Before emergency aneurysm surgery, CTA or DSA? A single center experience.

OBJECTIVE: Subarachnoid hemorrhage (SAH) due to an intracranial aneurysm is a life-threatening surgical emergency. After the diagnosis of SAH, physicians should find the reason for the bleeding. CT- Angiography (CTA) and Digital Subtraction Angiography (DSA) are techniques used to visualize the aneurysm. However, which one will surgeons prefer? In this study, we have compared these two radiological examinations. PATIENTS AND METHODS: This study includes 58 patients diagnosed with SAH and intracranial aneurysm diagnosis based on CTA (n=30) and DSA (n=28). We evaluated the patients according to demographic properties, CTA and DAS findings, aneurysm location, Fisher score, postoperative complications, and Glasgow outcome score. RESULTS: The most common location of aneurysms was the M1 level (48.3%). Patients in the DSA group had significantly more extended hospital stays (p= 0.021). There was no statistically significant difference between the two groups in complications. CONCLUSIONS: Enhanced CT Technologies provide higher fidelity images and shorten hospital stays. With CTA, surgeons may gain time for an emergency surgical procedure. Despite the fact that DSA remains a significant factor in aneurysm diagnosis, DSA is an invasive procedure and needs more time to diagnose.

A rare disease: a single-center experience of cerebral alveolar echinococcosis in 12 operated patients.

OBJECTIVE: In this study, we have evaluated 12 patients with cerebral alveolar echinococcosis (AE). All patients underwent surgery for cerebral AE. We aimed to demonstrate the relationship between the demographic properties of patients and surgical outcomes as well as surgical suggestions about surgical approaches. PATIENTS AND METHODS: Patients were analyzed according to demographic properties, hepatic/ pulmonary AE lesion existence, symptoms, neurological and radiological examination, histopathological findings, and outcome after treatment. RESULTS: Preoperative diagnosis based on the history of the patient, neurological examination, serological tests, and radiology. When enhanced radiological imaging like MR-Tractography and intraoperative neuromonitoring is combined with precision surgical methods cerebral AE is treatable. Ten of twelve cerebral AE patients had favorable outcomes after surgery. CONCLUSIONS: AE of the brain is a rare but life-threatening parasitic disease. Wherever the primary focus is, surgery for cerebral involvement of AE is challenging but safe with appropriate surgical techniques and the help of radiological examination.