Incidence of contrast-induced neurotoxicity following endovascular treatment of unruptured intracranial aneurysms: a single-centre cohort study.

Background: Contrast-induced neurotoxicity (CIN) is a recognised complication of endovascular procedures and has been increasingly observed in recent years. Amongst other clinical gaps, the precise incidence of CIN is unclear, particularly following intracranial interventional procedures.

Methods: A retrospective study of consecutive patients undergoing elective endovascular treatment of unruptured intracranial aneurysms (UIAs) was performed.

Neuroradiological features of contrast-induced neurotoxicity: A systematic review and pooled analysis.

Background: Contrast-induced neurotoxicity (CIN), is an increasingly recognised complication of endovascular procedures, presenting as a spectrum of neurological symptoms that mimic ischaemic stroke. The diagnosis of CIN remains a clinical challenge, and stereotypical imaging findings are not established. This study was conducted to characterise the neuroimaging findings in patients with CIN, to raise diagnostic awareness and improve decision making.

Clinical management of contrast-induced neurotoxicity: a systematic review.

Background: Contrast-induced neurotoxicity (CIN) is an increasingly recognised complication following endovascular procedures utilising contrast. It remains poorly understood with heterogenous clinical management strategies. The aim of this review was to identify commonly employed treatments for CIN to enhance clinical decision making.

Current knowledge and perspectives of contrast-induced neurotoxicity: A survey of Australian clinicians.

Background: Contrast-induced Neurotoxicity (CIN) is an increasingly recognised complication following endovascular procedures. It remains a relatively unexplored clinical entity, and we sought to characterise clinician perspectives towards CIN, as well as identify gaps in knowledge and provide directions for future research.

Methods: An online survey was distributed to members of the Australian and New Zealand Society of Neuroradiology, as well as several Australian tertiary hospitals.

Safety and effectiveness of spinal dural defect repair in the management of superficial siderosis: A systematic review and patient-level analysis.

Objective: Superficial siderosis (SS) is a disabling neurodegenerative condition that may be caused by spinal dural defects. Surgical repair is increasingly performed, however clinical outcomes remain unclear.

Methods: A systematic search of PubMed, MEDLINE, and EMBASE was conducted (inception to February 2020).

Is it time to rethink microsurgical training for the treatment of intracranial aneurysms in Australia?

Background: Case volume and complexity for microsurgical treatment of cerebral aneurysms have changed due to the growing use of endovascular therapy in clinical practice. The authors sought to quantify the clinical exposure of Australian neurosurgery trainees to cerebral aneurysm microsurgery.

Methods: This observational, retrospective cross-sectional study examined the Australian National Hospital Morbidity database for all admissions related to microsurgical and endovascular treatment of aneurysmal subarachnoid haemorrhage (aSAH) and unruptured intracranial aneurysms (UIAs) for the years 2008 to 2018.

Cytoreductive Surgery for Primary Central Nervous System Lymphoma: Is it time to consider extent of resection?

Background: Cytoreductive surgery for Primary Central Nervous System Lymphoma (PCNSL) is controversial and is not routinely practiced. Cumulative literature in recent years, however, suggests a potential survival benefit associated with a greater extent of resection.

Methods: A retrospective single institution cohort analysis of 58 consecutive patients with PCNSL was conducted between January 2011 and December 2020.

Cumulative Time of Cigarette Smoking Is Associated with a Greater Risk of Aneurysmal Subarachnoid Hemorrhage and Younger Age at Presentation: A Nationwide Observation Study.

Background: Smoking is known to be associated with an increased risk of intracranial aneurysm rupture; however, the risk in smokers stratified by age, sex, and aneurysm location is not clear.

Methods: A retrospective study of all aneurysmal subarachnoid hemorrhage (aSAH) cases in Australia between 2008 and 2018 was conducted. The relative risk of aSAH in smokers compared with nonsmokers was calculated on the basis of nationwide smoking statistics and was stratified according to sex, age group, and aneurysm location.

