A long-term study of durability and risk factors for aneurysm recurrence after microsurgical clip ligation.

OBJECTIVE With the recent evolution of endovascular therapies, objective evaluation of the efficacy of clip ligation for cerebral aneurysms should be performed. This study was undertaken to evaluate the durability of microsurgical clip ligation, identify risk factors for recurrence, and assess the need for long-term follow-up imaging. METHODS A retrospective review of medical records identified 616 consecutive patients (156 male and 460 female patients; mean age 48.

Surgical treatment of 127 anterior choroidal artery aneurysms: a cohort study of resultant ischemic complications.

Background: The anterior choroidal artery (AChA) supplies important areas of the nervous system, particularly the posterior limb of the internal capsule and optic radiation. Treatment of AChA aneurysms poses particular challenges because of the complex anatomy of the aneurysm associated with the relatively small diameter of AChAs, making preservation of the parent vessel during clip ligation or endosaccular coiling challenging.

Objective: To investigate the incidence and features of ischemia in treatment of AChA aneurysms.

Risk of hemorrhage from de novo cerebral aneurysms.

Object: A small percentage of patients will develop a completely new or de novo aneurysm after discovery of an initial aneurysm. The natural history of these lesions is unknown. The authors undertook this statistical evaluation a large cohort of patients with both ruptured and unruptured de novo aneurysms with the aim of analyzing risk factors for rupture and estimating a risk of subarachnoid hemorrhage (SAH).

Trends over time in the management of 2253 patients with cerebral aneurysms: A single practice experience.

Background: To better understand the longitudinal trend in the proportion of techniques employed for cerebral aneurysm treatment, we reviewed our experience with 2253 patients over the last 11 years.

Methods: We reviewed data in our prospective aneurysm database for all consecutive patients treated from January 1998 through December 2009. Data regarding age, sex, aneurysm location, presence or absence of hemorrhage, Fisher grade, clinical grade, treatment methods, length of hospitalization, and mortality rates by the time of discharge were retrieved and retrospectively analyzed.

Middle cerebral artery aneurysms in children: case series and review.

Object: Pediatric intracranial aneurysms are rare lesions that differ from their adult counterparts. Aneurysms involving the middle cerebral artery (MCA) are particularly challenging to treat in children, as they are often fusiform and cannot undergo direct clipping alone. The authors recently treated a patient with a heavily calcified, dysplastic, left-sided MCA aneurysm.

Endovascular treatment and radiographic follow-up of proximal traumatic intracranial aneurysms in adolescents: case series and review of the literature.

Purpose: Traumatic intracranial aneurysms are rare lesions that are relatively more common in the pediatric population. Proximal traumatic aneurysms occur near the skull base. Direct surgical repair of these lesions is difficult due to the anatomically confined area, clinical status of a head injury patient, and the transmural nature of the injury.

Endovascular retrograde suction decompression as an adjunct to surgical treatment of ophthalmic aneurysms: analysis of risks and clinical outcomes.

Objective: Endovascular retrograde suction decompression with balloon occlusion of the internal carotid artery is a useful adjunct in the surgical treatment of ophthalmic aneurysms. This technique helps establish proximal control, facilitates intraoperative angiography, and may aid dissection by evacuating blood and softening the aneurysm. Although the technical aspects of this procedure have been described, the published data on its safety are scant.

Results, outcomes, and follow-up of remnants in the treatment of ophthalmic aneurysms: a 16-year experience of a combined neurosurgical and endovascular team.

Objective: Ophthalmic aneurysms present unique challenges to a vascular team. This study reviews the 16-year experience of a multidisciplinary neurovascular service in the treatment, complications, outcomes, and follow-up of patients with ophthalmic aneurysms from 1990 to 2005.

Methods: A retrospective analysis of prospectively collected data of 134 patients with 157 ophthalmic aneurysms is presented.

Histologically benign intraventricular meningioma with concurrent pulmonary metastasis: case report and review of the literature.

Only 1-2% of all meningiomas are intraventricular in location. Metastasis from a histologically "benign" meningioma is a rare, but well-documented event. However, there are only four reported cases in the literature of metastatic spread from a purely intraventricular meningioma.

Analysis of intraoperative rupture in the surgical treatment of 1694 saccular aneurysms.

Objective: Intraoperative rupture (IOR) of an aneurysm is a known risk in the surgical management of intracranial aneurysms. The purpose of this study was to determine the incidence of IOR in a modern surgical series and to assess which factors bear upon it.

Methods: This study retrospectively examined 1269 patients with saccular aneurysms treated surgically between 1986 and 1998.

Efficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial.

Object: Catheter-related infection of the cerebrospinal fluid (CSF) pathways is a potentially life-threatening complication of external ventricular drainage. A major source of infection is bacterial contamination along the external ventricular drain (EVD) catheter track. The authors examined the efficacy of EVD catheters impregnated with minocycline and rifampin in preventing these catheter-related infections.