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Article ; Online: Increased Risk of Recurrent Stroke in Symptomatic Large Vessel Disease With Impaired BOLD Cerebrovascular Reactivity.

van Niftrik, Christiaan H B / Sebök, Martina / Germans, Menno R / Halter, Matthias / Pokorny, Thomas / Stumpo, Vittorio / Bellomo, Jacopo / Piccirelli, Marco / Pangalu, Athina / Katan, Mira / Wegener, Susanne / Tymianski, Michael / Kulcsár, Zsolt / Luft, Andreas R / Fisher, Joseph A / Mikulis, David J / Regli, Luca / Fierstra, Jorn

Stroke

2024 Volume 55, Issue 3, Page(s) 613–621

Abstract: Background: Impaired cerebrovascular reactivity (CVR) has been correlated with recurrent ischemic stroke. However, for clinical purposes, most CVR techniques are rather complex, time-consuming, and lack validation for quantitative measurements. The ... ...

Abstract	Background: Impaired cerebrovascular reactivity (CVR) has been correlated with recurrent ischemic stroke. However, for clinical purposes, most CVR techniques are rather complex, time-consuming, and lack validation for quantitative measurements. The recent adaptation of a standardized hypercapnic stimulus in combination with a blood-oxygenation-level-dependent (BOLD) magnetic resonance imaging signal as a surrogate for cerebral blood flow offers a potential universally comparable CVR assessment. We investigated the association between impaired BOLD-CVR and risk for recurrent ischemic events. Methods: We conducted a retrospective analysis of patients with symptomatic cerebrovascular large vessel disease who had undergone a prospective hypercapnic-challenged BOLD-CVR protocol at a single tertiary stroke referral center between June 2014 and April 2020. These patients were followed up for recurrent acute ischemic events for up to 3 years. BOLD-CVR (%BOLD signal change per mm Hg CO Results: Of 130 eligible patients, 28 experienced recurrent strokes (median, 85 days, interquartile range, 5-166 days). Risk factors associated with an increased recurrent stroke rate included impaired BOLD-CVR, a history of atrial fibrillation, and heart insufficiency. After adjusting for sex, age group, and atrial fibrillation, impaired BOLD-CVR exhibited a hazard ratio of 10.73 (95% CI, 4.14-27.81; Conclusions: Among patients with symptomatic cerebrovascular large vessel disease, those exhibiting impaired BOLD-CVR in the affected hemisphere had a 10.7-fold higher risk of recurrent ischemic stroke events compared with individuals with nonimpaired BOLD-CVR.
MeSH term(s)	Humans ; Ischemic Stroke ; Retrospective Studies ; Atrial Fibrillation ; Prospective Studies ; Cerebrovascular Disorders ; Magnetic Resonance Imaging/methods ; Stroke/diagnostic imaging ; Cerebral Infarction ; Hypercapnia/diagnostic imaging ; Cerebrovascular Circulation/physiology
Language	English
Publishing date	2024-02-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.123.044259
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Article ; Online: Recommendations for head and neck surgical procedures during the COVID-19 pandemic.

Kulcsar, Marco A V / Montenegro, Fabio L M / Santos, André B O / Tavares, Marcos R / Arap, Sergio S / Kowalski, Luiz P

Clinics (Sao Paulo, Brazil)

2020 Volume 75, Page(s) e2084

Abstract: The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it ...

Abstract	The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.
MeSH term(s)	Betacoronavirus ; Brazil ; COVID-19 ; Coronavirus ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Infectious Disease Transmission, Professional-to-Patient/prevention & control ; Pandemics ; Patient Safety ; Personal Protective Equipment ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Practice Guidelines as Topic ; Protective Devices ; SARS-CoV-2 ; Surgeons
Keywords	covid19
Language	English
Publishing date	2020-07-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182801-5
ISSN	1980-5322 ; 1807-5932
ISSN (online)	1980-5322
ISSN	1807-5932
DOI	10.6061/clinics/2020/e2084
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Article ; Online: Acute Stenting and Concomitant Tirofiban Administration for the Endovascular Treatment of Acute Ischemic Stroke Related to Intracranial Artery Dissections: A Single Center Experience and Systematic Review of the Literature.

