Introduction: In the field of medical research, large volumes of data need to be analysed accurately, and it is crucial to pre-process the data before it can be analysed. The 'R' environment is a programming language and environment for statistical computing and graphics suitable for the analysis of data sets. Objectives: To provide examples on how to utilise the R language for data processing, and its usefulness for medical researchers. Materials and Methods: Two real world datasets, ie, data for: 'Effect of Morning Blood Pressure Peak on Early Progressive Ischemic Stroke: A Prospective Clinical Study' and data for: 'Impact of early surgery of ruptured cerebral aneurysms on vasospasm and hydrocephalus after SAH: our preliminary series' have been used to present an example for two different approaches for the process of data analysis using R. Results: Accurate and tidy data sets were obtained. Conclusions: R is a reliable environment for the processing of large data sets.
{"title":"Statistical corner: Using R to build, analyse and plot clinical neurological datasets","authors":"Mikko J. Pyysalo, Teemu Vesterinen","doi":"10.4103/jcvs.jcvs_29_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_29_20","url":null,"abstract":"Introduction: In the field of medical research, large volumes of data need to be analysed accurately, and it is crucial to pre-process the data before it can be analysed. The 'R' environment is a programming language and environment for statistical computing and graphics suitable for the analysis of data sets. Objectives: To provide examples on how to utilise the R language for data processing, and its usefulness for medical researchers. Materials and Methods: Two real world datasets, ie, data for: 'Effect of Morning Blood Pressure Peak on Early Progressive Ischemic Stroke: A Prospective Clinical Study' and data for: 'Impact of early surgery of ruptured cerebral aneurysms on vasospasm and hydrocephalus after SAH: our preliminary series' have been used to present an example for two different approaches for the process of data analysis using R. Results: Accurate and tidy data sets were obtained. Conclusions: R is a reliable environment for the processing of large data sets.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123335243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Although aneurysms of the posterior circulation are not as common as those of the anterior circulation, the threat they pose can be reduced with timely surgical intervention. The study analyses factors that influence the outcome in surgically clipped posterior communicating artery (PCoA) aneurysms. Methods: A retrospective analysis of 85 cases of surgically clipped PCoA aneurysms was carried out, taking into consideration, the presenting signs and World Federation of Neurological Societies (WFNS) grade at admission, the timing of the surgery and the outcome of the surgery as per the Glasgow Outcome Scale. Results: About 56.8% of cases were clinically WFNS Grade I at admission. About 75.9% of all patients and 90% of patients who were Grade I and 74% of patients who were Grade II had a good recovery as per the Glasgow Outcome Scale. The overall mortality was 6.9%, and all patients who did not survive despite surgery were initially WFNS Grade IV patients. Conclusion: A higher or clinically worse WFNS grade of subarachnoid haemorrhage at the time of admission in patients with PCoA aneurysms predicts a poor surgical outcome, regardless of the timing of the surgery.
