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Clinical Research in Neurosurgery
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Clinical Research in Neurosurgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (1 December 2024) | Viewed by 4349

Special Issue Editor

Prof. Dr. Yasuo Murai

E-Mail Website
Guest Editor
Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
Interests: cerebral aneurysm; moyamoya disease; meningioma; RNF 213; exoscope; intracerebral hemorrhage
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In neurosurgery, surgical treatment employing a microscope has been the mainstay of therapy, but the roles of endovascular treatment, endoscopy, exoscope, and stereotactic radiation therapy are certainly expanding. However, from a global perspective, microscope surgery still holds a crucial position. Despite advancements in various surgical equipment, it is vital to remember that it is the surgeons who perform the surgeries, and the transmission of individual surgeons' education and technical nuances is indispensable.

In this project, we aim to examine the nuances of techniques in order to enhance surgical outcomes, education in those techniques, key points in the application of the latest surgical equipment, postoperative management considerations in the development of various novel drugs, as well as long-term prognosis and effectiveness. It is unclear whether the true treatment outcomes desired by patients can be adequately presented based solely on the short-term results of novel treatments. We look forward to receiving contributions from neurosurgeons, neurologists, and neuroradiologists regarding the latest diagnosis and treatment strategies and diagnostic equipment, and their clinically relevant and realistic effects.

Prof. Dr. Yasuo Murai
Guest Editor

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Keywords

  • cerebral aneurysm
  • microsurgery
  • surgical instrument
  • exoscope
  • surgical technique
  • moyamoya disease
  • endoscope
  • postoperative management
  • long-term results
  • vascular reconstructive surgery
  • brain tumor
  • cerebral hemorrhage

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Published Papers (3 papers)

