Vascular Neurosurgery Research Papers - Academia.edu (original) (raw)

After the senior author took chairmanship in Helsinki University Hospital in, he led the department into making neurosurgical operations much faster, safer and workflow more efficient, and at the same time maintaining high surgical quality and results. The aim was to describe the philosophies and style of Helsinki Microneurosurgery. The philosophies of Helsinki Neurosurgery are categorized into two concepts: The operation room TEAM concept and the main principle "Simple, clean, fast and respecting the normal anatomy". The way to be efficient is to find good methods based on logic, reason and experience. Specific and systematic procedures before the microneurosurgery followed by high quality skills under the microscope are of utmost importance. Moreover, intraoperatively, neuroanesthesia has to provide good surgical conditions. Today, Helsinki University Central hospital Department of Neurosurgery has an annual workflow 3500 neurosurgical operations. We believe that microneurosurgical treatment remains to be important for years ahead, and neurosurgeons of great hearts, minds and skills are welcomed all over the world.

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- Surgery, Neurosurgery, Revolutions, Microsurgery

Introducción: Con el advenimiento de las técnicas endovasculares para el tratamiento de los aneurismas intracraneales, cada vez se operan con menos frecuencia mediante craneotomía y clivaje. Nuestro grupo ha diseñado una conducta a seguir en dichas lesiones de acuerdo al estado neurológico de ingreso del paciente, condiciones generales y aparición de lesiones secundarias al sangrado. Todo esto respaldado con literatura y experiencia propia. Material y métodos: Durante los últimos cinco años hemos operado 140 aneurismas de circulación anterior en 126 pacientes, 74 mujeres y 52 hombres. Los sitios más frecuentes son bifurcación de arteria cerebral media en primer lugar, seguido por los del complejo carótida-comunicante posterior y por último el del

- by Boris Zurita Cueva
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- Vascular Neurosurgery

Background: Sylvian fissure arteriovenous malformations are rare but important vascular lesions, whose importance lies in both haemorrhage and seizure risk. Although surgery has been recommended as a treatment, the overall estimation of success has not been reported to render outcomes easier to understand in comparison to other treatment modalities. Objectives: This systematic review of the literature and two cases aims to illustrate the results of surgery as a contemporary treatment option and present a novel anatomical classification system for Sylvian fissure arteriovenous malformations. Materials and methods: A systematic review was performed by searching MEDLINE (PubMed), EMBASE and Cochrane electronic bibliographic databases from conception to 2018. The following keywords were used: 'Sylvian fissure' AND 'AVM' OR 'arteriovenous malformation' OR 'intracranial arteriovenous malformation' OR 'cerebral arteriovenous malformation' OR 'brain arteriovenous malformation'. The search strategy was not limited by study design but only included keywords in the English language. In addition, two local institution Sylvian fissure arteriovenous malformations are presented and incorporated. Results: A total of nine full-text articles were included in the analysis. The results of reported cases and the literature review emphasise the role of surgery in the treatment of Sylvian fissure arteriovenous malformations, with an acceptable result in carefully selected patients. We propose a classification system which may inform the choice of surgical approach for these lesions. Conclusions: Surgery remains the cornerstone of Sylvian fissure arteriovenous malformation treatment, which may apply to high-grade lesions in this special anatomical location.

- by Adam A Dmytriw and +1
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- Neurosurgery, Neuroradiology, Interventional Neuroradiology, Vascular Neurosurgery

As the incidental diagnosis of unruptured intracranial aneurysms has been increasing, several scores were developed to predict risk of rupture and growth to guide the management choice. We retrospectively applied these scores to a multicenter series of patients with subarachnoid hemorrhage to test whether they would have predicted the risk of bleeding in the event of aneurysm discovery previous to its rupture. Demographical, clinical, and radiological information of 245 adults were retrieved from two neurovascular centers' database. Data were pooled and PHASES, UCAS, and ELAPSS scores were retrospectively calculated for the whole population and their performances in identifying aneurysms at risk of rupture were compared. Mean PHASES, UCAS, and ELAPSS scores were 5.12 ± 3.08, 5.09 ± 2.62, and 15.88 ± 8.07, respectively. Around half (46%) of patients would have been assigned to the low-or very low-risk class (5-year rupture risk < 1%) in PHASES. Around 28% of patients would have been in a low-risk class, with a probability of 3-year rupture risk < 1% according to UCAS. Finally, ELAPSS score application showed a wider distribution among the risk classes, but a significant proportion of patients (45.5%) lie in the low-or intermediate-risk class for aneurysm growth. A high percentage of patients with ruptured aneurysms in this multicenter cohort would have been assigned to the lower risk categories for aneurysm growth and rupture with all the tested scores if they had been discovered before the rupture. Based on these observations, physicians should be careful about drawing therapeutic conclusions solely based on application of these scores.

- by Kristy Latour
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- Neurosurgery, Subarachnoid hemorrhage, Vascular Neurosurgery, Intracranial aneurysm

Vestibular paroxysmia is defined as paroxysms of vertigo that could be presented with paroxysmal pulsatile tinnitus.
It is usually caused by neurovascular compression of the vestibulocochlear nerve. The condition is responsive to
carbamazepine. Refractory cases are treated with microvascular decompression. We present a case of vestibular
paroxysmia of 27 years old patient that was her main presentation is tinnitus in addition to vertigo. She was treated with
microvascular decompression (MVD).