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Neurosurgical Review

Guillermo Ibáñez-Botella, Miguel Segura, Luis De Miguel, Bienvenido Ros, Miguel Ángel Arráez
Surgery for intraventricular tumors remains a controversial and evolving field, with endoscopic resection becoming more popular. We present a series of nine consecutive cases of purely endoscopic resection of intraventricular tumors with the aid of an ultrasonic aspirator specific for neuroendoscopy. Nine patients (five men, four women) aged 18-74 years (mean 43.7) underwent surgery. The most common symptom was headache. In all cases, magnetic resonance imaging showed single supratentorial intraventricular lesions (five lateral ventricle, four third ventricle)...
July 17, 2018: Neurosurgical Review
Radek Kaiser, Petr Waldauf, Gautham Ullas, Aneta Krajcová
The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified...
July 17, 2018: Neurosurgical Review
Soumya Sagar, Jonathan Rick, Ankush Chandra, Garima Yagnik, Manish K Aghi
Functional brain mapping (FBM) is an integral part of contemporary neurosurgery. It is crucial for safe and optimal resection of brain lesions like gliomas. The eloquent regions of the cortex like motor, somatosensory, Wernicke's, and Broca are usually mapped, either preoperatively or intraoperatively. Since its birth in the nineteenth century, FBM has witnessed immense modernization, radical refinements, and the introduction of novel techniques, most of which are non-invasive. Direct electrical stimulation of the cortex, despite its high invasiveness, remains the technique of choice...
July 13, 2018: Neurosurgical Review
Syed A Quadri, Mudassir Farooqui, Asad Ikram, Atif Zafar, Muhammad Adnan Khan, Sajid S Suriya, Chad F Claus, Brian Fiani, Mohammed Rahman, Anirudh Ramachandran, Ian I T Armstrong, Muhammad A Taqi, Martin M Mortazavi
Spinal cord injury (SCI) is a life-shattering neurological condition that affects between 250,000 and 500,000 individuals each year with an estimated two to three million people worldwide living with an SCI-related disability. The incidence in the USA and Canada is more than that in other countries with motor vehicle accidents being the most common cause, while violence being most common in the developing nations. Its incidence is two- to fivefold higher in males, with a peak in younger adults. Apart from the economic burden associated with medical care costs, SCI predominantly affects a younger adult population...
July 11, 2018: Neurosurgical Review
Toshihiro Ogiwara, Alhusain Nagm, Takatoshi Hasegawa, Yoshiki Hanaoka, Shunsuke Ichinose, Tetsuya Goto, Kazuhiro Hongo
Various skull base reconstruction techniques have been developed in endoscopic endonasal approach (EEA) for skull base lesions to prevent postoperative cerebrospinal fluid (CSF) leakage. This study was performed to evaluate the efficacy and pitfalls of our method of skull base reconstruction after EEA. A total of 123 patients who underwent EEA (127 surgeries) between October 2014 and May 2017 were reviewed. Our algorithm for skull base reconstruction in EEA was categorized based on intraoperative CSF leakage graded as follows: grade 0 was excluded from this study; grade 1, dural suturing with abdominal fat graft or packing of gelatin sponge into the cavity; grade 2, method for grade 1 with addition of mucosal flap or nasoseptal flap (NSF); and grade 3, duraplasty in fascia patchwork closure with NSF...
July 7, 2018: Neurosurgical Review
Lixue Zou, Jun Liu, Hougen Lu
There are still controversies on characteristics and risk factors for proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) patients. The objective of this study is to explore the characteristics and risk factors for PJK in ASD. A systematic online search in databases including PubMed, EMBASE, Web of Science, and the Cochrane Library was performed to identify eligible studies. OR and weight mean difference with 95% CI were used to evaluate characteristics and risk factors. A total of 31 studies were finally included...
July 7, 2018: Neurosurgical Review
Torstein R Meling, Michele Da Broi, David Scheie, Eirik Helseth
To compare outcomes after surgery for skull base meningiomas (SBMs) with non-skull base meningiomas (NSBMs) in the elderly. Overall, 128 consecutive patients ≥ 70 years of age with intracranial SBMs operated between 1990 and 2010 were compared to 193 consecutive patients ≥ 70 years of age with NSBMs operated within the same time period. Median age at surgery was 75.0 years (mean 75.7, range 70.0-92.4). Follow-up was complete with median 4.7 years (mean 5.5, range 0-19). The female-to-male ratio was 2...