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15 pages, 1495 KiB  
Article
Impact of Perioperative Acetylsalicylic Acid (ASA) Administration on Postoperative Intracranial Hemorrhage (pICH) and Thromboembolic Events in Patients with Intracranial Meningiomas
by Anatoli Pinchuk, Nikolay Tonchev, Klaus Peter Stein, Vanessa M. Swiatek, Claudia A. Dumitru, Belal Neyazi, Ibrahim Erol Sandalcioglu and Ali Rashidi
J. Clin. Med. 2024, 13(15), 4523; https://doi.org/10.3390/jcm13154523 - 2 Aug 2024
Cited by 1 | Viewed by 1246
Abstract
Background: In routine medical practice, patients are increasingly using ASA for primary and secondary prevention. Although many of these patients discontinue ASA prior to elective intracranial surgery, there are limited data to support whether perioperative ASA use raises the risk of postoperative [...] Read more.
Background: In routine medical practice, patients are increasingly using ASA for primary and secondary prevention. Although many of these patients discontinue ASA prior to elective intracranial surgery, there are limited data to support whether perioperative ASA use raises the risk of postoperative hemorrhage. This study aimed to investigate the implications of continuing or stopping ASA around the time of surgery in patients with intracranial meningiomas, focusing on postoperative hemorrhage and thromboembolic events. Methods: For this purpose, medical records and radiological images of 1862 patients who underwent cranial neurosurgical procedures for brain tumors over a decade at our neurosurgical institute were retrospectively analyzed. The risk of postoperative hemorrhage was evaluated by comparing meningioma patients who received ASA treatment with those who did not. Furthermore, we investigated other factors that influence postoperative hemorrhage and thromboembolic events, particularly in patients receiving ASA treatment. Results: A total of 422 patients diagnosed with meningiomas underwent surgical intervention. Among the patients who received ASA preoperatively, 4 out of 46 (8.69%) experienced postoperative hemorrhage requiring surgical intervention, whereas the same complication occurred in only 4 out of 376 patients (1.06%) in the non-ASA group (p = 0.007). There was no significant difference in the incidence of thromboembolic events between the two groups. Conclusions: Our analysis revealed an increased risk of postoperative hemorrhage in patients using ASA. Full article
(This article belongs to the Special Issue Clinical Research in Neurosurgery)
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11 pages, 1616 KiB  
Article
Pathological Findings of Donor Vessels in Bypass Surgery
by Yohei Nounaka, Yasuo Murai, Asami Kubota, Atsushi Tsukiyama, Fumihiro Matano, Kenta Koketsu and Akio Morita
J. Clin. Med. 2024, 13(7), 2125; https://doi.org/10.3390/jcm13072125 - 6 Apr 2024
Viewed by 1501
Abstract
(1) Background Cerebral revascularization is necessary to treat intracranial arterial stenosis caused by moyamoya disease, atherosclerosis, or large complex aneurysms. Although various donor vascular harvesting methods have been reported safe, there are no reports on the histological evaluation of donor vessels for each [...] Read more.
(1) Background Cerebral revascularization is necessary to treat intracranial arterial stenosis caused by moyamoya disease, atherosclerosis, or large complex aneurysms. Although various donor vascular harvesting methods have been reported safe, there are no reports on the histological evaluation of donor vessels for each disease, despite the variety of diseases wherein vascular anastomosis is required. (2) Methods Pathological findings of the superficial temporal artery (STA), radial artery (RA), occipital artery (OA), and saphenous vein (SV) harvested at the institution were analyzed. Patients classified according to aneurysm, atherosclerosis, and moyamoya disease were assessed for pathological abnormalities, medical history, age, sex, smoking, and postoperative anastomosis patency. (3) Results There were 38 cases of atherosclerosis, 15 cases of moyamoya disease, and 30 cases of aneurysm in 98 donor vessels (mean age 57.2) taken after 2006. Of the 84 STA, 11 RA, 2 OA, and 1 SV arteries that were harvested, 71.4% had atherosclerosis, 11.2% had dissection, and 10.2% had inflammation. There was no significant difference in the proportion of pathological findings according to the disease. A history of hypertension is associated with atherosclerosis in donor vessels. (4) Conclusions This is the first study to histologically evaluate the pathological findings of donor vessels according to disease. The proportion of dissection findings indicative of vascular damage due to surgical manipulation was not statistically different between the different conditions. Full article
(This article belongs to the Special Issue Clinical Research in Neurosurgery)
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10 pages, 7299 KiB  
Case Report
Mirror Aneurysms of the Pericallosal Artery Clipped During a Single Surgical Procedure: Case Report and Literature Review
by Corneliu Toader, Mugurel Petrinel Radoi, Felix-Mircea Brehar, Matei Serban, Luca-Andrei Glavan, Razvan-Adrian Covache-Busuioc, Alexandru Vlad Ciurea and Nicolae Dobrin
J. Clin. Med. 2024, 13(22), 6719; https://doi.org/10.3390/jcm13226719 - 8 Nov 2024
Cited by 3 | Viewed by 970
Abstract
Pericallosal artery aneurysms are rare, accounting for 2–9% of all intracranial aneurysms, and mirror aneurysms in this location are exceptionally uncommon, presenting unique surgical challenges due to their deep location and proximity to critical neurovascular structures. The aim of this case report is [...] Read more.
Pericallosal artery aneurysms are rare, accounting for 2–9% of all intracranial aneurysms, and mirror aneurysms in this location are exceptionally uncommon, presenting unique surgical challenges due to their deep location and proximity to critical neurovascular structures. The aim of this case report is to describe the surgical management and successful outcome of a patient with mirror pericallosal artery aneurysms and to contribute insights into the clinical and surgical considerations for this rare condition. We report the case of a 71-year-old female with multiple cardiovascular and metabolic conditions, including hypertension and smoking—well-established risk factors for intracranial aneurysm formation and rupture. She presented with a Hunt and Hess grade II subarachnoid hemorrhage resulting in communicating internal hydrocephalus. Preoperative angiography revealed mirror aneurysms of the pericallosal artery. The patient underwent a left basal paramedian frontal craniotomy, during which a ruptured aneurysm on the right A2 segment and an unruptured aneurysm on the left A2 segment were identified. Both aneurysms were successfully clipped using curved Yasargil clips. Postoperative recovery was favorable, with no neurological deficits and stable imaging findings at a three-month follow-up. This case underscores the necessity for precise microsurgical intervention and a thorough understanding of pericallosal artery anatomy to manage such rare and challenging conditions effectively. The role of hyperlipidemia and statin use in intracranial aneurysm development remains debated and warrants further investigation. Our successful management of mirror pericallosal artery aneurysms contributes to the limited literature on this rare condition and highlights the importance of meticulous surgical techniques for favorable outcomes. Full article
(This article belongs to the Special Issue Clinical Research in Neurosurgery)
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