Clip ligation of unruptured intracranial aneurysms: a prospective midterm outcome study

Background

We conducted a prospective study to investigate the clinical and radiological outcome in a surgical case series of 176 patients with 203 unruptured intracranial aneurysms (UIA).

Methods

The success of aneurysm obliteration was assessed within 2 weeks after surgery by digital subtraction angiography (DSA). Patients also underwent angiography 5 years after surgery. Clinical outcomes were assessed using the modified Rankin Scale (mRS). All predictors of poor surgical outcomes were assessed using an exact logistic regression.

Results

Overall, 83 % of the patients had a good outcome (mRS score 0 or 1); 10.8 % of the patients had a slight disability (mRS score 2), and 6.2 % of the patients had a moderate or moderate-severe disability (mRS score 3 or 4). The mortality rate was 0 % overall. The most important predictors of outcome were presence of history of ischemic cerebrovascular disease and postoperative stroke. Complete aneurysm occlusion was achieved in 93.5 % of all aneurysms. Sixty percent of treated aneurysms were checked with late follow-up DSA. No cases of hemorrhage from a surgically obliterated UIA were documented in this series during the 7.3?±?1.4 (SD)-year follow-up period.

Conclusions

If patients are carefully selected and individually assigned to their optimum treatment modality, IUAs can be obliterated by surgery with a low percentage of unfavorable outcomes.

     

Prior angina reduces ıschemic mitral regurgitation in patients with ST-Elevation myocardial ınfarction,role of ıschemic preconditioning

The International Journal of Cardiovascular Imaging - Mitral regurgitation may develop due to left ventricular (LV) remodeling within 3 months following acute myocardial...     

Metals in Two Species of Fish in Karasu River

In this study, cadmium (Cd), copper (Cu), iron (Fe), nickel (Ni), lead (Pb) and zinc (Zn) levels were determined in the tissues (muscle, liver and gills) of two fish species, Capoeta capoeta umbla and Chalcalburnus mosullensis, collected from three stations of the Karasu River. The lowest metal accumulation was detected in the muscle tissues. Moreover there was some variability in the metal concentrations measured in the same tissues from samples obtained from the three different stations. A positive correlation was observed for the concentration of metal pairs Fe–Cu, Fe–Zn, Ni–Pb, Pb–Zn. These findings were also compared with national and international food standards, and Pb and Cd concentrations were determined to be above the level set by the standards. In conclusion, it was supposed that excessive consumption of these two fish species, which already occurs in this region, might pose a public health risk.     

Lumbar Epidural Varix Mimicking Disc Herniation

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4–5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient''s complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.     

Association of combined small cell and large cell lung cancer with Lambert-Eaton myasthenic syndrome: case report

Lambert-Eaton myasthenic syndrome (LEMS) is a rare type of neuromusculer conduction disorder. This disease can be seen with lung cancer and, it is associated with otoimmunity. Among the symptoms of lung cancer LEMS can be seen, but it is very rare. In this case, LEMS symptoms were analyzed before lung cancer symptoms. The localization of the tumor was near the pulmonary artery. By the early diagnose, the patient had the chance of cure.     

Scrofuloderma after BCG vaccination

A 7-month-old boy with scrofuloderma following BCG vaccination is presented. He had a 2 cm x 1 cm erythematous lesion with a sinus tract in the right cervical area. In addition, he had ulcerated erythematous lesions 0.5 cm x 0.5 cm in size on the left deltoid area and left forearm where BCG vaccination and a PPD test were performed, respectively. Histopathologic findings were consistent with the clinical diagnosis.