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  • Frontiers Media SA  (3)
  • Xiao, Feng  (3)
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  • Frontiers Media SA  (3)
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  • 1
    Online Resource
    Online Resource
    Frontiers Media SA ; 2023
    In:  Frontiers in Aging Neuroscience Vol. 15 ( 2023-2-1)
    In: Frontiers in Aging Neuroscience, Frontiers Media SA, Vol. 15 ( 2023-2-1)
    Abstract: The unruptured intracranial aneurysm (UIA) has high disability and mortality rate after rupture, it is particularly important to assess the risk of UIA and to carry out individualized treatment. The objective of this research is to introduce a novel parameter to predict the rupture risk of UIA. Methods A total of 649 patients with 964 intracranial aneurysms in our center were enrolled. A novel parameter named mean arterial pressure-aneurysmal neck ratio (MAPN) was defined. Ten baseline clinical features and twelve aneurysm morphological characteristics were extracted to generate the MAPN model. The discriminatory performance of the MAPN model was compared with the PHASES score and the UCAS score. Results In hemodynamic analysis, MAPN was positively correlated with wall shear stress and aneurysm top pressure, with Pearson correlation coefficients of 0.887 and 0.791, respectively. The MAPN was larger in the ruptured group (36.62 ± 18.96 vs. 28.38 ± 14.58, P & lt; 0.001). The area under the curve (AUC) of the MAPN was superior than the AUC of aspect ratio (AR) and the bottleneck factor (BN), they were 0.64 ( P & lt; 0.001; 95% CI, 0.588–0.692), 0.611 ( P & lt; 0.001; 95% CI, 0.559–0.663) and 0.607 ( P & lt; 0.001; 95% CI, 0.554–0.660), respectively. The MAPN model constructed by aneurysm size, aneurysm location, presence of secondary sacs and MAPN, demonstrated good discriminatory ability. The MAPN model exhibited superior performance compared with the UCAS score and the PHASES score (the AUC values were 0.799 [ P & lt; 0.001; 95% CI, 0.756–0.840], 0.763 [ P & lt; 0.001; 95% CI,0.719–0.807] and 0.741 [ P & lt; 0.001; 95% CI, 0.695–0.787], respectively; the sensitivities were 0.849, 0.758 and 0.753, respectively). Conclusions Research demonstrates the potential of MAPN to augment the clinical decision-making process for assessing the rupture risk of UIAs.
    Type of Medium: Online Resource
    ISSN: 1663-4365
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2558898-9
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  • 2
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 11 ( 2021-8-9)
    Abstract: Microsurgical Transcranial approach (mTCA) is the primary choice for the resection of giant Tuberculum Sellae Meningiomas (TSM). The objective of this study is to explore surgical details of unilateral subfrontal approach. Methods Ten patients with giant TSM treated by unilateral subfrontal approach were included from January 2018 to June 2021. Demographic characteristics, surgical data, post-procedure complications and outcomes of patients have been descriptive analyzed, combined with systematic literature review to explore the surgical details and the prognosis of unilateral subfrontal approach. Results Ten patients include six male and four females, age range from 35 to 77 years, duration of visual impairment from 1 to 12 months, were all performed unilateral subfrontal approach. Nine patients achieved radical resection (Simpson grades I-II) through post-operative imaging confirmation, and Simpson IV resection was performed in the remaining one due to cavernous sinus invasion. The postoperative visual acuity was improved or maintained in 8 patients. Visual acuity decreased in 2 cases, including 1 case of optic nerve atrophy and the other case of optic canal not opening. Five cases with frontal sinus opened were repaired during the operation and there was no postoperative cerebrospinal fluid leakage or intracranial infection. One patient suffered from postoperative anosmia, one patient developed left limb weakness, but their symptoms have improved in the follow-up. Conclusion Summarize the experience of our center and previous literature, unilateral forehead bottom craniotomy is a feasible surgical approach for giant tuberculum sellae meningioma. Intraoperative application of EC glue and pedicled fascia flap to repair the frontal sinus can prevent complications associated with frontal sinus opening. Optic canal unroofing has huge advantage in visual improvement.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2649216-7
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  • 3
    In: Frontiers in Surgery, Frontiers Media SA, Vol. 8 ( 2021-9-3)
    Abstract: Cerebral radiation necrosis (RN), a complication of Gamma Knife radiosurgery, is difficult to treat, although bevacizumab seems to be effective. However, clinical data pertaining to bevacizumab treatment for RN are scarce, and its high price is problematic. This study explored the effectiveness of low-dose bevacizumab for RN caused by Gamma Knife. We retrospectively analyzed 22 patients who suffered cerebral RN post-Gamma Knife, and received bevacizumab treatment because of the poor efficacy of glucocorticoids. Low-dose bevacizumab (3 mg/kg) was administered for two cycles at 2-week intervals. T1- and T2-enhanced magnetic resonance imaging (MRI) images were examined for changes in RN status. We also monitored the dose of glucocorticoid, Karnofsky Performance Status (KPS) score, and adverse drug reactions. The mean volume of RN lesions decreased by 45% on T1-weighted images with contrast enhancement, and by 74% on T2-weighted images. All patients discontinued the use of glucocorticoids. According to the KPS scores, all patients showed an improvement in their symptoms and neurological function. No side effects were observed. Low-dosage bevacizumab at a dose of 3 mg/kg every 2 weeks is effective for treating cerebral RN after Gamma knife for brain metastases.
    Type of Medium: Online Resource
    ISSN: 2296-875X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2773823-1
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