Using the modified Delphi method to research the influencing factors of longterm health-related quality of life in patients with unruptured intracranial aneurysms after endovascular treatment

Background:The purpose of this study was to use the modified Delphi method to identify the influencing factors of health-related quality of life(HRQoL)in patients with unruptured intracranial aneurysms(UIAs)after endovascular treatment.Methods:A modified Delphi method to obtain expert consensus on the content of potential influencing factors of HRQoL in patients with UIAs treated by endovascular intervention was employed.The research team consists of three neuroradiologists and one epidemiologist from Xuanwu Hospital of Capital Medical University.They randomly selected 21 well-known experts in cerebrovascular disease diagnosis and treatment as participating experts.The importance of the indicator is based on the 5-Likert scale.The standard deviation(SD),coefficient of variation(CV),mean(x),and minimum and maximum scores of each indicator were calculated.The consistency was described by Kendall coefficient of concordance with a p value<0.05 indicating that the expert consistency was high.Result:Twenty-one and 18 questionnaires were responded in 2 rounds,with effective response rates of 85.7%and 100.0%,respectively.The average authoritative coefficient(Cr)of all 21 experts was 0.88,familiarity with the indicators(Cs)was 0.82,and the judgment basis of the indicators(Ca)was 0.94.Eventually,the x values of arterial puncture hematoma,hyperlipidemia,gender,marital status,and hospitalization for other diseases were lower than 3.5;CV for marital status and gender was higher than 0.35.The Kendall coefficient of concordance in the first round was 0.19(p<0.001),and the second round was 0.15(p<0.001).Conclusion:In this study,the factors affecting the recovery of HRQoL after endovascular treatment in patients with UIAs were analyzed by the modified Delphi method,which provided a valuable evidence for the clinical management and daily life guidance for UIAs patients.

Expert Consensus on Assessment of Rupture Factors in Unruptured Intracranial Aneurysms

Intracranial aneurysms have a high prevalence in the population and are associated with high rates of disability and mortality after rupture.It is essential to assess the rupture risk of unruptured intracranial aneurysms by selecting appropriate morphological parameters.However,there is still a need for consistent evidence-based medicine to provide a clinical reference.Therefore,the expert group has jointly written this consensus based on literature review and clinical experience,aiming to provide a standardized reference for predicting the development of intracranial aneurysms and evaluating their rupture risk factors.

Posterior reversible encephalopathy syndrome following uneventful clipping of an unruptured intracranial aneurysm:A case report

BACKGROUND Posterior reversible encephalopathy syndrome(PRES)is characterized mainly by occipital and parietal lobe involvement,which can be reversible within a few days.Herein,we report a rare case of PRES that developed after craniotomy for an unruptured intracranial aneurysm(UIA).CASE SUMMARY A 59-year-old man underwent clipping surgery for the treatment of UIA arising from the left middle cerebral artery.Clipping surgery was performed uneventfully,and he regained consciousness quickly immediately after the surgery.At the 4th hour after surgery,he developed a disorder of consciousness and aphasia.Magnetic resonance imaging revealed cortical and subcortical T2/FLAIR hyperintensities in the parietal,occipital,and frontal lobes ipsilaterally,without restricted diffusion,consistent with unilateral PRES.With conservative treatment,his symptoms and radiological findings almost completely disappeared within weeks.In our case,the important causative factor of PRES was suspected to be a sudden increase in cerebral perfusion pressure associated with temporary M1 occlusion.CONCLUSION Our unique case highlights that,to our knowledge,this is the second report of PRES developing after craniotomy for the treatment of UIA.Surgeons must keep PRES in mind as one of the causes of perioperative neurological abnormality following clipping of an UIA.