Bernava, Gianmarco / Meling, Torstein R / Rosi, Andrea / Hofmeister, Jeremy / Yilmaz, Hasan / Brina, Olivier / Reymond, Philippe / Muster, Michel / Corniola, Marco V / Carrera, Emmanuel / Lovblad, Karl-Olof / Kulcsar, Zsolt / Machi, Paolo

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2021 Volume 30, Issue 8, Page(s) 105891

Abstract: Background: Intracranial artery dissection is an uncommon cause of acute ischemic stroke. Although acute stenting of the dissected arterial segment is a therapeutic option, the associated antiplatelet regimen remains a matter of debate.: Objectives: ... ...

Abstract	Background: Intracranial artery dissection is an uncommon cause of acute ischemic stroke. Although acute stenting of the dissected arterial segment is a therapeutic option, the associated antiplatelet regimen remains a matter of debate. Objectives: To evaluate the efficacy and safety of acute intracranial stenting together with concomitant intravenous administration of tirofiban and to perform a systematic review of the literature. Materials and methods: A single-center, retrospective study of the clinical and radiological records of all patients treated at our center by intracranial stenting in the setting of acute ischemic stroke between January 2010 and December 2020. A systematic review of the literature was conducted according to the PRISMA-P guidelines for relevant publications from January 1976 to December 2020 on intracranial artery dissection treated by stent. Results: Seven patients with intracranial artery dissections underwent acute stenting with concomitant tirofiban during the study period. Mid-term follow-up showed parent artery patency in 6/7 cases (85.7%). The modified Rankin Score was ≤ 0-2 at 3 months in 5/7 cases (71.4%). The literature review identified 22 patients with intracranial artery dissection treated with acute stenting in association with different antithrombotic therapies. Complete revascularization was obtained in 86.3% of cases with a modified Rankin Score of ≤ 0-2 in 68% of patients at 3-month follow-up. Conclusions: Acute intracranial stenting together with intravenous tirofiban administration could be a therapeutic option in patients with intracranial artery dissection and a small ischemic core.
MeSH term(s)	Administration, Intravenous ; Adult ; Aged ; Aneurysm, Dissecting/complications ; Aneurysm, Dissecting/diagnostic imaging ; Aneurysm, Dissecting/physiopathology ; Aneurysm, Dissecting/therapy ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation ; Female ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/physiopathology ; Intracranial Aneurysm/therapy ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/etiology ; Ischemic Stroke/physiopathology ; Ischemic Stroke/therapy ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage ; Platelet Aggregation Inhibitors/adverse effects ; Retrospective Studies ; Stents ; Time Factors ; Tirofiban/administration & dosage ; Tirofiban/adverse effects ; Treatment Outcome ; Vascular Patency ; Young Adult
Chemical Substances	Platelet Aggregation Inhibitors ; Tirofiban (GGX234SI5H)
Language	English
Publishing date	2021-06-03
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2021.105891
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Article: Recommendations for head and neck surgical procedures during the COVID-19 pandemic

Kulcsar, Marco A. V. / Montenegro, Fabio L. M. / Santos, Andre B. O. / Tavares, Marcos R. / Arap, Sergio S. / Kowalski, Luiz P.

Clinics (Sao Paulo, Brazil)

Abstract: The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it ... ...

Abstract	The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers) As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #637684
Database	COVID19

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Article ; Online: Recommendations for head and neck surgical procedures during the COVID-19 pandemic

Kulcsar, Marco A.V. / Montenegro, Fabio L. M. / Santos, André B. O. / Tavares, Marcos R. / Arap, Sergio S. / Kowalski, Luiz P.

Clinics; v.; e2084 ; Clinics; Vol. 75 (2020); e2084 ; Clinics; Vol 75 (2020); e2084 ; 1980-5322 ; 1807-5932

2020 Volume 75

Abstract	The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual’s chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.
Keywords	COVID-19 ; Surgery ; Head and Neck ; Prevention ; Complications ; covid19
Language	English
Publishing date	2020-07-31
Publisher	Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
Publishing country	br
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing Perfusion in Steno-Occlusive Cerebrovascular Disease Using Transient Hypoxia-Induced Deoxyhemoglobin as a Dynamic Susceptibility Contrast Agent.

