Clinical implications and prognostic value of mastoid effusion in the management of aneurysmal subarachnoid hemorrhage.

Background: The clinical significance of mastoid effusion (ME) in intensive care unit (ICU) patients has not been well elucidated. Recently, an association between ME and intracranial pressure (ICP) has been reported. We aimed to investigate the clinical implications of ME occurrence in the management of aneurysmal subarachnoid hemorrhage (aSAH) patients and its association with their prognosis.

Clinical Practice Guideline for the Prehospital Stage in Acute Stroke : I. Use of Emergency Medical Services Assessment Tools.

Accurate and early identification of stroke and large vessel occlusion (LVO) in emergency settings is essential for improving patient outcomes and ensuring the efficient allocation of medical resources. This clinical practice guideline systematically reviews domestic and international literature and conducts meta-analyses to evaluate the utility and diagnostic accuracy of stroke assessment tools used in prehospital emergency medical services (EMS). We developed a guideline based on evidence from systematic reviews and meta-analyses via a de novo process.

Clinical Practice Guidelines for the Pre-hospital Stage of Acute Stroke in Korea II : Transport Decisions for Patients with Acute Ischemic Stroke.

The mothership (MS) model, where patients are directly transferred to a thrombectomy-capable center, and the drip-and-ship (DS) model, where thrombolysis is initiated at the nearest primary stroke center before transfer for thrombectomy, are the primary transport modes for patients with stroke. We aimed to establish guidelines for selecting the appropriate transfer strategy based on emergent large vessel occlusion (LVO). We developed this guideline based on evidence from systematic reviews and meta-analyses via a de novo process.

FloWise Flow Diverter for Treatment of Unruptured Wide-Neck Intracranial Aneurysms: A Prospective, Multicenter, Single-Arm, Open-Label, Pivotal Study.

Objective: We evaluated the safety and efficacy of a new flow diverter in the treatment of unruptured wide-neck aneurysms.

Materials And Methods: Patients who had unruptured intracranial aneurysms with a neck diameter ≥4 mm or dome-to-neck ratio <2 and who met other eligibility criteria were enrolled from seven institutions. The patients were treated with a new flow diverter (FloWise; Taewoong Medical, Seoul, Korea) and followed at 1, 3, 6, and 12 months after treatment.

Woven endobridge embolization versus microsurgical clipping for unruptured wide-neck cerebral aneurysms on middle cerebral artery bifurcation.

Woven EndoBridge (WEB) is an endovascular treatment for wide-neck bifurcation aneurysms (WNBAs). This study aimed to clarify the efficacy and safety of the WEB comparing to clipping for treating the middle cerebral artery (MCA) WNBAs. For the matched analysis, we designed a retrospective, tertiary, single-center study including 288 MCA WNBAs treated with WEB (n = 37) or clipping (n = 251).

Comparative analysis between stent-assisted coiling and Woven EndoBridge embolization for unruptured wide-necked bifurcation intracranial aneurysms: A propensity score matching study.

Background: Before the utilization of the Woven EndoBridge (WEB) for the treatment of wide-necked bifurcation intracranial aneurysms (WNBA), stent-assisted coiling (SAC) was the predominant endovascular treatment. Studies directly comparing the outcomes of these two methods are still limited. This study aimed to compare the safety and efficacy of SAC and WEB embolization for unruptured WNBAs through propensity score matching.

Incidence and Characteristics of Cerebral Infarction After Microsurgical Clipping of Unruptured Anterior Circulation Cerebral Aneurysms: Diffusion-Weighted Imaging-Based Analysis of 600 Patients.

Background And Objectives: Postclipping cerebral infarction (PCI) remains a major concern after treatment for unruptured intracranial aneurysms (UIAs). However, studies of microsurgical clipping based on diffusion-weighted imaging are limited. We aimed to present the incidence, risk factors, and types of PCI and its radiological and clinical characteristics.

Safety and efficacy of the novel Alpha stent for the treatment of intracranial wide-necked aneurysm.

The Alpha stent is an intracranial closed-cell stent with a unique mesh design to enhance wall apposition. It recently underwent structural modifications to facilitate easier stent deployment. This study aimed to evaluate the safety and efficacy of stent-assisted coil embolization for unruptured intracranial aneurysms using the Alpha stent.

Eye movement analysis for real-world settings using segmented linear regression.

Eye movement analysis is critical to studying human brain phenomena such as perception, cognition, and behavior. However, under uncontrolled real-world settings, the recorded gaze coordinates (commonly used to track eye movements) are typically noisy and make it difficult to track change in the state of each phenomenon precisely, primarily because the expected change is usually a slower transient process. This paper proposes an approach, Improved Naive Segmented linear regression (INSLR), which approximates the gaze coordinates with a piecewise linear function (PLF) referred to as a hypothesis.

One-year clinical and radiologic outcomes of Surpass Evolve flow diverter for large unruptured intracranial aneurysms.

Background: Surpass Evolve Flow Diverter (SE-FD; Stryker Neurovascular, Kalamazoo, MI, USA) was launched in 2019 as a new generation FD of Surpass Streamline. The aim of this study was to report the effectiveness and safety of SE-FD insertion for unruptured intracranial aneurysm at one-year follow-up.