Aneurysmal subarachnoid haemorrhage in Indigenous and non-Indigenous Australians: A retrospective study assessing patient characteristics and outcome.

Introduction: Smoking and hypertension are prevalent among Indigenous Australians (Aboriginal and Torres Strait Islanders). We investigated if these risk factors suggest a greater rate of aneurysmal subarachnoid haemorrhage in Indigenous Australians (IA) compared to non-IA.

Materials And Methods: A retrospective cross-sectional study was performed on data retrieved from the Nationwide Hospital Morbidity Database for all aSAH cases in Australia between 2012 and 2018.

A Meta-Analysis of Rupture Risk for Intracranial Aneurysms 10 mm or Less in Size Selected for Conservative Management Without Repair.

Background: Small unruptured intracranial aneurysms (UIAs) are considered to have low risk of rupture. The proportion of UIAs measuring 10 mm or less in size that rupture when selected for conservative management without repair is not well known. The aim of this study is to determine the proportion of UIAs that rupture by size threshold from ≤10 to ≤3 mm when selected for management without repair and to determine the level of precision and sources of heterogeneity in the rupture risk estimate.

Influence of socioeconomic status on the incidence of aneurysmal subarachnoid haemorrhage and clinical recovery.

Background: The relevance of socioeconomic status (SES) on the incidence of aneurysmal subarachnoid haemorrhage (aSAH) and discharge functional outcomes following treatment is not clear.

Methods: A retrospective cross-sectional study was performed on data retrieved from the Nationwide Hospital Morbidity Database for all aSAH cases in Australia between 2012 and 2018. Information on patient characteristics, procedures performed, discharge disposition and SES were extracted.

Adherence to evidence-based processes of care reduces one-year mortality after aneurysmal subarachnoid hemorrhage (aSAH).

Background: There is limited research on the provision of evidence-based care and its association with outcomes after aneurysmal subarachnoid hemorrhage (aSAH).

Aims: We examined adherence to evidence-based care after aSAH and associations with survival and discharge destination. Also, factors associated with evidence-based care including age, sex, Charlson comorbidity index, severity scores, and delayed cerebral ischemia and infarction were examined for association with survival and discharge destination.

Predictive Relevance of Early Temperature Elevation on the Risk of Delayed Cerebral Ischemia Development Following Aneurysmal Subarachnoid Hemorrhage.

Background: Fever in aneurysmal subarachnoid hemorrhage (aSAH) has been associated with delayed cerebral ischemia (DCI), but its relevance in risk stratification has not been explored. This study investigated whether early temperature elevation following aSAH predicts impending clinical deterioration caused by DCI.

Methods: Relevant cases were identified from a prospectively maintained database for consecutive patients with aSAH treated at our center between July 2015 and January 2020.

Natural history and surgical management of spontaneous intracerebral hemorrhage: a systematic review.

Introduction: Management of spontaneous intracerebral hemorrhage (ICH) remains controversial despite efforts to produce high level evidence in the past few years. We systematically examined the pooled literature data on the natural history and surgical management of ICH.

Evidence Acquisition: A systematic review was performed using the PubMed and Embase databases, encompassing English, full-text articles, reporting treatment outcomes for the conservative and surgical management of ICH.

Incidence and Case-Fatality of Aneurysmal Subarachnoid Hemorrhage in Australia, 2008-2018.

Background: Contemporary aneurysmal subarachnoid hemorrhage (aSAH) and case-fatality studies have suggested a diminishing worldwide incidence. The purpose of this study was to examine whether such epidemiologic trends occur in Australia.

Methods: This retrospective cross-sectional study was based on data retrieved from the Nationwide Hospital Morbidity Database for all aSAH cases across hospital networks in Australia between 2008 and 2018.

Spinal Pleomorphic Xanthoastrocytoma: Case Report and Literature Review.

