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World neurosurgery 210건

  1. [해외논문]   Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days  

    Safaee, Michael M. (Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA ) , Scheer, Justin K. (Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA ) , Ailon, Tamir (Department of Neurosurgery, The University of British Columbia, Vancouver, British Columbia, Canada ) , Smith, Justin S. (Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA ) , Hart, Robert A. (Department of Orthopedic Surgery, Oregon Health & Science University, Portland, Oregon, USA ) , Burton, Douglas C. (Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA ) , Bess, Shay (Denver International Spine Clinic, Presbyterian St. Luke's Medical Center, Rocky Mountain Hospital for Children, Denver, Colorado, USA ) , Neuman, Brian J. (Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA ) , Passias, Peter G. (Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, New York, New York, USA ) , Miller, Emily (Department of Orthopedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA) , Shaffrey, Christopher I. , Schwab, Frank , Lafage, Virginie , Klineberg, Eric O. , Ames, Christopher P.
    World neurosurgery v.115 ,pp. e422 - e427 , 2018 , 1878-8750 ,

    초록

    Background Length of stay (LOS) after surgery for adult spinal deformity (ASD) is a critical period that allows for optimal recovery. Predictive models that estimate LOS allow for stratification of high-risk patients. Methods A prospectively acquired multicenter database of patients with ASD was used. Patients with staged surgery or LOS >30 days were excluded. Univariable predictor importance ≥0.90, redundancy, and collinearity testing were used to identify variables for model building. A generalized linear model was constructed using a training dataset developed from a bootstrap sample; patients not randomly selected for the bootstrap sample were selected to the training dataset. LOS predictions were compared with actual LOS to calculate an accuracy percentage. Results Inclusion criteria were met by 653 patients. The mean LOS was 7.9 ± 4.1 days (median 7 days; range, 1–28 days). Following bootstrapping, 893 patients were modeled (653 in the training model and 240 in the testing model). Linear correlations for the training and testing datasets were 0.632 and 0.507, respectively. The prediction accuracy within 2 days of actual LOS was 75.4%. Conclusions Our model successfully predicted LOS after ASD surgery with an accuracy of 75% within 2 days. Factors relating to actual LOS, such as rehabilitation bed availability and social support resources, are not captured in large prospective datasets. Predictive analytics will play an increasing role in the future of ASD surgery, and future models will seek to improve the accuracy of these tools. Highlights LOS is a critical period of recovery after ASD surgery. Predictive modeling allows for complex assessment and prediction of LOS. There are 40 variables that can predict LOS with 75% accuracy within 2 days. No such model for ASD surgery currently exists. Future work will allow for point-of-care assessment to assess LOS preoperatively.

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  2. [해외논문]   Surgical Treatment of Large or Giant Fusiform Middle Cerebral Artery Aneurysms: A Case Series  

    Xu, Feng (Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China ) , Xu, Bin (Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China ) , Huang, Lei (Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China ) , Xiong, Ji (Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China ) , Gu, Yuxiang (Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China ) , Lawton, Michael T. (Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital & Medical Center, Phoenix, Arizona, USA)
    World neurosurgery v.115 ,pp. e252 - e262 , 2018 , 1878-8750 ,