Methods: Between November 2019 and October 2021, a total of 106 patients with 108 aneurysms were treated with FD in single institution.

Prediction of cerebral hemorrhagic transformation after thrombectomy using a deep learning of dual-energy CT.

Objectives: To develop and validate a deep learning model for predicting hemorrhagic transformation after endovascular thrombectomy using dual-energy computed tomography (CT).

Materials And Methods: This was a retrospective study from a prospective registry of acute ischemic stroke. Patients admitted between May 2019 and February 2023 who underwent endovascular thrombectomy for acute anterior circulation occlusions were enrolled.

Surgical outcomes of acetabular fracture of elderly patients with superomedial dome impaction.

This study aimed to investigate the outcomes of elderly acetabular fractures according to the reduction of impacted dome fragments. A retrospective cohort study was performed in two institutions. Fifty-four patients aged ≥ 60 years with acetabular fractures were enrolled.

Perioperative Low-Dose Aspirin Management for Planned Clipping Surgery: When, How Long, and With What Precautions?

Background And Objective: Perioperative low-dose aspirin (ASA) management for open craniotomy surgery lacked information. We analyze to establish the perioperative ASA strategy to minimize both hemorrhagic and thromboembolic complications.

Methods: The investigators designed a multicenter retrospective study, which included patients scheduled to have clipping surgery for unruptured intracranial aneurysm.

Endoscope-assisted microsurgical clipping and reduction of post-clipping cerebral infarction: historical comparison using diffusion-weighted images.

Endoscopic assistance for aneurysm clipping and its possible benefits have been suggested in previous studies, but its clinical significance has not been fully elucidated. This study aimed to present the efficacy of endoscopy-assisted clipping in reducing post-clipping cerebral infarction (PCI) and clinical outcomes via a historical comparison of patients in our institution from January 2020 to March 2022. A total of 348 patients were included, 189 of whom underwent endoscope-assisted clipping.

Subdural hygroma and hemorrhagic conversion after microsurgical clipping for unruptured intracranial aneurysm.

Background: Chronic subdural hematoma (cSDH) is a unique hemorrhagic complication associated with microsurgical clipping. We aimed to investigate the risk factors of subdural hygroma (SDG) formation and its hemorrhagic conversion to cSDH.

Methods: We reviewed the medical records of 229 patients who underwent microsurgical clipping for unruptured intracranial aneurysms (UIA) from 2016 to 2019.

New morphological parameter for intracranial aneurysms and rupture risk prediction based on artificial neural networks.

Background: Numerous studies have evaluated the rupture risk of intracranial aneurysms using morphological parameters because of their good predictive capacity. However, the limitation of current morphological parameters is that they do not always allow evaluation of irregularities of intracranial aneurysms. The purpose of this study is to propose a new morphological parameter that can quantitatively describe irregularities of intracranial aneurysms and to evaluate its performance regarding rupture risk prediction.

Outcomes of dual plating for unstable distal femoral fractures: a subgroup comparison between periprosthetic and non-periprosthetic fractures.

Purpose: This study aimed to evaluate the outcomes of dual plating for unstable distal femoral fractures via a subgroup analysis between periprosthetic and non-periprosthetic fractures.

Methods: This retrospective cohort study analyzed the outcomes of dual plating for unstable distal femoral fractures among 49 consecutive patients (43 women and 6 men) enrolled from July 2008 to August 2020. The patients were divided into periprosthetic (group P, n = 29) and non-periprosthetic (group N, n = 20) groups.

Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures: a retrospective comparative study.

Background: This study aimed to compare the clinical outcomes and complications between two minimally invasive surgical techniques: percutaneous transiliac plate fixation and iliosacral (IS) screw fixation for the treatment of Tile C-type pelvic bone fractures.

Methods: We retrospectively reviewed the data of 77 consecutive patients with Tile C pelvic ring injuries who underwent either percutaneous transiliac plate fixation or IS screw fixation in a single academic center between November 2007 and January 2018. We recorded patients' demographics, surgery-related data, and postoperative surgical outcomes and compared the incidence of complications and revision surgery rates between the two groups.

The clinical application of a scoring protocol to select endarterectomy or stenting for carotid artery stenosis.

Previously we described the protocol-based decision for choosing the proper surgical treatment option for carotid stenosis. The objective of this study is to describe our experiences of using this scoring protocol in the selection of endarterectomy or stenting for carotid stenosis. Between October 2014 and March 2018, the scoring protocol was applied to a total of 105 consecutive patients.

Rupture risk prediction of cerebral aneurysms using a novel convolutional neural network-based deep learning model.

Background: Cerebral aneurysms should be treated before rupture because ruptured aneurysms result in serious disability. Therefore, accurate prediction of rupture risk is important and has been estimated using various hemodynamic factors.

Objective: To suggest a new way to predict rupture risk in cerebral aneurysms using a novel deep learning model based on hemodynamic parameters for better decision-making about treatment.

Acetabular fractures in elderly.

Background: This study aimed to determine characteristics of acetabular fractures in the elderly by evaluating clinical course and computed tomography-based radiological features between low- and high-energy acetabular fractures.

Methods: We reviewed 178 consecutive patients with acetabular fractures aged ≥60 years from six centers. Low-energy fractures (group 1) were identified in 23 (12.