Objective: Many patients with ruptured intracranial aneurysms (RIAs) underrepresented or excluded from previous randomized controlled trials (RCTs) comparing surgery with endovascular treatment (EVT) are still considered for surgical clipping, but the best management of these patients remains unknown.
Methods: The International Subarachnoid Aneurysm Trial-2 was a randomized trial comparing surgical versus EVT of RIAs considered for surgical clipping, despite the results of previous RCTs, and also eligible for EVT. The primary endpoint was death or dependency according to the modified Rankin Scale score (mRS score > 2) at 1 year.
Background: Accurate volumetric assessment of spontaneous aneurysmal subarachnoid hemorrhage (aSAH) is a labor-intensive task performed with current manual and semiautomatic methods that might be relevant for its clinical and prognostic implications. In the present research, we sought to develop and validate an artificial intelligence-driven, fully automated blood segmentation tool for subarachnoid hemorrhage (SAH) patients via noncontrast computed tomography (NCCT) scans employing a transformer-based Swin-UNETR architecture.
Methods: We retrospectively analyzed NCCT scans from patients with confirmed aSAH utilizing the Swin-UNETR for segmentation.
Objetive: In Europe, units with Dual-trained Neurovascular Surgeons (DTNS) skilled in both open neurosurgery (ON) and endovascular neurosurgery (EN) are scarce. For instance, in Spain, our unit is unique within the public health system, where all neurovascular procedures are carried out by DTNS. Our study aims to evaluate the evolution in treating ruptured intracranial aneurysms (rICAs) and assess the impact of this evolution on clinical outcomes.
View Article and Find Full Text PDFPurpose: In an era characterized by rapid progression in neurosurgical technologies, traditional tools such as the non-navigated two-dimensional intraoperative ultrasound (nn-2D-IOUS) risk being overshadowed. Against this backdrop, this study endeavors to provide a comprehensive assessment of the clinical efficacy and surgical relevance of nn-2D-IOUS, specifically in the context of glioma resections.
Methods: This retrospective study undertaken at a single center evaluated 99 consecutive, non-selected patients diagnosed with both high-grade and low-grade gliomas.
Background: Subarachnoid hemorrhage (SAH) entails high morbidity and mortality rates. Convolutional neural networks (CNN) are capable of generating highly accurate predictions from imaging data. Our objective was to predict mortality in SAH patients by processing initial CT scans using a CNN-based algorithm.
View Article and Find Full Text PDFGlioblastoma, a highly aggressive primary brain tumor, is associated with poor patient outcomes. Although magnetic resonance imaging (MRI) plays a critical role in diagnosing, characterizing, and forecasting glioblastoma progression, public MRI repositories present significant drawbacks, including insufficient postoperative and follow-up studies as well as expert tumor segmentations. To address these issues, we present the "Río Hortega University Hospital Glioblastoma Dataset (RHUH-GBM)," a collection of multiparametric MRI images, volumetric assessments, molecular data, and survival details for glioblastoma patients who underwent total or near-total enhancing tumor resection.
View Article and Find Full Text PDFThe globally accepted surgical strategy in glioblastomas is removing the enhancing tumor. However, the peritumoral region harbors infiltration areas responsible for future tumor recurrence. This study aimed to evaluate a predictive model that identifies areas of future recurrence using a voxel-based radiomics analysis of magnetic resonance imaging (MRI) data.
View Article and Find Full Text PDFNeurocirugia (Astur : Engl Ed)
March 2023
Introduction: Carotid endarterectomy (CEA) is usually performed using the anterior cervical triangle as a surgical corridor but, when needed, the retromandibular space makes dissection of higher structures difficult in some cases. The posterior cervical triangle (PCT) can be useful in these demanding cases.
Methods: We retrospectively reviewed cases from July 2013 to November 2019 in which PCT was used as an approach for CEA.
: Survival estimation for patients diagnosed with Glioblastoma (GBM) is an important information to consider in patient management and communication. Despite some known risk factors, survival estimation remains a major challenge. Novel non-invasive technologies such as radiomics and artificial intelligence (AI) have been implemented to increase the accuracy of these predictions.
View Article and Find Full Text PDFObjective: Open surgical clipping has been generally considered the best treatment option for unruptured middle cerebral artery aneurysms (uMCAAs). However, this type of aneurysm is being treated endovascularly with the appearance of new devices. We have carried out a systematic review of randomized and quasi-experimental studies to conduct a network meta-analysis (NMA) to assess the safety and efficacy of the different treatment methods currently used in uMCAAs.
View Article and Find Full Text PDFBackground: The understanding of white matter (WM) was revolutionized by the emergence of tractography based on diffusion tensor imaging (DTI). Currently, DTI simulations are implemented in preoperative planning to optimize surgical approaches. The reliability of these simulations has been questioned and investigated seeking for correlation between neurological performance and anomalies in DTI parameters.