{"title":"Posterior communicating artery aneurysms: Analysis of predictors of surgical outcome","authors":"Sumeet Narang, H. Kaur, J. Dil, A. Raja","doi":"10.4103/jcvs.jcvs_16_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_16_20","url":null,"abstract":"Background: Although aneurysms of the posterior circulation are not as common as those of the anterior circulation, the threat they pose can be reduced with timely surgical intervention. The study analyses factors that influence the outcome in surgically clipped posterior communicating artery (PCoA) aneurysms. Methods: A retrospective analysis of 85 cases of surgically clipped PCoA aneurysms was carried out, taking into consideration, the presenting signs and World Federation of Neurological Societies (WFNS) grade at admission, the timing of the surgery and the outcome of the surgery as per the Glasgow Outcome Scale. Results: About 56.8% of cases were clinically WFNS Grade I at admission. About 75.9% of all patients and 90% of patients who were Grade I and 74% of patients who were Grade II had a good recovery as per the Glasgow Outcome Scale. The overall mortality was 6.9%, and all patients who did not survive despite surgery were initially WFNS Grade IV patients. Conclusion: A higher or clinically worse WFNS grade of subarachnoid haemorrhage at the time of admission in patients with PCoA aneurysms predicts a poor surgical outcome, regardless of the timing of the surgery.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128537266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Kumar, V. Ratha, Rithesh Nair, S. Karthikeyan, A. Rajendran, R. Soundararajan
Context: Adults with haemodynamic stroke secondary to cerebrovascular ischaemic events, continue to develop stroke despite optimum medical management. Aims: This study aims to identify patients with adult ischaemic stroke presenting with significant haemodynamic failure based on radiological and molecular imaging and perform Revascularisation procedure to prevent further stroke. Settings and Design: This is a retrospective database analysis of patients with CVOD requiring cerebral revasularisation procedure from 2013 to 2019. Materials and Methods: Twenty-two adult patients with age ranging from 26 to 72 years presenting with recurrent transient ischaemic attacks (TIAs) were evaluated for haemodynamic insufficiency by neuroimaging and acetazolamide challenged single-photon emission computed tomography perfusion. Those with decompensated haemodynamic insufficiency underwent cerebral revascularisation with superficial temporal artery (STA) to middle cerebral artery (MCA) bypass. Results: Of the 22 patients, in 12 patients, the procedure was done electively and in remaining 10 patients as emergency (<48 h of the onset of symptoms). Ninety-one per cent of the patients recovered well without any further TIAs. Neurological worsening was observed in 4.5%. Two patients who presented with refractory migraine like symptoms improved dramatically without further headaches. Uneventful wound complications were associated in 9% of cases. Follow-up radiological evaluation showed good graft patency in 95% (21/22) patients. The single case of graft thrombosis developed new MCA territory infarct requiring prolonged rehabilitation for the neurological deterioration. Conclusion: Cerebral revascularisation with STA-MCA bypass in selected patients with impending haemodynamic insufficiency results in good outcome and prevents further strokes despite continuing optimum medical therapy.
{"title":"Effectiveness of cerebral bypass revascularisation procedures in adult cerebrovascular ischaemic stroke: Looking beyond COSS – A single surgeon's experience of 7 years","authors":"V. Kumar, V. Ratha, Rithesh Nair, S. Karthikeyan, A. Rajendran, R. Soundararajan","doi":"10.4103/jcvs.jcvs_30_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_30_20","url":null,"abstract":"Context: Adults with haemodynamic stroke secondary to cerebrovascular ischaemic events, continue to develop stroke despite optimum medical management. Aims: This study aims to identify patients with adult ischaemic stroke presenting with significant haemodynamic failure based on radiological and molecular imaging and perform Revascularisation procedure to prevent further stroke. Settings and Design: This is a retrospective database analysis of patients with CVOD requiring cerebral revasularisation procedure from 2013 to 2019. Materials and Methods: Twenty-two adult patients with age ranging from 26 to 72 years presenting with recurrent transient ischaemic attacks (TIAs) were evaluated for haemodynamic insufficiency by neuroimaging and acetazolamide challenged single-photon emission computed tomography perfusion. Those with decompensated haemodynamic insufficiency underwent cerebral revascularisation with superficial temporal artery (STA) to middle cerebral artery (MCA) bypass. Results: Of the 22 patients, in 12 patients, the procedure was done electively and in remaining 10 patients as emergency (<48 h of the onset of symptoms). Ninety-one per cent of the patients recovered well without any further TIAs. Neurological worsening was observed in 4.5%. Two patients who presented with refractory migraine like symptoms improved dramatically without further headaches. Uneventful wound complications were associated in 9% of cases. Follow-up radiological evaluation showed good graft patency in 95% (21/22) patients. The single case of graft thrombosis developed new MCA territory infarct requiring prolonged rehabilitation for the neurological deterioration. Conclusion: Cerebral revascularisation with STA-MCA bypass in selected patients with impending haemodynamic insufficiency results in good outcome and prevents further strokes despite continuing optimum medical therapy.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"32 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120912993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masaraf Hussain, S. Sharma, Baiakmenlang Synmon, Y. Hynniewta
