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Neurosurgical Review

Pengjun Jiang, Qingyuan Liu, Jun Wu, Xin Chen, Maogui Li, Fan Yang, Zhengsong Li, Shuzhe Yang, Rui Guo, Bin Gao, Yong Cao, Rong Wang, Fei Di, Shuo Wang
Intracranial aneurysms can be classified into thick-walled aneurysms and thin-walled aneurysms according to their intraoperative appearances; previous publications have revealed that different kinds of intraoperative appearances were associated with intraoperative rupture and postoperative complications. Here, we tried to evaluate the association between hemodynamic features and aneurysm wall appearance using computational fluid dynamics (CFD) method. Forty-one consecutive patients with unruptured middle cerebral artery (MCA) bifurcation aneurysms were included in our study...
September 21, 2018: Neurosurgical Review
Xiangke Ma, Yang Yang, Yiming Zhou, Weihua Jia
Management of ruptured intracranial aneurysm in elderly patients is still a major challenge in the treatment of cerebrovascular disease. This study aimed to evaluate safety and efficacy profiles of ruptured intracranial aneurysms in elderly patients treated with endovascular techniques (EVTs). We conducted a retrospective case review of 53 consecutive elderly patients with ruptured intracranial aneurysms treated by EVT between the year 2011 and 2016. The patients' angiographic outcomes, clinical outcomes, and procedure-related complications were reviewed retrospectively...
September 17, 2018: Neurosurgical Review
Patrick Schuss, Ági Güresir, Matthias Schneider, Markus Velten, Hartmut Vatter, Erdem Güresir
Patients presenting with neurological deficits and/or pain due to spinal metastasis usually require immediate or subacute surgical treatment. Nevertheless, it is unclear whether or not side effects of primary cancer location might influence postoperative complication rate. We therefore analyzed our spinal database to identify factors influencing early postoperative complications after surgery for symptomatic spinal metastases. From 2013 to 2017, 163 consecutive patients suffering from symptomatic spinal metastases were treated at our department...
September 15, 2018: Neurosurgical Review
Kiyohiko Sakata, Keiko Suematsu, Nobuyuki Takeshige, Yui Nagata, Kimihiko Orito, Naohisa Miyagi, Naoki Sakai, Tsunekazu Koseki, Motohiro Morioka
Intraoperative monitoring systems that utilize various evoked potentials for the detection and/or preservation of cranial nerves have become increasingly common due to recent technical and commercial developments, particularly during skull base surgeries. We established a novel system for the intraoperative monitoring of the extraocular motor nerves (eOMNs) using a piezoelectric device capable of detecting imperceptible vibrations induced by ocular movement, with sensors placed on the eyelids alone. We first evaluated the efficacy and reliability of this device for the intraoperative monitoring of eOMNs in two Beagle dogs...
September 12, 2018: Neurosurgical Review
Andrea Talacchi, Aurel Hasanbelliu, Alberto D'Amico, Nicolò Regge Gianas, Francesca Locatelli, Alberto Pasqualin, Michele Longhi, Antonio Nicolato
Meningioma arising in the inner third of the sphenoidal wing has been well recognized since the origin of neurosurgery, yet it still poses a formidable challenge for the surgeon. Treatment strategies can be optimized through a tailored approach to surgical timing and use of a non-surgical armamentarium. The aim of this study was to evaluate the long-term effect of different strategies on progression-free survival and overall survival. We examined the clinical records of brain tumor patients to assess determinants for surgery (extent of tumor removal, postoperative complications) and for progression-free survival and overall survival in relation to timing of surgery eventually followed by stereotactic radiosurgery (SRS)...
September 5, 2018: Neurosurgical Review
Tomohiro Miyashita, Hiromi Ataka, Kei Kato, Hiromitsu Takaoka, Takaaki Tanno
The disc angle at the fused segment is extended in operative prone position, but eventually returns to preoperative neutral position within 6 months to 1 year. This study aimed to assess pedicle screw (PS) shift without loosening to identify the mechanism of the change in disc angle after posterior fusion for degenerative lumbar spondylolisthesis (DLS). Sixty-three consecutive patients who underwent facet fusion for L4 single-level DLS were retrospectively reviewed using computed tomography (CT) immediately after surgery and 6 months postoperatively...
September 5, 2018: Neurosurgical Review
Enrico Giordan, Thomas J Sorenson, Giuseppe Lanzino
Involvement of the superior sagittal sinus (SSS) by meningiomas poses specific challenges, without an agreement about the degree of surgical aggressiveness when dealing with these lesions. In this systematic review and meta-analysis, we compare outcomes and complication rates, after different surgical strategies. Studies focused on meningiomas involving the SSS were collected from numerous online databases. Surgical outcome and complication data were abstracted. Comparisons were made considering complication and recurrence rates between an "aggressive" and a "non-aggressive" surgical attitude...
August 31, 2018: Neurosurgical Review
Saravanan Sadashivam, Mathew Abraham, Krishnakumar Kesavapisharady, Suresh Narayanan Nair
Spinal hemangioblastomas constitute 1.6-5.8% of all spinal cord tumors. Microsurgical excision of these tumors is challenging. The purpose of this study is to analyze the neurological improvement and long-term functional outcome of spinal hemangioblastomas. This retrospective study included 15 patients who underwent surgery for intramedullary spinal hemangioblastoma at the Department of Neurosurgery of Sri Chitra Tirunal Institute for Medical Sciences and Technology from January 2001 to June 2014. Eight patients (53%) were diagnosed to have von Hippel-Lindau (vHL) disease...