Pleomorphic xanthoastrocytoma (PXA) is an uncommon central nervous system neoplasm with an overall favorable survival prognosis. Metastatic spread of PXA to the spinal cord and the cauda equina is rare and may have a different clinicopathologic course. Treatment and prognostic outcomes, in this context, are not well defined.

Asymptomatic Intracranial Aneurysms in the Elderly: Long-Term Clinical and Radiologic Follow-Up of 193 Consecutive Patients.

Background: Evidence is lacking regarding the role of radiologic surveillance for asymptomatic intracranial aneurysms (AIAs) in the elderly (≥65 years). We sought to establish if long-term clinical and radiologic observation is warranted for older patients with AIAs.

Methods: A retrospective cohort of 193 consecutive patients with 255 AIAs were clinically and radiologically observed between January 2011 and January 2019.

Hearing Improvement Following Middle Cranial Fossa Floor Defect Repair Utilizing a Modified Middle Fossa Approach and Reconstructive Techniques.

Background: Few studies report hearing preservation following middle cranial fossa (MCF) floor defect repair.

Objective: To investigate audiological outcomes following MCF floor defect repair using a modified MCF suprapetrous approach.

Study Design: Retrospective cohort.

Glioblastoma Presenting as Spontaneous Subarachnoid Hemorrhage: Technical Case Note of Combined Endovascular and Microsurgical Vision-Sparing Treatment.

Background: Clinical utility of endovascular adjunct for tumor resection is well established, but its role in acute subarachnoid hemorrhage secondary to neoplastic pseudoaneurysm rupture has not been reported.

Case Description: We discuss a 46-year-old patient presenting with a World Federation of Neurological Surgeons grade 1 subarachnoid hemorrhage from a ruptured posterior cerebral artery pseudoaneurysm due to glioblastoma tumor invasion.

Conclusions: A combined targeted endovascular embolization with microsurgical resection to spare the calcarine artery was used to avoid disruption to the optic radiation fiber pathway.

Primary intradural extramedullary Ewing sarcoma of the cervical spine: A case report and review of the literature.

Spinal intradural Ewing sarcoma (ES) of the cervical region is not common. Few cases have been reported and optimal management remain poorly defined. We described a case of a young woman with extensive primary leptomeningeal spinal ES and conducted a review of the literature.

Influence of comorbidities on treatment of unruptured intracranial aneurysms in the elderly.

Current evidence does not conclusively justify conservative management of unruptured intracranial aneurysms (UIA) in the elderly (age ≥ 65 years). To rationalise intervention, the authors investigated the role of age and comorbidity burden on treatment outcomes. A retrospective chart review for consecutive cases of UIAs treated in the elderly between 2007 and 2018 was performed.

Natural history of incidental colloid cysts of the third ventricle: A systematic review.

Objective: Clinical significance and management of asymptomatic colloid cysts of the third ventricle is not well defined. The aim of this study was to investigate the risk of cyst progression necessitating surgical intervention during a surveillance period.

Methods: A systematic pooled analysis of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Ruptured Distal Anterior Choroidal Artery Aneurysm Presenting as Isolated Intraventricular Hemorrhage: Case Report and Comprehensive Review of the Literature.

Distal anterior choroidal artery (AChA) aneurysms are infrequent. We discuss the case of a 59-year-old patient who presented with an isolated intraventricular hemorrhage (IVH) secondary to a ruptured distal AChA aneurysm. Initial noninvasive cerebral computed tomography angiography revealed no evidence of an underlying vascular pathology.

Neonatal intracranial aneurysms: case report and review of the literature.

Intracranial aneurysms in the neonate, presenting in the first 4 weeks of life, are exceedingly rare. They appear to have characteristics, including presentation and location, that vary from those found in adults. The authors present a case of a 28-day-old neonate with a ruptured distal middle cerebral artery (MCA) aneurysm.