Article
Clinical Neurology
Silvia Hernandez-Duran, Leonie Meinen, Veit Rohde, Christian von der Brelie
Summary: This study found that in patients with malignant cerebral infarction, an intracranial pressure (ICP) persistently above 10 mm Hg in the first 72 hours after decompressive hemicraniectomy predicts mortality. The research also calls for a redefinition of ICP thresholds for further treatment.
Article
Clinical Neurology
Maryam Said, Meltem Gumus, Annika Herten, Thiemo Florin Dinger, Mehdi Chihi, Marvin Darkwah Oppong, Cornelius Deuschl, Karsten H. Wrede, Christoph Kleinschnitz, Ulrich Sure, Ramazan Jabbarli
Summary: The study identified factors such as younger age, female sex, poor initial clinical condition, intracerebral hemorrhage, hypothyroidism, and renal comorbidity as being associated with the severity of early brain edema after aneurysm rupture. Furthermore, severe early brain edema was independently associated with the need for conservative ICP treatment, decompressive craniectomy, development of cerebral infarcts, and unfavorable outcome.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Yong -Hong Duan, Jian He, Xiao-Fei Liu, Yuan -Ding Jiang, Tao Wang, Jie Luo, Peng Xu, Yong-Dong Li, Zhen-Kun Xiao, Aihua Liu, Fei Peng, Yong -Mei Yang
Summary: The study shows that SEBES can provide good imaging support for intracranial pressure management in poor-grade aSAH patients, potentially improving DC-related decision-making and 180-day survival.
WORLD NEUROSURGERY
(2022)
Editorial Material
Medicine, General & Internal
Shankar Gopinath
Summary: Traumatic acute subdural hematomas often require emergency evacuation of the blood clot to prevent further cerebral compression and its consequences. After clot removal, the decision whether to replace the bone flap (craniotomy) or not (decompressive craniectomy) is crucial for neurosurgeons. In certain situations, the decision is relatively straightforward, such as in older individuals with atrophic brains or patients with massively swollen brains, where the bone flap should or should not be replaced.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Maryam Said, Meltem Guemues, Jan Rodemerk, Mehdi Chihi, Laurel Rauschenbach, Thiemo F. F. Dinger, Marvin Darkwah Oppong, Yahya Ahmadipour, Philipp Dammann, Karsten H. H. Wrede, Ulrich Sure, Ramazan Jabbarli
Summary: This study evaluated the association between ventricular indices and the clinical course, occurrence of complications, and outcome of aneurysmal subarachnoid hemorrhage (SAH). The results showed that higher ventricular indices and older age were associated with higher WFNS and Fisher's scores and lower SEBES score at admission. Patients with larger ventricles had shorter duration of intracranial pressure increase and less frequent need for decompressive craniectomy. Ventricular indices were independently associated with inflammatory response parameters and all primary endpoints.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Immunology
Sung-Ho Ahn, Angela Burkett, Atzhiry Paz, Jude P. Savarraj, Sarah Hinds, Georgene Hergenroeder, Aaron M. Gusdon, Xuefeng Ren, Jeong-Ho Hong, Huimahn A. Choi
Summary: The study identified serum cytokines at different time points that were independently associated with persistent CE, particularly persistent elevations of Eotaxin were associated with persistent CE after SAH.
JOURNAL OF NEUROINFLAMMATION
(2022)
Article
Clinical Neurology
Ramazan Jabbarli, Shi-Qing He, Marvin Darkwah Oppong, Annika Herten, Mehdi Chihi, Daniela Pierscianek, Philipp Dammann, Ulrich Sure, Karsten H. Wrede
Summary: The study revealed that in patients with aneurysmal subarachnoid hemorrhage, a decompressive craniectomy larger than 105 cm(2) may reduce the risk of cerebral infarcts, lower in-hospital mortality, and improve overall outcomes. Conversely, a craniectomy size smaller than 75 cm(2) may require prolonged and enhanced postoperative intracranial pressure treatment.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Article
Medicine, General & Internal
Yi-Chieh Wu, Hsiang-Chih Liao, Jang-Chun Lin, Yu-Ching Chou, Da-Tong Ju, Dueng-Yuan Hueng, Chi-Tun Tang, Kuan-Yin Tseng, Kuan-Nien Chou, Bon-Jour Lin, Shao-Wei Feng, Yi-An Chen, Ming-Hsuan Chung, Peng-Wei Wang, Wei-Hsiu Liu
Summary: This study retrospectively analyzed data from 39 patients with cerebral herniation and found that the timing of surgery, cigarette smoking, and alcohol consumption were significantly associated with the occurrence of postoperative hydrocephalus.