July 5, 2018: Neurosurgical Review
Yahui Zhao, Qian Zhang, Shuo Wang, Dong Zhang, Yan Zhang, Yuanli Zhao
Blood blister-like aneurysms (BBAs) were considered a therapeutic challenge for both microsurgeons and endovascular therapists. While a great deal of efforts had been put to refining the treatment of BBAs, the diagnostic criteria had not been established yet. In this study, we reviewed data of 43 suspicious, small (< 1 cm), broad-necked aneurysms at supraclinoid segment of internal carotid artery (ICA) in 41 patients who had been treated with microsurgery in our hospital during the past 5 years. Diagnosis of BBAs and non-blister aneurysms was based on intraoperative findings...
July 4, 2018: Neurosurgical Review
Junwei Zhang, Naresh SatyaNarayan Kumar, Barry Wei Loong Tan, Liang Shen, Gopinathan Anil
A large variety of vertebral tumours undergoes transarterial embolisation (TAE) prior to surgery. However, the subsequent intra-operative blood loss is unpredictable. This retrospective analysis, aims to determine the impact of various factors that may potentially influence the estimated intra-operative blood loss (EBL) in these patients. The study included 56 consecutive patients with spinal tumours who underwent pre-operative TAE. Demographic information, treatment history, tumour type, MRI characteristics, angiographic appearance, embolisation technique and surgical invasiveness were correlated with EBL using univariate and multivariate analysis...
July 4, 2018: Neurosurgical Review
Federico Cagnazzo, Davide Tiziano Di Carlo, Giandomenico Petrella, Paolo Perrini
The risk of ventriculostomy-related hemorrhage among patients requiring antiplatelet therapy (AT) for the endovascular treatment of acutely ruptured intracranial aneurysms needed further investigation. The authors performed a systematic review and meta-analysis of the literature examining the EVD-related hemorrhage rate among patients with and without AT (controls). According to PRISMA guidelines, a comprehensive review of studies published between January 1990 and April 2018 was carried out. The authors identified series with > 5 patients reporting the EVD-associated hemorrhage rate among the AT group and the control group...
July 2, 2018: Neurosurgical Review
Olga Gutkowska, Jacek Martynkiewicz, Maciej Urban, Jerzy Gosk
Brachial plexus injuries are among the rarest but at the same time the most severe complications of shoulder dislocation. The symptoms range from transient weakening or tingling sensation of the upper limb to total permanent paralysis of the limb associated with chronic pain and disability. Conflicting opinions exist as to whether these injuries should be treated operatively and if so when surgery should be performed. In this review, available literature dedicated to neurological complications of shoulder dislocation has been analysed and management algorithm has been proposed...
June 30, 2018: Neurosurgical Review
Christian Fung, Evangelos Mavrakis, Andreas Filis, Igor Fischer, Marian Suresh, Angelo Tortora, Jan F Cornelius, Richard Bostelmann, Jan Gralla, Jürgen Beck, Andreas Raabe, Muhammad Owais Khan, Hans Jakob Steiger, Athanasios K Petridis
In patients with aneurysmal subarachnoid hemorrhage (aSAH) and multiple aneurysms, there is a need to objectively identify the ruptured aneurysm. Additionally, studying the intra-individual rupture risk of multiple aneurysms eliminates extrinsic risk factors and allows a focus on anatomical factors, which could be extrapolated to patients with single aneurysms too. Retrospective bi-center study (Department of Neurosurgery of the University Hospital Duesseldorf and Bern) on patients with multiple aneurysms and subarachnoid hemorrhage caused by the rupture of one of them...
June 30, 2018: Neurosurgical Review
Davide Tiziano Di Carlo, Hugues Duffau, Federico Cagnazzo, Nicola Benedetto, Riccardo Morganti, Paolo Perrini
WHO grade II diffuse low-grade gliomas (DLGGs) were recently divided into sub-groups on the basis of their molecular profiles. IDH wild-type (IDH-wt) tumors seem to be associated with unfavorable prognoses due to biological similarities to glioblastomas. The authors performed a systematic review and meta-analysis of literature examining epidemiology, clinical characteristics, management, and the outcome of IDH-wt grade II DLGGs. According to PRISMA guidelines, a comprehensive review of studies published from January 2009 to October 2017 was carried out...
June 26, 2018: Neurosurgical Review
Markus Bruder, Sepide Kashefiolasl, Fee Keil, Nina Brawanski, Sae-Yeon Won, Volker Seifert, Juergen Konczalla
Acetylsalicylic acid (ASA) is a well-known and widely used analgesic for acute pain. Patients with acute headache due to subarachnoid hemorrhage (SAH) are inclined to take ASA in this situation. Due to the antithrombotic effects, ASA intake is related to higher bleeding rates in case of hemorrhage or surgical treatment. Between January 2006 and December 2016, 941 patients without continuous antithrombotic or anticoagulant medication were treated due to SAH in our institution. Fourteen of them (1.5%) had taken ASA as a single dose because of headache within 24 h before hospital admission...