Sayin, Ece Su / Duffin, James / Stumpo, Vittorio / Bellomo, Jacopo / Piccirelli, Marco / Poublanc, Julien / Wijeya, Vepeson / Para, Andrea / Pangalu, Athina / Bink, Andrea / Nemeth, Bence / Kulcsar, Zsolt / Mikulis, David J / Fisher, Joseph A / Sobczyk, Olivia / Fierstra, Jorn

AJNR. American journal of neuroradiology

2023 Volume 45, Issue 1, Page(s) 37–43

Abstract: Background and purpose: Resting brain tissue perfusion in cerebral steno-occlusive vascular disease can be assessed by MR imaging using gadolinium-based susceptibility contrast agents. Recently, transient hypoxia-induced deoxyhemoglobin has been ... ...

Abstract	Background and purpose: Resting brain tissue perfusion in cerebral steno-occlusive vascular disease can be assessed by MR imaging using gadolinium-based susceptibility contrast agents. Recently, transient hypoxia-induced deoxyhemoglobin has been investigated as a noninvasive MR imaging contrast agent. Here we present a comparison of resting perfusion metrics using transient hypoxia-induced deoxyhemoglobin and gadolinium-based contrast agents in patients with known cerebrovascular steno-occlusive disease. Materials and methods: Twelve patients with steno-occlusive disease underwent DSC MR imaging using a standard bolus of gadolinium-based contrast agent compared with transient hypoxia-induced deoxyhemoglobin generated in the lungs using an automated gas blender. A conventional multi-slice 2D gradient echo sequence was used to acquire the perfusion data and analyzed using a standard tracer kinetic model. MTT, relative CBF, and relative CBV maps were generated and compared between contrast agents. Results: The spatial distributions of the perfusion metrics generated with both contrast agents were consistent. Perfusion metrics in GM and WM were not statistically different except for WM MTT. Conclusions: Cerebral perfusion metrics generated with noninvasive transient hypoxia-induced changes in deoxyhemoglobin are very similar to those generated using a gadolinium-based contrast agent in patients with cerebrovascular steno-occlusive disease.
MeSH term(s)	Humans ; Contrast Media ; Gadolinium ; Cerebrovascular Disorders ; Magnetic Resonance Imaging/methods ; Hypoxia ; Perfusion ; Cerebrovascular Circulation ; Hemoglobins
Chemical Substances	Contrast Media ; deoxyhemoglobin (9008-02-0) ; Gadolinium (AU0V1LM3JT) ; Hemoglobins
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A8068
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Article ; Online: Amelanotic melanoma presenting as a tongue tumor.

Leite, Ana Kober / Kulcsar, Marco Aurélio V / Matsuura, Danielli / Matos, Leandro Luongo / Kowalski, Luiz Paulo

Oral oncology

2020 Volume 114, Page(s) 105075

MeSH term(s)	Humans ; Male ; Melanoma, Amelanotic/complications ; Melanoma, Amelanotic/pathology ; Middle Aged ; Tongue Neoplasms/etiology ; Tongue Neoplasms/physiopathology
Language	English
Publishing date	2020-11-11
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	1120465-5
ISSN	1879-0593 ; 0964-1955 ; 1368-8375
ISSN (online)	1879-0593
ISSN	0964-1955 ; 1368-8375
DOI	10.1016/j.oraloncology.2020.105075
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Article ; Online: Recommendations for head and neck surgical procedures during the COVID-19 pandemic

Kulcsar, Marco A.V. / Montenegro, Fabio L.M. / Santos, André B.O. / Tavares, Marcos R. / Arap, Sergio S. / Kowalski, Luiz P.