Review
Medicine, General & Internal
Julien N. Jost
Summary: Traumatic brain injuries continue to have a significant impact on public health globally. The role and indications of primary decompressive craniectomy (DC) in the treatment of severe traumatic brain injuries are still controversial. Secondary decompressive craniectomy is considered as a last resort option to control intracranial pressure for medically refractory intracranial hypertension. Ongoing research and trials aim to provide more refined guidelines and establish evidence-based recommendations for the management of traumatic brain injuries.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Clinical Neurology
Sirin Falconi, Alex Demopoulos, Reagan Collins, John Garza, Laszlo Nagy
Summary: This study investigated the outcomes and interventions for pediatric patients with traumatic brain injury (TBI) and cerebral herniation in a rural community. The results showed that early intervention with decompressive craniectomy improved morbidity in severe TBI patients. The study highlights the importance of aggressive surgical intervention in rural communities.
WORLD NEUROSURGERY
(2023)
Review
Clinical Neurology
Michael Veldeman, Walid Albanna, Miriam Weiss, Soojin Park, Anke Hoellig, Hans Clusmann, Raimund Helbok, Yasin Temel, Gerrit Alexander Schubert
Summary: The review summarized the diagnostic value of invasive neuromonitoring in detecting DCI, with data supporting its use in selected patients at high risk for DCI.
Article
Clinical Neurology
Kavelin Rumalla, Joshua S. Catapano, Visish M. Srinivasan, Abby Lawson, Mohamed A. Labib, Jacob F. Baranoski, Tyler S. Cole, Candice L. Nguyen, Caleb Rutledge, Redi Rahmani, Joseph M. Zabramski, Michael T. Lawton
Summary: Microsurgical treatment for aneurysmal subarachnoid hemorrhage is associated with a relatively low risk of wound infection. However, patients undergoing decompressive craniectomy may be at an increased risk for infection, necessitating additional attention and comprehensive wound care.
WORLD NEUROSURGERY
(2021)
Article
Medicine, General & Internal
Jong-Myong Lee
Summary: This study describes 7 cases of acute paraparesis caused by anterior communicating artery aneurysm rupture and evaluates the clinical and radiological factors associated with this syndrome. The results show that acute paraparesis is associated with acute hydrocephalus and global cerebral edema.
Article
Clinical Neurology
Jatinder S. Minhas, Tom J. Moullaali, Gabriel J. E. Rinkel, Craig S. Anderson
Summary: Blood pressure is an important factor in managing intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage. However, there are controversies surrounding the management of blood pressure for these conditions. Current research involves analyzing patient data to determine the strength and direction of blood pressure changes and provide recommendations for clinical practice and future research.
Article
Surgery
Tyler J. Johnston, Ian F. Hulsebos, Phillip A. Bonney, Yu-Tung Wu, Cameron A. Ghafil, Makoto Aoki, Reynold Henry, Natthida Owattanapanich, Kenji Inaba, Kazuhide Matsushima
Summary: This study compared the practice patterns and patient outcomes of severe traumatic brain injury between two study periods over the past decade. The use of decompressive craniectomy has decreased over time, while in-hospital mortality has increased and discharge to home/rehab has improved.
