Flow diversion is an emerging endovascular treatment option for cerebral aneurysms. Quantitative assessment of hemodynamic changes induced by flow diversion can aid clinical decision making in the treatment of cerebral aneurysms. In this article, besides summarizing past key research efforts, we propose a novel metric for the angiographic assessment of flow diverter deployments in the treatment of cerebral aneurysms. By analyzing the frequency spectra of signals derived from digital subtraction angiography (DSA) series, the metric aims to quantify the prevalence of frequency components that correspond to the patient-specific heart rate. Indicating the decoupling of aneurysms from healthy blood circulation, our proposed metric could advance clinical guidelines for treatment success prediction. The very promising results of a retrospective feasibility study on 26 DSA series warrant future efforts to study the validity of the proposed metric within a clinical setting.
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http://dx.doi.org/10.1109/TMI.2014.2320602 | DOI Listing |
Acta Neurochir (Wien)
January 2025
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Background: Variability in long-term endovascular treatment outcomes for intracranial aneurysms has prompted questions regarding the effects of these treatments on aneurysm hemodynamics. Endovascular techniques disrupt aneurysmal blood flow and shear, but their influence on intra-aneurysmal pressure remains unclear. A better understanding of aneurysm pressure effects may aid in predicting outcomes and guiding treatment decisions.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Background: The Focused Sylvian Approach (FSA) is a refined, minimally invasive technique for clipping small to medium-sized middle cerebral artery (MCA) aneurysms, prioritizing safety and aesthetics.
Method: The craniotomy remains confined to the superior temporal line, with the incision concealed within the temporal muscle. The Sylvian fissure is carefully dissected to preserve venous structures.
Neurosurg Rev
January 2025
Division of Neurosurgery, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
The mini-pterional craniotomy (mPT) was designed to be a minimally invasive alternative to the standard pterional (PT) approach. However, it remains unclear which technique produces better results. Thus, we aimed to perform a meta-analysis comparing functional, surgical, and aesthetic outcomes between mPT and PT in intracranial aneurysms.
View Article and Find Full Text PDFElife
January 2025
Department of Neurosurgery, Washington University School of Medicine, Springfield, United States.
Background: Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia. Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients. However, the effects of taVNS on cardiovascular dynamics in critically ill patients, like those with SAH, have not yet been investigated.
View Article and Find Full Text PDFNagoya J Med Sci
November 2024
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
The anatomical characteristics of middle cerebral artery aneurysms make endovascular treatment difficult. This study evaluated the efficacy and safety of endovascular treatment of unruptured middle cerebral artery aneurysm in preventing rupture. A retrospective review of patients who underwent coil embolization for unruptured middle cerebral artery aneurysm between 2006 and 2022 at Nagoya University Hospital with at least 12 months followed up was conducted.
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