Publications by authors named "Thomas Fodor"
Background: Multiple factors have been proposed to affect the vessel ingrowth from the superficial temporal artery (STA) after Encephalo-Duro-Arterio-Synangiosis (EDAS).
Methods: This retrospective single-center analyses included patients with Moyamoya Disease (MMD) undergoing EDAS from January 1st, 2013, to December 31st, 2023. Evaluated variables included demographic characteristics, clinical presentation, technical details, modified Rankin Scale (mRS) scores, and radiographic outcomes.
Objective: As endovascular interventions become safer and their use more prevalent for treating extracranial pseudoaneurysms, fewer pseudoaneurysms are treated with medical therapy alone. This study aimed to assess the indications for intervention and the safety of medical management.
Methods: A dual-center retrospective analysis was conducted on patients diagnosed with extracranial carotid and vertebral pseudoaneurysms between December 2006 and June 2023.
Background: The Matsushima grade has traditionally been used to evaluate vessel ingrowth from the superficial temporal artery after encephalo-duro-arterio-synangiosis (EDAS) for Moyamoya disease (MMD) patients. However, this grading is subjective and prone to measurement variability. Herein, we propose the orbital grading system quantifying leptomeningeal and burr hole-related vessel-ingrowth from the superficial temporal artery and/or middle meningeal artery to the middle and anterior cerebral arteries post EDAS in MMD patients.
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- Thromboembolic (TE) events, which can arise even with proper dual antiplatelet therapy, are serious complications following flow diversion (FD) procedures used to treat aneurysms, leading to significant morbidity and mortality.
- A study was conducted on 651 FD procedures in 591 patients from 2013 to 2023, revealing a TE event rate of 5.8%, with permanent deficits in 20 patients and 4 fatalities linked to vascular occlusions.
- Factors such as aspirin resistance, age, and aneurysm characteristics were identified as predictors for the occurrence of TE events, particularly highlighting the high morbidity associated with large-vessel occlusions in the middle cerebral artery.
Background: Factors impacting the rate of aneurysm occlusion after flow diversion (FD) have been well described in the literature. In this article, we sought to evaluate those variables to develop and validate a scoring system predicting aneurysm incomplete occlusion after FD.
Methods: Retrospective review of patients with intracranial aneurysms treated with FD at a single institution between March 2013 and March 2023.
Background And Objectives: Postoperative seizures are a common complication after surgical drainage of nonacute chronic subdural hematomas (SDHs). The literature increasingly supports the use of prophylactic antiepileptic drugs for craniotomy, a procedure that is often associated with larger collections and worse clinical status at admission. This study aimed to compare the incidence of postoperative seizures in patients treated with burr-hole drainage and those treated with craniotomy through propensity score matching (PSM).
View Article and Find Full Text PDFObjective: Concern about thromboembolic events after flow diversion (FD) warrants dual antiplatelet therapy for 3 to 6 months. Platelet function tests are routinely performed prior to the procedure to detect clopidogrel responsiveness, as resistance is associated with CYP2C19 gene polymorphisms. This study aimed to identify optimal cutoff values in light transmission aggregometry (LTA) for clopidogrel and aspirin as predictive indicators of thromboembolic complications.
View Article and Find Full Text PDFBackground: Advances in the use of flow diversion (FD) now extend to bifurcation aneurysms; herein, we compare thromboembolic events in patients with internal carotid artery (ICA) aneurysms treated with and without exclusion of the anterior cerebral artery (ACA).
Methods: Retrospective analysis of aneurysms in the terminal ICA treated with FD from 2013 to 2023 at a single-center study. Procedures were classified according to the coverage at the origin of the ACA and compared through bivariate-analysis.
Article Synopsis
- Flow diversion treatment for bifurcation aneurysms raises concerns about ischemic events, particularly when covering the posterior cerebral artery (PCA) during the procedure.
- A study analyzed 28 patients with basilar and proximal PCA aneurysms over 10 years, finding that exclusion of the PCA occurred in 15 cases, with an 80.8% success rate in occluding the aneurysms.
- Despite some patients experiencing thromboembolic complications, the occurrence was not significantly higher in those where the PCA was covered, and there was no notable difference in post-treatment disability between the two groups.
Background: The long-term outcomes after stereotactic radiosurgery (SRS) for pediatric brain arteriovenous malformations (AVMs) remain poorly understood given the paucity of longitudinal studies. A systematic review was conducted to pool cumulative incidences for all outcomes.
Methods: PubMed, Embase, and Web of Science were queried to systematically extract potential references.
Background And Objectives: The pipeline embolization device (PED) Flex with Shield technology is a third-generation flow diverter used for intracranial aneurysm treatment designed to decrease thrombogenicity through a phosphorylcholine coating. Herein, we aim to compare the rate of thromboembolic events in PED with Shield technology and PED without it through propensity score matching.
Methods: We conducted a retrospective analysis of aneurysms treated with PED first-generation/PED Flex and PED with Shield between 2013 and 2023 at a single academic institution.
Background: Recent data have identified that certain risk factors for rupture differ between small and larger intracranial aneurysms (IAs). Such differing risk factors make up 5 out of the 6 predictor variables used in the PHASES score, which raises the question on whether IA size has a significant effect on the score's performance.
Methods: Patients who were diagnosed with an IA incidentally or due to a subarachnoid hemorrhage between 2015 and 2023 were selected for potential inclusion.
Late-developing posttraumatic dural arteriovenous fistula of the vertebral artery: illustrative case.
J Neurosurg Case Lessons
October 2023
Background: A dural arteriovenous fistula (dAVF) involving the vertebral artery (VA) is a rare vascular pathology that can result from damage to the VA, most frequently following cervical spine trauma. In most traumatic cases, the dAVF develops and manifests shortly after trauma.
Observations: A patient was admitted after a fall from the stairs causing neck pain.