Article
Neuroimaging
Christoph J. Griessenauer, Alejandro Enriquez-Marulanda, Sissi Xiang, Tao Hong, Hongqi Zhang, Philipp Taussky, Ramesh Grandhi, Muhammad Waqas, Vincent M. Tutino, Adnan H. Siddiqui, Elad Levy, Christopher S. Ogilvy, Ajith J. Thomas, Christian Ulfert, Markus A. Moehlenbruch, Leonardo Renieri, Nicola Limbucci, Carmen Parra-Farinas, Jan-Karl Burkhardt, Peter Kan, Lorenzo Rinaldo, Giuseppe Lanzino, Waleed Brinjikji, Julian Spears, Erasmia Mueller-Thies-Broussalis, Monika Killer-Oberpfalzer, Civan Islak, Naci Kocer, Michael Sonnberger, Tobias Engelhorn, Mandeep Ghuman, Victor X. D. Yang, Arsalaan Salehani, Mark R. Harrigan, Ivan Radovanovic, Vitor M. Pereira, Timo Krings, Charles C. Matouk, Karen Chen, Mohammad Ali Aziz-Sultan, Mohammad Ghorbani, Clemens M. Schirmer, Oded Goren, Shamsher S. Dalal, Matthew J. Koch, Christopher J. Stapleton, Aman B. Patel, Thomas Finkenzeller, Markus Holtmannspotter, Jan Hendrik Buhk, Paul Michael Foreman, Marshall Cress, Robert Hirschl, Wolfgang Reith, Andreas Simgen, Hendrik Janssen, Thomas R. Marotta, Adam A. Dmytriw
Summary: This study compared PED and FRED for the treatment of unruptured posterior circulation aneurysms and found no significant differences in aneurysm occlusion or neurological complications between the two devices. However, there were variations in functional outcomes, indicating the need for further investigations.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2021)
Article
Neuroimaging
Justin R. Mascitelli, Michael R. Levitt, Christoph J. Griessenauer, Louis J. Kim, Bradley Gross, Adib Abla, Ethan Winkler, Brian Jankowitz, Ramesh Grandhi, Oded Goren, Clemens M. Schirmer
Summary: The multicenter experience using the transcirculation approach for stent-assisted coiling of intracranial aneurysms showed low complication rates and good clinical outcomes, demonstrating its effectiveness for a variety of aneurysms.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2021)
Article
Neuroimaging
Robert M. Starke, Min S. Park, Richard Bellon, Bradley Bohnstedt, Clemens M. Schirmer, Reade De Leacy, David Fiorella, Albert J. Yoo, Alejandro M. Spiotta
Summary: Over a period of more than two years, 851 patients from 66 North American centers underwent endovascular coil embolization of saccular aneurysms using the Penumbra SMART Coil System. The results demonstrate the adequate safety profile of the system for treating cerebral aneurysms in routine clinical practice.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Article
Neuroimaging
Ching-Jen Chen, Reda Chalhoub, Dale Ding, Jeyan S. Kumar, Natasha Ironside, Ryan T. Kellogg, Bradford B. Worrall, Andrew M. Southerland, Pascal Jabbour, Stacey Q. Wolfe, Adam S. Arthur, Nitin Goyal, Isabel Fragata, Ilko Maier, Charles Matouk, Jonathan A. Grossberg, Peter Kan, Clemens M. Schirmer, R. Webster Crowley, William J. Ares, Christopher S. Ogilvy, Ansaar T. Rai, Michael R. Levitt, Maxim Mokin, Waldo R. Guerrero, Justin R. Mascitelli, Albert J. Yoo, Richard Williamson, Andrew Walker Grande, Roberto Javier Crosa, Sharon Webb, Marios N. Psychogios, Robert M. Starke, Alejandro M. Spiotta, Min S. Park
Summary: This study compared the clinical outcomes of stroke patients treated with mechanical thrombectomy achieving mTICI 2c versus 3, and found that complete and near-complete reperfusion after MT had comparable outcomes in patients with acute stroke.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Article
Clinical Neurology
James P. Caruso, Owoicho Adogwa, Catherine Mazzola, Michael Steinmetz, Scott D. Simon, Clemens M. Schirmer
Summary: The survey conducted by the Council of State Neurosurgical Societies from 2008 to 2013 found that respondents in 2013 felt more prepared in certain neurosurgery techniques and socioeconomic skills, but less prepared in open vascular neurosurgery techniques. Most respondents believe that additional work is needed to optimize training in endovascular procedures and the socioeconomic aspects of neurosurgery practice.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
James P. Caruso, Karin Swartz, Catherine Mazzola, Vin Shen Ban, Ravi Singh, Cody Eldridge, Clemens Schirmer, Joseph Cheng, Andrew M. Bauer, Michael Steinmetz, Owoicho Adogwa
Summary: The COVID-19 pandemic has resulted in decreases in patient and procedural volume, as well as physician compensation, while practice expenses remain stable. Significantly more respondents in the Northeast region noted declines in procedural volume and reassignment to non-neurosurgical COVID-related medical duties. Further analysis is needed as the pandemic continues to evolve and the long-term clinical and economic implications become clearer.
WORLD NEUROSURGERY
(2021)
Article
Neuroimaging
Fawaz Al-Mufti, Clemens M. Schirmer, Robert M. Starke, Neeraj Chaudhary, Reade De Leacy, Stavropoula Tjoumakaris, Neil Haranhalli, Isaac Josh Abecassis, Krishna Amuluru, Ketan R. Bulsara, Steven W. Hetts
Summary: Mechanical thrombectomy can be effective for treating ELVO in ischemic stroke in special populations such as those over 80, under 18, with thrombocytopenia, pregnant, or with endocarditis. While outcomes may not be as favorable as in younger or normal platelet count patients, there is still potential benefit, especially in the elderly. Limited data is available for patients with collagen vascular diseases, but in carefully selected cases, MT may still be appropriate.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Article
Clinical Neurology
Philipp Hendrix, Itay Melamed, Malie Collins, Noah Lieberman, Vaibhav Sharma, Oded Goren, Ramin Zand, Clemens M. Schirmer, Christoph J. Griessenauer
Summary: The 24-hour NIHSS is a strong predictor for 90-day functional outcome following mechanical thrombectomy, especially when the NIHSS score is ≤ 8. Younger age and lower NIHSS score are independently associated with favorable functional outcome. However, factors such as older age, higher baseline NIHSS, and coexisting comorbidities may negate this relationship despite achieving a low 24-hour NIHSS score.