June 22, 2018: Neurosurgical Review
Neşe Asal, Nuray Bayar Muluk, Mikail Inal, Mehmet Hamdi Şahan, Adil Doğan, Osman Kürşat Arıkan
In the present study, we investigated the relationship between sphenoid sinus, carotid canal, and optic canal on paranasal sinus computed tomography (PNSCT). This study was performed retrospectively. PNSCT images of 300 adult subjects (159 male, 141 female). Sphenoid sinus (pneumatisation, dominancy, septation, inter-sinus septa deviation), anterior clinoid process pneumatisation, Onodi cell, carotid and optic canals (width, dehiscence, classification) were measured. In males, type 3 pneumatised sphenoid sinus (in both sides) and in females type 2 pneumatised sphenoid sinus (right side) and type 3 pneumatised sphenoid sinus (left side) were detected more...
June 21, 2018: Neurosurgical Review
Simon Heinrich Bayerl, Florian Pöhlmann, Tobias Finger, Vincent Prinz, Peter Vajkoczy
In contrast to a one-level cervical corpectomy, a multilevel corpectomy without posterior fusion is accompanied by a high material failure rate. So far, the adequate surgical technique for patients, who receive a two-level corpectomy, remains to be elucidated. The aim of this study was to determine the long-term clinical outcome of patients with cervical myelopathy, who underwent a two-level corpectomy. Outcome parameters of 21 patients, who received a two-level cervical corpectomy, were retrospectively analyzed concerning reoperations and outcome scores (VAS, Neck Disability Index (NDI), Nurick scale, modified Japanese Orthopaedic Association score (mJOAS), Short Form 36-item Health Survey Questionnaire (SF-36))...
June 18, 2018: Neurosurgical Review
Shuling Shang, Da Zhou, Jingyuan Ya, Sijie Li, Qi Yang, Yuchuan Ding, Xunming Ji, Ran Meng
Moyamoya disease is characterized by progressive stenosis or occlusion of the intracranial portion of the internal carotid artery and their proximal branches, resulting in ischemic or hemorrhagic stroke with high rate of disability and even death. So far, available treatment strategies are quite limited, and novel intervention method is being explored. This review encapsulates current advances of moyamoya disease on the aspects of epidemiology, etiology, clinical features, imaging diagnosis and treatment. In addition, we also bring forward our conjecture, which needs to be testified by future research...
June 18, 2018: Neurosurgical Review
Zhang Zhe, Yang Bo
To discuss the association of the T786C and G894T polymorphisms of endothelial nitric oxide synthase (eNOS) with the occurrence and prognosis of aneurismal subarachnoid hemorrhage (aSAH). One hundred sixty-nine patients with aSAH were collected as the case group, which was divided into the good prognosis group and adverse prognosis group according to the condition 3 months after the treatment. One hundred fifty-six healthy volunteers were collected as the control group. The allele and genotype of T786C and G894T polymorphisms of eNOS were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)...
June 15, 2018: Neurosurgical Review
Jiajie Gu, Haoping Huang, Yuejun Huang, Haitao Sun, Hongwu Xu
Hyperosmolar therapy is regarded as the mainstay for treatment of elevated intracranial pressure (ICP) in traumatic brain injury (TBI). This still has been disputed as application of hypertonic saline (HS) or mannitol for treating patients with severe TBI. Thus, this meta-analysis was performed to further compare the advantages and disadvantages of mannitol with HS for treating elevated ICP after TBI. We conducted a systematic search on PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Wan Fang Data, VIP Data, SinoMed, and China National Knowledge Infrastructure (CNKI) databases...
June 15, 2018: Neurosurgical Review
Belal Neyazi, I Erol Sandalcioglu, Homajoun Maslehaty
The PHASES score was developed to determine the risk of rupture of un-ruptured intracranial aneurysms (UIAs). The purposes of the current study were to apply this score on patients with actually ruptured intracranial aneurysms and to analyze the hypothetically prediction of the risk in this particularly patient group. We extracted the data of 100 recently treated patients (23 male, 77 female, mean age 56.4 years, range 17-93 years) with ruptured saccular intracranial aneurysms from our prospectively maintained neurovascular database according to the parameters used in the PHASES score (population, hypertension, age, earlier SAH, size and site of the aneurysm)...
June 11, 2018: Neurosurgical Review
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