes of SRS for the treatment of AVM in pediatric patients aged ≤ 18 years.
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