CLINICAL NEURORADIOLOGY
(2022)
Article
Clinical Neurology
Philipp Hendrix, Monika Killer-Oberpfalzer, Erasmia Broussalis, Itay Melamed, Vaibhav Sharma, Sebastian Mutzenbach, Slaven Pikija, Malie Collins, Noah Lieberman, Constantin Hecker, Oded Goren, Ramin Zand, Clemens M. Schirmer, Eugen Trinka, Christoph J. Griessenauer
Summary: Nonagenarians undergoing mechanical thrombectomy showed similar revascularization and intracranial hemorrhage rates to octogenarians and younger age groups, but significantly different functional outcomes and mortality rates when compared to those aged under 80 years.
CLINICAL NEURORADIOLOGY
(2022)
Article
Clinical Neurology
Alejandro M. Spiotta, Min S. Park, Richard J. Bellon, Bradley N. Bohnstedt, Clemens M. Schirmer, Reade A. De Leacy, David J. Fiorella, Albert J. Yoo, Travis M. Dumont, Robert M. Starke
Summary: The study is a prospective investigation on the treatment of intracranial aneurysms using Penumbra SMART COIL System, with results demonstrating good technical success and occlusion rates in a real-world setting.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Nitin de Agarwal, Stephanie M. Casillo, Gary Simonds, Andrew Wakefield, Jeremy Phelps, Mark E. Linskey, Randy Bell, Omar Zalatimo, S. Hassan Akbari, Matthew Decker, Michael J. Benko, Ciara Harraher, Vincent Wang, Bharat Guthikonda, Kristopher T. Kimmell, Richard Menger, Joshua M. Rosenow, Jeffrey Cozzens, Clemens Schirmer
Summary: In the modern healthcare system, successful delivery of high-value patient care relies on collaborative professional relationships among healthcare team members. This article discusses the socio-economic implications of professional relationships within care delivery systems and potential employment models.
WORLD NEUROSURGERY
(2021)
Article
Neuroimaging
Reade De Leacy, Sameer A. Ansari, Clemens M. Schirmer, Daniel L. Cooke, Charles J. Prestigiacomo, Ketan R. Bulsara, Steven W. Hetts
Summary: The multidisciplinary evaluation and treatment of brain AVMs are evolving. Recommendations include using digital subtraction catheter cerebral angiography in pre-treatment assessment (I, B-NR), endovascular embolization within a complete multidisciplinary treatment plan aiming for obliteration (I, B-NR), and preoperative embolization to reduce blood loss and surgical complexity (IIa, B-NR).
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2022)
Article
Clinical Neurology
James P. Caruso, Ravinderjit Singh, Catherine Mazzola, Cody M. Eldridge, Sai Chilakapati, Palvasha Deme, Karin Swartz, Clemens M. Schirmer, Kristin Huntoon, Joseph Cheng, Michael Steinmetz, Owoicho Adogwa
Summary: This study provides a comparative analysis of racial and ethnic representation in different medical subspecialties, highlighting the significant disparities in neurosurgery. Initiatives are recommended to increase minority participation in neurosurgery practice and scholarship.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
P. Hendrix, M. K. Collins, O. Goren, G. M. Weiner, S. S. Dalal, I. Melamed, M. J. Kole, C. J. Griessenauer, A. Noto, C. M. Schirmer
Summary: This study compared the femoral access-site complication rates of tenecteplase and alteplase before mechanical thrombectomy for large-vessel-occlusion stroke. The results showed that there was no significant difference in access-site complications between the two drugs.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Article
Neuroimaging
Clemens M. Schirmer, Ketan R. Bulsara, Fawaz Al-Mufti, Neil Haranhalli, Lucie Thibault, Steven W. Hetts
Summary: Management of antiplatelet and antithrombotic medication before, during, and after neurointerventional procedures is highly variable. This document provides updated recommendations based on specific pathologies and comorbidities. It emphasizes the need for individualized treatment and further research to support these recommendations.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)