    초록

    Background Management of large or giant fusiform middle cerebral artery (MCA) aneurysms represents a significant challenge. Objective To describe the authors' experience in the treatment of large or giant fusiform MCA aneurysm by using various surgical techniques. Methods We retrospectively reviewed a database of aneurysms treated at our division between 2015 and 2017. Results Overall, 20 patients (11 males, 9 females) were identified, with a mean age of 40.7 years (range, 13–65 years; median, 43 years). Six patients (30%) had ruptured aneurysms and 14 (70%) had unruptured aneurysms. The mean aneurysm size was 19 mm (range, 10–35 mm). The aneurysms involved the prebifurcation in 5 cases, bifurcation in 4 cases, and postbifurcation in 11 cases. The aneurysms were treated by clip reconstruction ( n = 5), clip wrapping ( n = 1), proximal occlusion or trapping ( n = 4), and bypass revascularization ( n = 10). Bypasses included 7 low-flow superficial temporal artery–MCA bypasses, 2 high-flow extracranial-intracranial bypasses, and 1 intracranial-intracranial bypass (reanastomosis). Bypass patency was 90%. Nineteen aneurysms (95%) were completely obliterated, and no rehemorrhage occurred during follow-up. There was no procedural-related mortality. Clinical outcomes were good (modified Rankin Scale score ≤2) in 18 of 20 patients (90%) at the last follow-up. Conclusions Surgical treatment strategy for large or giant fusiform MCA aneurysms should be determined on an individual basis, based on aneurysm morphology, location, size, and clinical status. Favorable outcomes can be achieved by various surgical techniques, including clip reconstruction, wrap clipping, aneurysm trapping, aneurysm excision followed by reanastomosis, and partial trapping with bypass revascularization. Highlights Management of large or giant fusiform middle cerebral artery (MCA) aneurysms represents a significant challenge. Treatment strategies should be tailored on a case-by-case basis. Nondissecting fusiform aneurysm may be amenable to clip reconstruction and wrap-clipping. Giant fusiform dissecting aneurysms cannot usually be clipped and require alternative treatment modalities.

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  3. [해외논문]   Burr-Hole Craniostomy with T-Tube Drainage as Surgical Treatment for Chronic Subdural Hematoma  

    Lu, Wenchao (To whom correspondence should be addressed: Wenchao Lu) , Wang, Hui , Wu, Tao , Sheng, Xudong , Ding, Zhibin , Xu, Gangzhu
    World neurosurgery v.115 ,pp. e756 - e760 , 2018 , 1878-8750 ,

    초록

    Objective We sought to investigate the effect of burr-hole craniostomy with T-tube drainage to treat chronic subdural hematoma (CSDH). Methods Eighty-seven patients with CSDH who were recruited from January 2012 to June 2017 at the Department of Neurosurgery, The First Affiliated Hospital of Xi'an Medical University, were divided into 2 groups according to the method of drainage: T-tube drainage system ( n = 45) and conventional subdural drainage system ( n = 42). Retrospective analysis of clinical data and efficacy was performed between the 2 groups. Results There were no significant differences in age, preoperative Markwalder grade scale, preoperative hematoma volume, hospitalization days, and discharge Markwalder grade scale between the 2 groups ( P > 0.05). The incidence of postoperative complications and hematoma recurrence in the group of patients with T-tube drainage was significantly reduced when compared with conventional subdural drainage systems ( P Conclusions Both methods were effective in the treatment of CSDH; however, we found a lower overall surgical complication rate following treatment with burr-hole craniostomy and T-tube drainage. This indicates that it may be a better therapeutic option for management of CSDH. Highlights T-tube and conventional drainage systems are equally effective in treating CSDH. T-tube drainage systems result in decreased rates of complications and recurrence. T-tube drainage systems may be a better option for treatment of CSDH.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   Safety, Efficacy, and Cost-Analysis of Percutaneous Endoscopic Gastrostomy and Ventriculoperitoneal Shunt Placement in a Simultaneous Surgery  

    Jack, Megan M. (Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas, USA ) , Peterson, Jeremy C. (Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas, USA ) , McGinnis, J.P. (University of Kansas School of Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA ) , Alley, John (Department of General Surgery, The University of Kansas Medical Center, Kansas City, Kansas, USA ) , Chamoun, Roukoz B. (Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas, USA)
    World neurosurgery v.115 ,pp. e233 - e237 , 2018 , 1878-8750 ,