Clinics v.75 2020

2020

Abstract	The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.
Keywords	COVID-19 ; Surgery ; Head and Neck ; Prevention ; Complications ; covid19
Language	English
Publishing date	2020-01-01
Publisher	Faculdade de Medicina / USP
Publishing country	br
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recommendations for head and neck surgical procedures during the COVID-19 pandemic

Marco A.V. Kulcsar / Fabio L.M. Montenegro / André B.O. Santos / Marcos R. Tavares / Sergio S. Arap / Luiz P. Kowalski

Clinics, Vol

2020 Volume 75

Abstract	The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.
Keywords	COVID-19 ; Surgery ; Head and Neck ; Prevention ; Complications ; Medicine (General) ; R5-920
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	Elsevier España
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Impact of Very Small Aneurysm Size and Anterior Communicating Segment Location on Outcome after Aneurysmal Subarachnoid Hemorrhage.

Roethlisberger, Michel / Aghlmandi, Soheila / Rychen, Jonathan / Chiappini, Alessio / Zumofen, Daniel W / Bawarjan, Schatlo / Stienen, Martin N / Fung, Christian / D'Alonzo, Donato / Maldaner, Nicolai / Steinsiepe, Valentin K / Corniola, Marco V / Goldberg, Johannes / Cianfoni, Alessandro / Robert, Thomas / Maduri, Rodolfo / Saliou, Guillaume / Starnoni, Daniele / Weber, Johannes /

Seule, Martin A / Gralla, Jan / Bervini, David / Kulcsar, Zsolt / Burkhardt, Jan-Karl / Bozinov, Oliver / Remonda, Luca / Marbacher, Serge / Lövblad, Karl-Olof / Psychogios, Marios / Bucher, Heiner C / Mariani, Luigi / Bijlenga, Philippe / Blackham, Kristine A / Guzman, Raphael

Neurosurgery

2022 Volume 92, Issue 2, Page(s) 370–381

Abstract: Background: Very small anterior communicating artery aneurysms (vsACoA) of <5 mm in size are detected in a considerable number of patients with aneurysmal subarachnoid hemorrhage (aSAH). Single-center studies report that vsACoA harbor particular risks ... ...

Abstract	Background: Very small anterior communicating artery aneurysms (vsACoA) of <5 mm in size are detected in a considerable number of patients with aneurysmal subarachnoid hemorrhage (aSAH). Single-center studies report that vsACoA harbor particular risks when treated. Objective: To assess the clinical and radiological outcome(s) of patients with aSAH diagnosed with vsACoA after aneurysm treatment and at discharge. Methods: Information on n = 1868 patients was collected in the Swiss Subarachnoid Hemorrhage Outcome Study registry between 2009 and 2014. The presence of a new focal neurological deficit at discharge, functional status (modified Rankin scale), mortality rates, and procedural complications (in-hospital rebleeding and presence of a new stroke on computed tomography) was assessed for vsACoA and compared with the results observed for aneurysms in other locations and with diameters of 5 to 25 mm. Results: This study analyzed n = 1258 patients with aSAH, n = 439 of which had a documented ruptured ACoA. ACoA location was found in 38% (n = 144/384) of all very small ruptured aneurysms. A higher in-hospital bleeding rate was found in vsACoA compared with non-ACoA locations (2.8 vs 2.1%), especially when endovascularly treated (2.1% vs 0.5%). In multivariate analysis, aneurysm size of 5 to 25 mm, and not ACoA location, was an independent risk factor for a new focal neurological deficit and a higher modified Rankin scale at discharge. Neither very small aneurysm size nor ACoA location was associated with higher mortality rates at discharge or the occurrence of a peri-interventional stroke. Conclusion: Very small ruptured ACoA have a higher in-hospital rebleeding rate but are not associated with worse morbidity or mortality.
MeSH term(s)	Adult ; Humans ; Child ; Subarachnoid Hemorrhage/diagnostic imaging ; Subarachnoid Hemorrhage/surgery ; Subarachnoid Hemorrhage/etiology ; Treatment Outcome ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Aneurysm, Ruptured/complications ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/surgery ; Radiography
Language	English
Publishing date	2022-11-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002212
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In stock of ZB MED Cologne/Königswinter

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