BACKGROUND AND PURPOSE:Asymmetric hypointensity of cerebral veins on susceptibility-weighted imaging has been shown to indirectly reflect tissue hypoxia after cerebral ischemia. We therefore investigated whether patients with prominent asymmetry of the cerebral veins on SWI and a relatively small diffusion-weighted imaging lesion (SWI-DWI mismatch), representing the presence of salvageable tissue, were more likely to benefit from thrombolytic therapy.

Précis: Micropulse cyclophotocoagulation (MPCP) lowered intraocular pressure (IOP) in the short-term but nearly half required additional intervention. Mydriasis was the most common complication (11%); 15% lost ≥3 Snellen lines of acuity; 11% had persistent complications at last follow-up. Purpose: The purpose of this study was to evaluate the efficacy and complications of MPCP in a large series of patients with all stages of glaucoma. Design: Multicenter, retrospective chart review of patients from 3 clinical sites. Participants: One hundred sixty-seven eyes of 143 patients. Methods: MPCP was performed with 2000 mW energy, 31.3% duty cycle and 2 to 4 180-degree applications of 80 seconds duration each per treatment. The procedure was considered a failure if any of the following occurred: additional IOP lowering intervention, <20% IOP reduction from baseline at the last follow-up (with or without medication), or severe complications. Results: Mean age was 71 years, 53% were female, and 53% were Asian. 60% of eyes had POAG, 63% were pseudophakic, 38% had prior glaucoma surgery, and 51% had Snellen visual acuity (VA) of 20/40 or better. Mean follow-up time was 11.9±7.8 months. Mean IOP was 21.9±8.4 mm Hg before intervention, and 17.4±7.2 mm Hg at last follow-up (P<0.0001). There was no change in mean logMAR VA (P=0.0565) but 15% lost ≥3 Snellen lines of VA. The success rate was 36.5% (61/167 eyes) at last follow-up. The probability of survival by Kaplan-Meier analysis was 82%, 71%, and 57% at 3, 6, and 12 months after the procedure, respectively. The reasons for failure were additional intervention in 47%, inadequate IOP reduction in 14%, and severe complication in 1.8%. In a multivariable Cox proportional hazard model, female sex was associated with a 56% decrease in failure rate compared with males (P<0.0001), while a unit increase in baseline IOP corresponded with a 5.7% increase in failure rate (P<0.0001). If repeat MPCP was allowed then success rate increased to 58%. There were no complications in 73% (122/167) but 11% (18/167) had persistent complications at the last follow-up and half of these 18 eyes had decrease in VA of 1 to 6 Snellen lines. Asian race (odds ratio 13.5, P=0.0131) and phakic status (odds ratio 3.1, P=0.0386) were associated with higher odds of developing mydriasis, which was the most common complication. Conclusions: MPCP lowered IOP in the short-term but nearly half required additional IOP lowering intervention. Potential complications should be discussed in detail especially when the procedure is being considered for those with good VA and early stage disease.

AIM:To compare neuroendoscopy versus minimal puncture drainage for surgical treatment of supratentorial hypertensive intracerebral hemorrhage.MATERIAL and METHODS: A total of 108 cases involving supratentorial intracerebral hemorrhage were retrospectively analyzed. In 30 cases, endoscopic surgery was performed, while 78 cases involved puncture surgery. We compared hematoma clearance rate, postoperative rebleeding rate, incidence of postoperative complications, operation duration, and Glasgow coma score seven days after surgery. Clinical data such as early postoperative rehabilitation time, Glasgow outcome score three months after surgery, and intensive care unit (ICU) stay were also compared between the two groups. RESULTS:The results showed that endoscopic surgery was associated with a superior clinical therapeutic effect in hematoma clearance rates, GCS scores on postoperative day 7, the average ICU stay, early postoperative rehabilitation time and intracranial infection outcomes than minimal puncture drainage surgery for the treatment of supratentorial intracerebral hemorrhage (p<0.05). Three months after surgery, the favorable prognosis rate in the endoscopic treatment group was significantly higher than that in the craniotomy group [83.3% (28/34) vs. 61.5% (31/51), respectively; χ 2 =4.698, p=0.030]. In contrast, no significant differences in rebleeding, pulmonary infection, tracheotomy, secondary epilepsy, gastrointestinal hemorrhage, death in late postoperative period, or in baseline parameters were observed between the two groups (p>0.05). CONCLUSION:Endoscopic surgery potentially represents a beneficial surgical procedure for treatment of supratentorial spontaneous intracerebral hemorrhage.