Background: Stroke is the second-most common cause of mortality worldwide. Stroke-related mortality data are needed for following health trends and for planning health policy. Objective: The objective is to determine the incidence of stroke-related mortality in 1 year, to study the demographic profile and risk factors of stroke mortality, and to study the complications due to stroke leading to mortality. Materials and Methods: We conducted a retrospective hospital-based study for stroke-related mortality that had occurred between March 2019 and March 2020. The data were reviewed for demographic profile, co-morbidities and complications which had occurred during hospital stay. Results: A total of 51 patients had stroke-related mortality, mostly involving the age group of 41–50 years. There was a male pre-dominance of stroke-related mortality, except in the oldest (>80 years) age group. Haemorrhagic stroke had higher mortality, as compared to ischaemic stroke, with a lower mean age of mortality. Hypertension and alcohol consumption were the most common co-morbidities for haemorrhagic stroke-related morbidities, while dyslipidaemia, diabetes mellitus, smoking and cardiac illness were more common in ischaemic stroke-related mortality. Aspiration pneumonia was the most common complication in stroke-related mortalities. Conclusion: The study has shown a concerning trend of stroke-related mortality involving younger age group. Aggressive treatment of co-morbidities and complications is necessary to reduce mortality due to stroke.
{"title":"A hospital-based study of stroke-related mortality","authors":"Masaraf Hussain, S. Sharma, Baiakmenlang Synmon, Y. Hynniewta","doi":"10.4103/jcvs.jcvs_25_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_25_20","url":null,"abstract":"Background: Stroke is the second-most common cause of mortality worldwide. Stroke-related mortality data are needed for following health trends and for planning health policy. Objective: The objective is to determine the incidence of stroke-related mortality in 1 year, to study the demographic profile and risk factors of stroke mortality, and to study the complications due to stroke leading to mortality. Materials and Methods: We conducted a retrospective hospital-based study for stroke-related mortality that had occurred between March 2019 and March 2020. The data were reviewed for demographic profile, co-morbidities and complications which had occurred during hospital stay. Results: A total of 51 patients had stroke-related mortality, mostly involving the age group of 41–50 years. There was a male pre-dominance of stroke-related mortality, except in the oldest (>80 years) age group. Haemorrhagic stroke had higher mortality, as compared to ischaemic stroke, with a lower mean age of mortality. Hypertension and alcohol consumption were the most common co-morbidities for haemorrhagic stroke-related morbidities, while dyslipidaemia, diabetes mellitus, smoking and cardiac illness were more common in ischaemic stroke-related mortality. Aspiration pneumonia was the most common complication in stroke-related mortalities. Conclusion: The study has shown a concerning trend of stroke-related mortality involving younger age group. Aggressive treatment of co-morbidities and complications is necessary to reduce mortality due to stroke.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117023902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Sharma, A. Jagetia, A. Srivastava, Daljit Singh
Background: The endovascular coiling of ruptured aneurysms with complicated geometry presents a significant treatment challenge, especially with the non-availability of adequate sized coils and balloon/stent. The dual microcatheter technique is an alternative treatment for stent-assisted coiling in acutely ruptured wide-necked aneurysms because of no antiplatelet therapy. Objective: We report our initial experience with the use of a dual microcatheter technique in seven patients. The technique provided an efficient strategy for treating aneurysms with complicated configurations and high risks. Patients and Methods: We describe a technique used to treat seven patients with irregular shaped and wide-necked aneurysms. In the initial attempts at embolisation, coil instability within the aneurysm or significant impingement of coil loops on the parent artery was observed. The advancement of a second microcatheter into the aneurysm allowed two coils to be braced across the aneurysmal neck before the detachment of either coil. This technique permitted successful coil treatment. Conclusion: The dual microcatheter technique is a safe and effective treatment for acutely ruptured wide-necked aneurysms due to few treatment-related complications and mortality rate.