View Article and Find Full Text PDFClin Neurol Neurosurg
September 2022
Objectives: Brain dural arteriovenous fistulas(bDAVFs) are anomalous connections between dural arteries and cerebral veins or sinuses. Cerebral venous thrombosis(CVT) often precedes or coincides with bDAVFs and is considered a risk factor for these vascular malformations. Recently, vaccine-induced thrombotic thrombocytopenia causing CVTs has been associated with COVID-19 vaccines.
View Article and Find Full Text PDFBackground: Strain elastography is an intraoperative ultrasound (ioUS) modality currently under development with various potential applications in neurosurgery.
Objective: To describe the main technical aspects, usefulness, and limitations of ioUS strain elastography applied in a large case series of brain tumors.
Methods: We retrospectively analyzed patients who underwent craniotomy for a brain tumor between March 2018 and March 2021.
Radiomics, in combination with artificial intelligence, has emerged as a powerful tool for the development of predictive models in neuro-oncology. Our study aims to find an answer to a clinically relevant question: is there a radiomic profile that can identify glioblastoma (GBM) patients with short-term survival after complete tumor resection? A retrospective study of GBM patients who underwent surgery was conducted in two institutions between January 2019 and January 2020, along with cases from public databases. Cases with gross total or near total tumor resection were included.
View Article and Find Full Text PDFBackground: The endoscopic transorbital approach (eTOA) is a new mini-invasive procedure used to explore different areas of the skull base. Authors propose an extradural anterior clinoidectomy (AC) through this corridor, defining the anatomical landmarks of the anterior clinoid process (ACP) projection onto the posterior orbit wall and the technical feasibility of this approach. We describe the exposure of the opticocarotid region and the surgical freedom and the angles of attack obtained with this novel approach.
View Article and Find Full Text PDFBiochim Biophys Acta Mol Cell Res
July 2021
Brain tumors comprise a large series of tumor cancer from benign to highly malignant gliomas and metastases from primary tumors outside the brain. Intracellular Ca homeostasis is involved in a large series of cell functions including cell proliferation, migration, and cell death. Store-operated Ca entry (SOCE), the most important Ca entry pathway in non-excitable cells, is involved in cell proliferation and migration and enhanced in tumor cells from breast cancer, colon cancer and cell lines derived from glioblastoma but there are almost no studies in human primary glioblastoma cells or other brain tumors.
View Article and Find Full Text PDFIntraoperative ultrasound elastography (IOUS-E) is a novel image modality applied in brain tumor assessment. However, the potential links between elastographic findings and other histological and neuroimaging features are unknown. This study aims to find associations between brain tumor elasticity, diffusion tensor imaging (DTI) metrics, and cell proliferation.
View Article and Find Full Text PDFBackground: This study involves analysis of the relationship between variables obtained using diffusion tensor imaging (DTI) and motor outcome in gliomas adjacent to the corticospinal tract (CST).
Methods: Histologically confirmed glioma patients who were to undergo surgery between January 2018 and December 2019 were prospectively enrolled. All patients had a preoperative magnetic resonance imaging (MRI) study that included DTI, a tumor 2 cm or less from the CST, and postsurgical control within 48 h.
Background: The differential diagnosis of glioblastomas (GBM) from solitary brain metastases (SBM) is essential because the surgical strategy varies according to the histopathological diagnosis. Intraoperative ultrasound elastography (IOUS-E) is a relatively novel technique implemented in the surgical management of brain tumors that provides additional information about the elasticity of tissues. This study compares the discriminative capacity of intraoperative ultrasound B-mode and strain elastography to differentiate GBM from SBM.
View Article and Find Full Text PDFPurpose: Predicting the survival of patients diagnosed with glioblastoma (GBM) is essential to guide surgical strategy and subsequent adjuvant therapies. Intraoperative ultrasound (IOUS) can contain biological information that could be correlated with overall survival (OS). We propose a simple extraction method and radiomic feature analysis based on IOUS imaging to estimate OS in GBM patients.
View Article and Find Full Text PDFBackground: The consistency of meningioma is a factor that may influence surgical planning and the extent of resection. The aim of our study is to develop a predictive model of tumor consistency using the radiomic features of preoperative magnetic resonance imaging and the tumor elasticity measured by intraoperative ultrasound elastography (IOUS-E) as a reference parameter.
Methods: A retrospective analysis was performed on supratentorial meningiomas that were operated on between March 2018 and July 2020.
Objectives: Since the introduction of endovascular treatment for cerebral aneurysms, hospitals in which subarachnoid hemorrhage is treated show different availability and/or preferences towards both treatment modalities. The main aim is to evaluate the clinical and angiographic results according to the hospital's treatment preferences applied.
Methods: This study was conducted based on use of the subarachnoid hemorrhage database of the Vascular Pathology Group of the Spanish Neurosurgery Society.