    초록

    Background Limited historical data suggest that concomitant placement of both a ventriculoperitoneal (VP) shunt and percutaneous endoscopic gastrostomy (PEG) tube is associated with an increased risk of complications, including VP shunt infections. Here we compare the outcomes and cost difference between 2 groups of patients, one in which a VP shunt and PEG tube were placed in the same operation and the other in which separate operations were performed. Methods A total of 10 patients underwent simultaneous placement of a VP shunt and PEG tube. This group was compared with a group of 18 patients that underwent separate placements. Hospital billing charges were used to compare the total cost of the procedures in the 2 groups. Results Eight of the 10 patients presented with aneurysmal subarachnoid hemorrhage. The average length of stay was 25 ± 2 days for the simultaneous procedure group and 43 ± 7 days for the separate procedures group. The average duration of follow-up was 12 ± 3 months after simultaneous placement. No patient in the simultaneous surgery group had signs of infection or shunt malfunction at last follow-up. The overall complication rate was significantly lower in the simultaneous surgery group. A cost analysis demonstrated significant cost savings by completing both procedures in the same surgical procedure. Conclusions Simultaneous placement of a PEG tube and VP shunt is safe, efficacious, and cost-effective. Thus, in patients requiring both a VP shunt and PEG tube, placement of both devices in a single surgical procedure should be considered. Highlights Simultaneous placement of a PEG tube and a VP shunt is safe and cost-effective. The length of stay and overall complication rates were significantly less when these 2 surgeries are performed together. The cost of completing the procedures simultaneously was less than that of the procedures performed separately.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   Risk Factors for Perioperative Blood Transfusions in Adult Spinal Deformity Surgery  

    White, Samuel J.W. (To whom correspondence should be addressed: Samuel K. Cho, M.D.) , Cheung, Zoe B. , Ye, Ivan , Phan, Kevin , Xu, Joshua , Dowdell, James , Kim, Jun S. , Cho, Samuel K.
    World neurosurgery v.115 ,pp. e731 - e737 , 2018 , 1878-8750 ,

    초록

    Objective Adult spinal deformity (ASD) surgery is associated with a high rate of perioperative blood transfusions, and it is important to understand the risk factors for perioperative blood transfusions to implement strategies to reduce transfusions. The aim of this study was to identify independent risk factors of perioperative blood transfusions in patients undergoing surgery for ASD. Methods A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2014. Adult patients undergoing surgery for ASD were separated into 2 cohorts based on whether they received a perioperative blood transfusion. Univariate and multivariate regression models were used to identify risk factors for blood transfusion. Results In our cohort of 5805 patients, 27.1% received a blood transfusion. Multivariate regression analysis showed that patient-specific risk factors were age 65 years or older (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.49–2.03; P P = 0.033), cardiac comorbidity (OR, 1.21; 95% CI, 1.03–1.41; P = 0.018) and bleeding disorder (OR, 2.01; 95% CI, 1.10–3.66; P = 0.023). Surgery-specific risk factors were a posterior approach (OR, 4.25; 95% CI, 3.46–5.22; P P P Conclusions Recognition of patient- and surgery-specific risk factors for perioperative blood transfusion is important to identify patients who are at high risk and to implement strategies to minimize intraoperative blood loss and decrease healthcare costs. Highlights Adult spinal deformity surgery is associated with a high rate of perioperative blood transfusions. Risk factors for blood transfusion include age ≥65 years, ASA classification ≥3, cardiac comorbidity and bleeding disorder. Surgery-specific risk factors for blood transfusion include posterior approach, pelvic fixation and osteotomy. Longer operative time is a risk factor with a duration-dependent effect on the odds of blood transfusion. Recognition of risk factors for perioperative blood transfusion is an important step in reducing perioperative complications.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   Contents  


    World neurosurgery v.115 ,pp. i - xvi , 2018 , 1878-8750 ,

    초록

    Objective Adult spinal deformity (ASD) surgery is associated with a high rate of perioperative blood transfusions, and it is important to understand the risk factors for perioperative blood transfusions to implement strategies to reduce transfusions. The aim of this study was to identify independent risk factors of perioperative blood transfusions in patients undergoing surgery for ASD. Methods A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2014. Adult patients undergoing surgery for ASD were separated into 2 cohorts based on whether they received a perioperative blood transfusion. Univariate and multivariate regression models were used to identify risk factors for blood transfusion. Results In our cohort of 5805 patients, 27.1% received a blood transfusion. Multivariate regression analysis showed that patient-specific risk factors were age 65 years or older (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.49–2.03; P P = 0.033), cardiac comorbidity (OR, 1.21; 95% CI, 1.03–1.41; P = 0.018) and bleeding disorder (OR, 2.01; 95% CI, 1.10–3.66; P = 0.023). Surgery-specific risk factors were a posterior approach (OR, 4.25; 95% CI, 3.46–5.22; P P P Conclusions Recognition of patient- and surgery-specific risk factors for perioperative blood transfusion is important to identify patients who are at high risk and to implement strategies to minimize intraoperative blood loss and decrease healthcare costs. Highlights Adult spinal deformity surgery is associated with a high rate of perioperative blood transfusions. Risk factors for blood transfusion include age ≥65 years, ASA classification ≥3, cardiac comorbidity and bleeding disorder. Surgery-specific risk factors for blood transfusion include posterior approach, pelvic fixation and osteotomy. Longer operative time is a risk factor with a duration-dependent effect on the odds of blood transfusion. Recognition of risk factors for perioperative blood transfusion is an important step in reducing perioperative complications.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   The Effect of Underlying Liver Disease on Perioperative Outcomes Following Craniotomy for Tumor: An American College of Surgeons National Quality Improvement Program Analysis  

