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Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study

BACKGROUND: BRI is estimated to occur in 10% of skull-base surgery and 5% of aneurysm surgery. These estimates are based on a few studies with unclear methodology. The purpose of this study is to assess the rate of BRI occurrence, its risk factors, and the association between BRI and postoperative f...

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Autores principales: Konya, B., Dankbaar, J. W., van der Zwan, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913465/
https://www.ncbi.nlm.nih.gov/pubmed/35107618
http://dx.doi.org/10.1007/s00701-022-05131-y
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author Konya, B.
Dankbaar, J. W.
van der Zwan, A.
author_facet Konya, B.
Dankbaar, J. W.
van der Zwan, A.
author_sort Konya, B.
collection PubMed
description BACKGROUND: BRI is estimated to occur in 10% of skull-base surgery and 5% of aneurysm surgery. These estimates are based on a few studies with unclear methodology. The purpose of this study is to assess the rate of BRI occurrence, its risk factors, and the association between BRI and postoperative focal neurological deficit in patients that underwent elective aneurysm surgery in a single institution. METHODS: All patients that underwent elective aneurysm surgery in a single tertiary center in the Netherlands were included. BRI was defined as cortical hypodensities in the surgical trajectory not matching areas of large arterial infarction. Risk ratios were calculated between BRI and (a) the use of temporary parent artery occlusion during clipping, (b) anterior communicating artery (ACom), and (c) middle cerebral artery (MCA) location of the aneurysm, (d) presence of mentioned CVA risk factors, (e) the clipping of > 1 aneurysm during the same procedure, and (f) new focal neurological deficit. Statistical analysis further included t-tests and binary logistical regression analysis on the correlation between age and BRI. RESULTS: BRI was identified postoperatively in 42 of the 94 patients included in this study. A new focal neurological deficit was found in 7 patients in the BRI group. A total of 5 patients had persisting symptoms at 3-month follow-up, of which 2 were caused by BRI. Increasing age is a risk factor for developing BRI. CONCLUSIONS: The high rate of BRI and significant risk of new postoperative focal neurological deficit in our patients should be considered when counseling patients for elective aneurysm surgery.
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spelling pubmed-89134652022-03-15 Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study Konya, B. Dankbaar, J. W. van der Zwan, A. Acta Neurochir (Wien) Original Article - Vascular Neurosurgery - Ischemia BACKGROUND: BRI is estimated to occur in 10% of skull-base surgery and 5% of aneurysm surgery. These estimates are based on a few studies with unclear methodology. The purpose of this study is to assess the rate of BRI occurrence, its risk factors, and the association between BRI and postoperative focal neurological deficit in patients that underwent elective aneurysm surgery in a single institution. METHODS: All patients that underwent elective aneurysm surgery in a single tertiary center in the Netherlands were included. BRI was defined as cortical hypodensities in the surgical trajectory not matching areas of large arterial infarction. Risk ratios were calculated between BRI and (a) the use of temporary parent artery occlusion during clipping, (b) anterior communicating artery (ACom), and (c) middle cerebral artery (MCA) location of the aneurysm, (d) presence of mentioned CVA risk factors, (e) the clipping of > 1 aneurysm during the same procedure, and (f) new focal neurological deficit. Statistical analysis further included t-tests and binary logistical regression analysis on the correlation between age and BRI. RESULTS: BRI was identified postoperatively in 42 of the 94 patients included in this study. A new focal neurological deficit was found in 7 patients in the BRI group. A total of 5 patients had persisting symptoms at 3-month follow-up, of which 2 were caused by BRI. Increasing age is a risk factor for developing BRI. CONCLUSIONS: The high rate of BRI and significant risk of new postoperative focal neurological deficit in our patients should be considered when counseling patients for elective aneurysm surgery. Springer Vienna 2022-02-02 2022 /pmc/articles/PMC8913465/ /pubmed/35107618 http://dx.doi.org/10.1007/s00701-022-05131-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article - Vascular Neurosurgery - Ischemia
Konya, B.
Dankbaar, J. W.
van der Zwan, A.
Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
title Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
title_full Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
title_fullStr Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
title_full_unstemmed Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
title_short Brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
title_sort brain retraction injury after elective aneurysm clipping: a retrospective single-center cohort study
topic Original Article - Vascular Neurosurgery - Ischemia
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913465/
https://www.ncbi.nlm.nih.gov/pubmed/35107618
http://dx.doi.org/10.1007/s00701-022-05131-y
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