{"title":"Dual microcatheter technique for coil embolisation of irregular and wide-necked intracranial aneurysms: A case series","authors":"Amit Sharma, A. Jagetia, A. Srivastava, Daljit Singh","doi":"10.4103/jcvs.jcvs_2_21","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_2_21","url":null,"abstract":"Background: The endovascular coiling of ruptured aneurysms with complicated geometry presents a significant treatment challenge, especially with the non-availability of adequate sized coils and balloon/stent. The dual microcatheter technique is an alternative treatment for stent-assisted coiling in acutely ruptured wide-necked aneurysms because of no antiplatelet therapy. Objective: We report our initial experience with the use of a dual microcatheter technique in seven patients. The technique provided an efficient strategy for treating aneurysms with complicated configurations and high risks. Patients and Methods: We describe a technique used to treat seven patients with irregular shaped and wide-necked aneurysms. In the initial attempts at embolisation, coil instability within the aneurysm or significant impingement of coil loops on the parent artery was observed. The advancement of a second microcatheter into the aneurysm allowed two coils to be braced across the aneurysmal neck before the detachment of either coil. This technique permitted successful coil treatment. Conclusion: The dual microcatheter technique is a safe and effective treatment for acutely ruptured wide-necked aneurysms due to few treatment-related complications and mortality rate.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123287609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Aneurysm surgery during the COVID-19 pandemic: Ecstasy, agony and dilemma","authors":"Daljit Singh","doi":"10.4103/jcvs.jcvs_3_21","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_3_21","url":null,"abstract":"","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131392252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Anomia is a problem with naming objects. Anomic aphasia, also called as anomia or amnesic aphasia, is characterised by word-finding difficulties in the absence of major syntactic impairment. Objectives: To determine the effectiveness of therapy techniques in recovery of language abilities in a patient with anomic aphasia. Materials and Methods: Prospective study of a patient diagnosed with anomic aphasia secondary to ischaemic stroke, whose response and progress was followed from the time of presentation, along the course of therapy with techniques including semantic feature analysis (SFA) and phonological component analysis (PCA), and scored according to the guidelines of Manual for Adult Non-Fluent Aphasia Therapy in Kannada (MANAT-K). Results: Significant improvement was noted in the patient's naming skills, with an increase in almost 20% in the score in confrontation naming, responsive naming, and word fluency, post-therapy, as compared to pre-therapy. Conclusion: Although there is contribution of spontaneous recovery in the betterment of a person with aphasia, timely planned therapy brings about a marked improvement in the patient's language abilities.
{"title":"Effectiveness of speech and language therapy and spontaneous recovery in anomic aphasia","authors":"K. Sandhya","doi":"10.4103/jcvs.jcvs_11_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_11_20","url":null,"abstract":"Introduction: Anomia is a problem with naming objects. Anomic aphasia, also called as anomia or amnesic aphasia, is characterised by word-finding difficulties in the absence of major syntactic impairment. Objectives: To determine the effectiveness of therapy techniques in recovery of language abilities in a patient with anomic aphasia. Materials and Methods: Prospective study of a patient diagnosed with anomic aphasia secondary to ischaemic stroke, whose response and progress was followed from the time of presentation, along the course of therapy with techniques including semantic feature analysis (SFA) and phonological component analysis (PCA), and scored according to the guidelines of Manual for Adult Non-Fluent Aphasia Therapy in Kannada (MANAT-K). Results: Significant improvement was noted in the patient's naming skills, with an increase in almost 20% in the score in confrontation naming, responsive naming, and word fluency, post-therapy, as compared to pre-therapy. Conclusion: Although there is contribution of spontaneous recovery in the betterment of a person with aphasia, timely planned therapy brings about a marked improvement in the patient's language abilities.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130414243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Menon, Sandesh Onkarappa, R. Sanjeev, Saurabh Beedkar, R. Nair
We present a case of bilateral subdural haematomas secondary to spontaneous intracranial hypotension. The diagnostic features and the management issues are discussed.