    Goel, Nicholas J. (Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Abdullah, Kalil G. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Choudhri, Omar A. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Kung, David K. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Lucas, Timothy H. (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA ) , Chen, H. Isaac (Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA)
    World neurosurgery v.115 ,pp. e85 - e96 , 2018 , 1878-8750 ,

    초록

    Background The association between underlying liver disease and poor surgical outcomes has been well documented across a wide variety of surgical disciplines. However, little is known about the importance of liver disease in neurosurgery. In this report, we assess the independent effect of liver disease on perioperative outcomes in patients undergoing craniotomy for tumor. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients undergoing craniotomy for tumor from 2006 to 2015. Presence and severity of underlying liver disease was assessed with the aspartate aminotransferase-to-platelet ratio index and the Model for End-Stage Liver Disease-Sodium scores, computed from preoperative laboratory values. Results Among 11,897 patients, mild and advanced disease was identified in 2.4% and 1.9% of patients, respectively. Rates of 30-day mortality were 4.5% and 15.8% in these patients, compared with 3.1% in patients with healthy livers. The 30-day complication rate was 40.3%, 28.0%, and 19.8% in patients with advanced, mild, and no liver disease, respectively. In multivariate analysis, the presence of any liver disease (mild or advanced) was independently associated with mortality (OR = 2.46; 95% confidence interval [CI], 1.68–3.59; P P = 0.001), and length of hospital stay over 10 days (OR, 1.35; 95% CI, 1.07–1.70; P = 0.012), when compared with 13 covariates. Liver disease showed the strongest independent association with mortality of all risk factors analyzed. Conclusions Liver disease is an independent predictor of poor 30-day outcomes following craniotomy for tumor. Consideration of underlying liver function can have a role in surgical decision making and postoperative care for these patients. Highlights Underlying liver disease was discovered in 4.3% of patients undergoing craniotomy. Liver disease independently predicts greater morbidity and length of hospital stay. Among 13 risk factors, liver disease is the strongest predictor of 30-day mortality.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   Intracranial Arterial Fenestration and Risk of Aneurysm: A Systematic Review and Meta-Analysis  

    Guo, Xiang (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Gao, Lingyun (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Shi, Zhitao (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Liu, Deguo (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Wang, Yuhong (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Sun, Zhanguo (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Chen, Yueqin (Department of Medical Imaging, the Affiliated Hospital of Jining Medical University, Jining, China ) , Chen, Weijian (Department of Medical Imaging, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China ) , Yang, Yunjun (Department of Medical Imaging, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China)
    World neurosurgery v.115 ,pp. e592 - e598 , 2018 , 1878-8750 ,

    초록

    Background Previous studies have been inconsistent regarding risk for intracranial aneurysm related to intracranial arterial fenestration. We conducted a meta-analysis to examine the association between intracranial arterial fenestration and risk of aneurysm. Methods We performed a systematic review of PubMed and Embase through August 2017 for potentially relevant articles. Summary odds ratios with 95% confidence intervals were pooled using a random-effects model. Results Of 446 articles found, 7 were selected for meta-analysis. Pooled odds ratios revealed an increased risk of aneurysm owing to fenestration of 1.50 (95% confidence interval, 0.61–3.71; P = 0.38). Subgroup analyses based on the population presenting with various indications suggested that pooled odds ratios indicated a significant increase in risk for aneurysm of 2.43 (95% confidence interval, 1.04–5.69; P = 0.04). Conclusions Our findings indicate that intracranial arterial fenestration may be associated with increased risk for aneurysm formation. Highlights Pooled OR indicated a significantly increased aneurysm risk owing to fenestration. There was no significant relationship between fenestration and aneurysm in patients with sSAH. Fenestration may be a marker of aneurysm formation in the general population.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  9. [해외논문]   Upcoming Events  


