Cosamalon-Gan I, Villar Vega V, Cosamalon-Gan T, Cobo R, Mattos-Piaggio G, Garcia-Cosamalon J, and Vega JA*
The German pathologist C.G. Schmorl was the first to systematically describe the normal structure and the degenerative changes of the human intervertebral disc, considering the age-related changes as primary degeneration. He established the terms of chondrosis, osteochondrosis, disc prolapse or herniation and intraosseus node. This paper briefly summarized the contribution of Schmorl to the knowledge of the intervertebral disc.
Angel Horcajadas*, Isabel Ortiz*, Majed Katati, Ana Jorques, and Gonzalo Olivares
Object: To evaluate the clinical and angiographic results as well as the costs of surgical treatment against endo-vascular treatment in a SAH in a paired series of patients.
Methods: A retrospective study of a series of 78 SAH patients treated endovascularly (EV) or surgically (SC) and paired according to age, Hunt-Hess scale at admission, Fischer grade, aneurysm localization and follow-up time. A descriptive study was performed, as well as clinical results (Glasgow Outcome Scale, GOS, at 6 months), angiographic data (occlusion classification) and economic costs in each of the groups.
Results: The mean age was 51.4 years (25-82) with a female predominance (7:10). The mean follow-up time was 37.3 months. Glasgow Outcome Scale (GOS) at 6 months was favorable (4-5) in 69.7% of the cases (bet-ter in the SC group). The average length of stay (ALOS) was 36.3 days (slightly higher in the EV group). Complete occlusion of the aneurysm was obtained in 80.0% of the patients in SC series and 47.3% in the EV series. 18.4% of the EV patients required retreatment. Costs of the SC treatment were slightly higher than the EV costs for the first admission (0.2% higher) but EV costs are considerably higher when the costs of follow-up and retreatment were added (13.4% more). The factors that made EV treatment more expensive were the costs of embolization material and retreatment.
Conclusions: SC and EV treatment have similar clinical results; however SC treatment has greater stability and lower costs. Adequate selection of patients for treatment modality could save costs.
Nonato MB*, Prandini MN, and De Muzio SDC
Subarachnoid hemorrhage secondary to ruptured aneurysms is one of the major concerns of neurosurgeons when performing the currently available invasive rupture prevention treatments. Assuming that antiplatelet therapy not only reduces the formation of thrombi but also acts on the physiology of inflammation and decreases its progression, several studies have recently trying to establish a beneficial relationship of the aneurysms rupture prevention with antiplatelet therapy against the hypothesis of causing rates increase in aneurysms bleeding. The aim of the present study was to analyze the published literature on the relationship between antiplatelet therapy and its effect on the rupture of intracranial aneurysms.