Background The objective of this study was to assess the relationship between inflammation-based scores and prognosis of patients who had undergone mechanical thrombectomy (MT) for large artery occlusion (LAO). Methods A total of 411 patients were enrolled and inflammation-based scores, such as neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) were calculated based on laboratory data. Prognoses were evaluated with unfavorable outcome (modified Rankin Scale, mRS score of 3-6), symptomatic intracranial hemorrhage (sICH), hemorrhagic transformation (HT) of infarct, and mortality. Multivariate analyses were performed to explore the relationships of inflammation-based scores with various clinical outcomes. Results Patients with unfavorable outcome showed higher mean NLR and MHR but lower mean LMR than those with favorable outcome (NLR 7.32 vs. 3.78, P ≤ 0.001; MHR 1.42 vs. 1.15, P = 0.012; LMR 2.76 vs. 3.70, P = 0.003). In multivariate analysis, higher value of NLR (≥ 5.1) (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.04-2.12, P = 0.014) and higher value of MHR (≥ 1.4) (OR 1.32, 95% CI 1.10-1.74, P = 0.028), lower value of LMR ( less then 2.5) (OR 1.28, 95% CI 1.08-1.58, P = 0.032) were independently associated with unfavorable outcome. Conclusions After MT, higher NLR, higher MHR, and lower LMR values were found in patients with unfavorable outcome. Inflammation based scores, such as, NLR, LMR, and MHR might be independent factors that can predict outcomes in patients with MT.Introduction Pituitary apoplexy is defined as a sudden neurologic deficit as a result of infarction or hemorrhage within the pituitary gland. In this study, we report a rare case of apoplexy presenting with cerebral infarction due to direct compression of the internal carotid artery (ICA) and review the literature. Case report A 31-year-old male presented with sudden-onset headache, right hemiparesis, decreased left monocular visual acuity, and a nasal visual field deficit of the left eye. On computed tomography angiography (CTA) there was evidence of a hyperdense sellar/suprasellar mass with stenosis of the cavernous and supraclinoid segments of the ICAs bilaterally. However, on magnetic resonance imaging angiography (MRI/MRA) the following day there was a complete occlusion of the left cervical ICA as well as cystic changes of the sellar and suprasellar mass suggestive of pituitary hemorrhage. The patient underwent urgent endoscopic endonasal decompression of the mass and post-operative DSA demonstrated restored flow within the left cervical ICA. Conclusion Twenty-nine cases of cerebral infarction due to pituitary apoplexy have been previously documented with the majority of cases related to direct ICA compression. Vascular compression is associated with a high rate of mortality (24%) and should be treated urgently by surgical decompression in cases of severe or progressive neurological symptoms.Background Although extraparenchymal Neurocysticercosis (NCC) is well established, presentation in the suprasellar space is rare. When presenting in the suprasellar space, the imaging characteristics may mimic more common lesions including craniopharyngioma and Rathke cleft cyst depending on the life cycle of the parasite. Although antiparasitic medical therapy may be effective for viable NCC, it is not routinely employed for calcified NCC. Case description This report presents a 39-year-old male patient who presented with profound visual decline secondary to a partially calcified suprasellar NCC. Suprasellar NCC was presumed based on specific radiologic findings which are discussed. Medical therapy was not offered because of the proximity to the optic chiasm and the partial calcification of the lesion leading to the presumption that the mass was non-viable. The patient underwent successful endoscopic endonasal resection of the suprasellar NCC and experienced significant improvement in vision. In spite of the calcification, pathological evaluation revealed that a portion remained viable. Conclusions Regardless of the life cycle stage, endonasal resection offers a minimally invasive approach for suprasellar NCC; treatment can be tailored to the patient's presentation and stage of infection.Objective We aimed to quantify and compare surgical exposure and freedom at the Anterior Communicating Artery (ACoA) complex using pterional (PT), supraorbital (SO), extended supraorbital with orbital osteotomy (SOO), and endonasal endoscopic transtubercular-transplanum (EEATT) approaches. Methods Right-sided PT, SO, SOO, and EEATT approaches were performed using 10 cadaveric heads. Surgical exposure and freedom (horizontal and vertical attack angle) at the ACoA complex were measured. The farthest clipping distance from ACoA to A1/A2 was also quantified. Result There was a significantly greater exposure length of right A1 in the PT (12.20 ± 2.48mm) compared to the EEATT (9.52 ± 2.09mm, p=0.029). Among the four approaches, the EEATT provided the shortest clipping distance for right A1 (6.56 ± 1.33mm, p=0.001) and the longest clipping distance for right A2 (3.36 ± 1.24mm, p=0.003). SO, SOO and PT (2.9±0.9) had more numbers of observations on perforators from ACoA than EEATT (2.0±0.66, p=0.029). https://www.selleckchem.com/products/vu661013.html The EEATT (50.90 ± 17.45mm2) provided better exposure of the superior part of the ACoA complex compared to SO (29.37±17.27mm2, p=0.05). The PT and SOO provided the greatest horizontal (36.88 ± 5.85°) and vertical (19.37 ± 4.70°) attack angle, respectively. Conclusion The SO, SOO, and PT approach provided a better hemilateral view of the ACoA complex and similar surgical exposure, while the EEATT offered a greater exposure in the upper part of the ACoA complex, with relatively limited exposure of perforators from ACoA and surgical freedom. The EEATT can play a potential role in exposure of lesion involving the ACoA complex.Background There has been much attention recently on whether the involvement of neurosurgical residents during surgery impacts patient outcomes. Our goal was to perform a meta-analysis of all existing studies in order to determine the true effect of resident involvement. Methods We performed a systematic review and identified studies that compared resident involvement during surgery to attending neurosurgeons alone. Event rates and adjusted odds ratios were collected and pooled to generate estimates. Results 11 studies were identified, of which 9 reported adjusted odds ratios. Meta-analysis showed that there were no significant differences in patient baseline characteristics (age, gender, the majority of medical comorbidities). Analysis of operative variables showed increases in a number of complications. However, adjustment of odds ratios for confounders eliminated most of these effects but continued to show a mild increase in overall complications with an OR of 1.14 (p = 0.02). Notably, for both adjusted and un-adjusted estimates, no significant differences were seen in 30-day mortality.