    World neurosurgery v.115 ,pp. xx - xxi , 2018 , 1878-8750 ,

    초록

    Background Previous studies have been inconsistent regarding risk for intracranial aneurysm related to intracranial arterial fenestration. We conducted a meta-analysis to examine the association between intracranial arterial fenestration and risk of aneurysm. Methods We performed a systematic review of PubMed and Embase through August 2017 for potentially relevant articles. Summary odds ratios with 95% confidence intervals were pooled using a random-effects model. Results Of 446 articles found, 7 were selected for meta-analysis. Pooled odds ratios revealed an increased risk of aneurysm owing to fenestration of 1.50 (95% confidence interval, 0.61–3.71; P = 0.38). Subgroup analyses based on the population presenting with various indications suggested that pooled odds ratios indicated a significant increase in risk for aneurysm of 2.43 (95% confidence interval, 1.04–5.69; P = 0.04). Conclusions Our findings indicate that intracranial arterial fenestration may be associated with increased risk for aneurysm formation. Highlights Pooled OR indicated a significantly increased aneurysm risk owing to fenestration. There was no significant relationship between fenestration and aneurysm in patients with sSAH. Fenestration may be a marker of aneurysm formation in the general population.

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  10. [해외논문]   Aseptic Bone Flap Resorption after Cranioplasty with Autologous Bone: Incidence, Risk Factors, and Clinical Implications  

    Kim, Jang Hun (Department of Neurosurgery, Guro Hospital, Seoul, Republic of Korea ) , Kim, Jong Hyun (Department of Neurosurgery, Guro Hospital, Seoul, Republic of Korea ) , Kwon, Taek-Hyun (Department of Neurosurgery, Guro Hospital, Seoul, Republic of Korea ) , Chong, Kyuha (Department of Neurosurgery, Guro Hospital, Seoul, Republic of Korea ) , Hwang, Soon-Young (Biostatistical Consulting Laboratory, Medical Science Research Center, Korea University College of Medicine, Seoul, Republic of Korea ) , Yoon, Won Ki (Department of Neurosurgery, Guro Hospital, Seoul, Republic of Korea)
    World neurosurgery v.115 ,pp. e111 - e118 , 2018 , 1878-8750 ,

    초록

    Objectives Aseptic bone flap resorption (ABFR) is a known complication of cranioplasty (CP) with an autologous bone flap. The incidence of ABFR has been reported to be as high as 34.2% in the literature; however, it is underestimated in clinical fields. We retrospectively reviewed 13 years of clinical cases of patients who underwent CP after decompressive craniectomy (DC) to investigate the incidence and risk factors of ABFR. Methods Ninety-one patients who underwent DC and CP in Guro Hospital, Korea University Medical Center, were enrolled. ABFR was defined using serial brain computed tomography. To identify possible risk factors for ABFR, univariate and multivariate Cox regression and receiver operating characteristic curve analyses were performed. Results Of the 91 patients enrolled, ABFR was diagnosed in 32 patients (35.1%). Bone flap size, existence of a shunting system, and the DC-CP interval were significant in the univariate analysis. Bone flap size was statistically significant in the multivariate analysis ( P = 0.0189). The cutoff points of the DC-CP interval and bone flap size were 44 days and 110 cm 2 , respectively. Conclusions The incidence of ABFR was remarkably high. Bone flap size, the existence of a shunting system, and the DC-CP interval were shown to be potential risk factors of ABFR after CP. Highlights ABFR rate after autologous bone CP for DC patients was higher than expected. Large bone flap size was an independent risk factor for ABFR. Shunting system presence and a long interval between DC and CP were risk factors.

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