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The study is devoted to the hemodynamics during cerebral vascular bypass surgery for the treatment of cerebral aneurysms in two patients. The location, morphological characteristics and treatment approaches of the patients were similar, but different outcomes were observed as a result of the performed microsurgical procedures. Computational approach was used to analyze the hemodynamic differences of aneurysms, treated via extra-intra cranial (EC-IC) cerebral bypass shunt. The paper presents a new criterion based on the energy parameters of healthy compartment of cerebral circulation. The applied approach demonstrates a new effective method of preoperative risk modelling for medical decision-making. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the long-term functional and neurodevelopmental outcomes in pediatric patients who underwent neurosurgical intervention following suspected abusive head trauma (AHT). We performed a single-center retrospective review (January 1, 2007, to December 31, 2019) of patients aged less than three years who had intracranial injury suspicious for AHT and received a neurosurgical procedure. Long-term functional outcome was measured using the Pediatric Cerebral Performance Category (PCPC), Pediatric Overall Performance Category (POPC), and the Mullen Scales of Early Learning (MSEL). Seventy-seven patients were identified; 53 survived to discharge and had at least one-year follow-up. To examine long-term functional outcome, PCPC at the last available visit was examined and found to be 1 or 2 (normal to mild disability) for 64% of patients and 3 or 4 (moderate to severe disability) for 36%. The last available MSEL composite score for neurodevelopmental assessment also demonstrated that 13% of patients scored in the "average" range, 17% in the "below average" range, and 70% in the "very low" range. There was no statistical difference in the last available PCPC or POPC score or the last available MSEL score for patients who received a craniotomy when compared with those who received an intracranial shunt. For patients with AHT who survived to discharge, functional improvements over time were noted in both patients who received craniotomy or who simply required shunt placement. These results suggest that, for patients who survive to discharge, operative management of AHT can lead to reasonable long-term functional outcomes. [ABSTRACT FROM AUTHOR]