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 devel...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.展开更多
A measure called the Uncertainty in Unruptured Intracranial Aneurysm Patients Undergoing Endovascular Coiling Scale (UUIACS) was developed and its validity and reliability were examined. The 49 questions that comprise...A measure called the Uncertainty in Unruptured Intracranial Aneurysm Patients Undergoing Endovascular Coiling Scale (UUIACS) was developed and its validity and reliability were examined. The 49 questions that comprised the original draft of the UUIACS were created based on interview data. Based on data from 172 participants, exploratory and confirmatory factor analyses were conducted. As a result of exploratory factor analysis, the UUIACS e retained 17 items and extracted four factors (“Lack of decision-making cues”, “Lack of information and complexity of information interpretation”, “The ambiguous nature of the disease”, and “The unpredictable living with UIA”). All of the UUIACS items showed adequate internal consistency. Between the UUIAC scale and the Universal Uncertainty in Illness Scale (UUIS), the Health Locus of Control (HLC) scale, and the SF-36v2® (Japanese version), positive correlations were found between the UUIACS and UUIS, and the HLC scale at a 1% significance level indicating concurrent validity. According to confirmatory factor analysis, the UUIACS had an acceptable goodness of fit. Given these findings, the UUIACS was judged to have satisfied the criteria for use in a clinical setting, although further investigation was required.展开更多
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 endo...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.展开更多
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 aneury...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.展开更多
基金Supported by Clinical Research Grant from Pusan National University Hospital in 2022.
文摘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.
文摘A measure called the Uncertainty in Unruptured Intracranial Aneurysm Patients Undergoing Endovascular Coiling Scale (UUIACS) was developed and its validity and reliability were examined. The 49 questions that comprised the original draft of the UUIACS were created based on interview data. Based on data from 172 participants, exploratory and confirmatory factor analyses were conducted. As a result of exploratory factor analysis, the UUIACS e retained 17 items and extracted four factors (“Lack of decision-making cues”, “Lack of information and complexity of information interpretation”, “The ambiguous nature of the disease”, and “The unpredictable living with UIA”). All of the UUIACS items showed adequate internal consistency. Between the UUIAC scale and the Universal Uncertainty in Illness Scale (UUIS), the Health Locus of Control (HLC) scale, and the SF-36v2® (Japanese version), positive correlations were found between the UUIACS and UUIS, and the HLC scale at a 1% significance level indicating concurrent validity. According to confirmatory factor analysis, the UUIACS had an acceptable goodness of fit. Given these findings, the UUIACS was judged to have satisfied the criteria for use in a clinical setting, although further investigation was required.
基金This work was supported by the National Key R&D program of China with grant 2016YFC1300800the Beijing Municipal Administration of Hospitals’Ascent Plan with grant DFL20180801
文摘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.
基金supported by the Project of“Key Research&Development(R&D)Plan of Zhejiang Province”[NO.2019C03034].
文摘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.