我们报告一例双侧硬膜下血肿继发于自发性颅内低血压。讨论了其诊断特点和管理问题。
{"title":"Bilateral subdural haematomas secondary to spontaneous intracranial hypotension-A dilemma in management","authors":"G. Menon, Sandesh Onkarappa, R. Sanjeev, Saurabh Beedkar, R. Nair","doi":"10.4103/jcvs.jcvs_19_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_19_20","url":null,"abstract":"We present a case of bilateral subdural haematomas secondary to spontaneous intracranial hypotension. The diagnostic features and the management issues are discussed.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117015192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gautam Dutta, Daljit Singh, A. Jagetia, A. Srivastava
Acute subarachnoid haemorrhage (SAH) generally appears hyperdense on computed tomography (CT) scan. However, in some rare circumstances, it may appear hypodense which can pose a diagnostic problem and compromise patient care. We report the case of a 32-year-old man who had presented with acute posterior fossa SAH. A cranial CT scan revealed a hypodense posterior fossa lesion mimicking cerebellar infarct. Surgical intervention confirmed that it was an acute bleed in the subarachnoid space. Treating physicians should be cautious in interpreting CT images as that can sometimes be misleading leading to misdiagnosis and incorrect treatment choices.
{"title":"Pitfalls in diagnosis: Acute hypodense posterior fossa subarachnoid haemorrhage on computed tomography scan – An unusual entity","authors":"Gautam Dutta, Daljit Singh, A. Jagetia, A. Srivastava","doi":"10.4103/jcvs.jcvs_22_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_22_20","url":null,"abstract":"Acute subarachnoid haemorrhage (SAH) generally appears hyperdense on computed tomography (CT) scan. However, in some rare circumstances, it may appear hypodense which can pose a diagnostic problem and compromise patient care. We report the case of a 32-year-old man who had presented with acute posterior fossa SAH. A cranial CT scan revealed a hypodense posterior fossa lesion mimicking cerebellar infarct. Surgical intervention confirmed that it was an acute bleed in the subarachnoid space. Treating physicians should be cautious in interpreting CT images as that can sometimes be misleading leading to misdiagnosis and incorrect treatment choices.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124495420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Anterior communicating artery (ACoA) aneurysms are one of the most common cerebral aneurysms encountered by neurovascular surgeons. They are surgically complex and sensitive and the scope for dialogue and exchange towards development are never over rated. Aims and objectives: The authors seek to discuss and emphasize on key lessons learnt from the observations from ACoA aneurysms treated by micro-vascular clipping. Materials and Methods: Hospital based retrospective observational study of 237 cases of ACoA aneurysms admitted to the study hospital and treated by micro-vascular clipping. Conclusion: The lessons learnt are broadly under the headings: exposure, intracranial pressure, gyrus rectus resection, vascular anatomy, perforator preservation, temporary clipping, damage control, lamina terminalis fenestration, team play, cognitive and morbidity assessment, and timing of surgery.
{"title":"Surgery for anterior communicating artery aneurysms: Lessons learnt","authors":"J. Dil, Sumeet Narang, H. Kaur, A. Raja","doi":"10.4103/jcvs.jcvs_8_20","DOIUrl":"https://doi.org/10.4103/jcvs.jcvs_8_20","url":null,"abstract":"Background: Anterior communicating artery (ACoA) aneurysms are one of the most common cerebral aneurysms encountered by neurovascular surgeons. They are surgically complex and sensitive and the scope for dialogue and exchange towards development are never over rated. Aims and objectives: The authors seek to discuss and emphasize on key lessons learnt from the observations from ACoA aneurysms treated by micro-vascular clipping. Materials and Methods: Hospital based retrospective observational study of 237 cases of ACoA aneurysms admitted to the study hospital and treated by micro-vascular clipping. Conclusion: The lessons learnt are broadly under the headings: exposure, intracranial pressure, gyrus rectus resection, vascular anatomy, perforator preservation, temporary clipping, damage control, lamina terminalis fenestration, team play, cognitive and morbidity assessment, and timing of surgery.","PeriodicalId":218723,"journal":{"name":"Journal of Cerebrovascular Sciences","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116491597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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