August 31, 2018: Neurosurgical Review
Debraj Mukherjee, Veysel Antar, Burcak Soylemez, Ulas Cikla, Bora Gürer, Mehmet A Ekici, Aaron S Field, M Shahriar Salamat, Mustafa K Başkaya
Operative management of intrinsic brainstem lesions remains challenging despite advances in electrophysiological monitoring, neuroimaging, and neuroanatomical knowledge. Surgical intervention in this region requires detailed knowledge of adjacent critical white matter tracts, brainstem nuclei, brainstem vessels, and risks associated with each surgical approach. Our aim was to systematically verify internal anatomy associated with each brainstem safety entry zone (BSEZ) via neuroimaging modalities commonly used in pre-operative planning, namely high-resolution magnetic resonance imaging (MRI) and diffusion tensor tractography (DTT)...
August 22, 2018: Neurosurgical Review
Sayied Abdol Mohieb Hosainey, Benjamin Lassen, John K Hald, Eirik Helseth, Torstein R Meling
The efficacy of tumor removal via craniotomies on preoperative hydrocephalus (HC) in adult patients with intracranial tumors is largely unknown. Therefore, we sought to evaluate the effect of tumor resection in patients with preoperative HC and identify the incidence and risk factors for postoperative VP shunt dependency. All craniotomies for intracranial tumors at Oslo University Hospital in patients ≥ 18 years old during a 10-year period (2004-2013) were reviewed. Patients with radiologically confirmed HC requiring surgery and subsequent development of shunt dependency were identified by cross-linking our prospectively collected tumor database to surgical procedure codes for hydrocephalus treatment (AAF)...
August 17, 2018: Neurosurgical Review
Alessandro Di Rienzo, Roberto Colasanti, Valentina Liverotti, Roberta Benigni, Riccardo Paracino, Gianluca Bizzocchi, Massimo Scerrati, Maurizio Iacoangeli
The early identification and optimized treatment of wound dehiscence are a complex issue, with implications on the patient's clinical and psychological postoperative recovery and on healthcare system costs. The most widely accepted treatment is surgical debridement (also called "wash out"), performed in theater under general anesthesia (GA), followed by either wide-spectrum or targeted antibiotic therapy. Although usually effective, in some cases, such a strategy may be insufficient (generally ill, aged, or immunocompromised patients; poor tissue conditions)...
August 17, 2018: Neurosurgical Review
Hun Ho Park, Jeong-Yoon Park, Dong-Kyu Chin, Kyu-Sung Lee, Chang-Ki Hong
Clival chordoma with occipito-cervical (OC) joint invasion can result in preoperative and postoperative instability. The authors investigate the appropriate timing of OC fusion to prevent instability-, fusion-, and surgery time-related morbidity. Twenty-two consecutive patients underwent surgery for clival chordoma from December 2008 to September 2014. OC fusion was performed for patients with OC joint invasion and instability due to preoperative destruction of the occipital condyle or extensive postoperative condylectomy...
August 16, 2018: Neurosurgical Review
Benedito Jamilson Araújo Pereira, Antônio Nogueira de Almeida, Wellingson Silva Paiva, Paulo Henrique Pires de Aguiar, Manoel Jacobsen Teixeira, Suely Kazue Nagahashi Marie
Review the data published on the subject to create a more comprehensive natural history of intraventricular meningiomas (IVMs). A Medline search up to March 2018 using "intraventricular meningioma" returned 98 papers. As a first selection step, we adopted the following inclusion criteria: series and case reports about IVMs, as well as papers written in other languages, but abstracts written in English were evaluated. Six hundred eighty-one tumors were evaluated from 98 papers. The majority of the tumors were located in the lateral ventricles (602-88...
August 15, 2018: Neurosurgical Review
Luke Mugge, Tarek R Mansour, Megan Crippen, Yasaman Alam, Jason Schroeder
Glioblastoma multiforme (GBM) is the most common primary brain cancer. Depression is a common co-morbidity of this condition. Despite this common interaction, relatively little research has been performed on the development of GBM-associated depression. We performed a literary search of the PubMed database for articles published relating to GBM and depression. A total of 85 articles were identified with 46 meeting inclusion criteria. Depression significantly impacts care, decreasing medication compliance, and patient survival...
August 9, 2018: Neurosurgical Review
Nazife Dinc, J Quick-Weller, S Tritt, J Konczalla, J Mersmann, M Bruder, E Herrmann, V Seifert, C Senft
The basilar artery (BA), as a reference vessel for laboratory investigations of cerebral vasospasm (CVS) in many experimental models, warrants a sufficient blood supply despite hemodynamic changes during CVS. In a prospective evaluation study, we analyzed  patients who were admitted to our department with subarachnoid hemorrhage (SAH) for the occurrence and sequelae of CVS. Specifically, we sought to identify patients with CVS of the BA. As per institutional protocol, all patients with CVS detected in the posterior circulation had magnetic resonance imaging (MRI) examinations instead of CTA...
August 7, 2018: Neurosurgical Review
Jian Zhang, Liang Yao, Shaopeng Peng, Yuan Fang, Ruitian Tang, Jianxiong Liu
Epilepsy is a common manifestation of glioma patients and negatively impacts on quality of life and neurocognitive function. The risk of preoperative seizures in patients with glioma is currently under discussion. We aimed to evaluate the relationship between tumor locations in the cerebrum and preoperative seizures in patients with glioma. PubMed, EMBASE, Web of Science, China Biology Medicine, and the Cochrane Library were systematically searched from inception to July 15, 2017, for original studies including reports of preoperative seizures in patients with gliomas in different brain regions...
August 3, 2018: Neurosurgical Review
Simon Heinrich Bayerl, Tobias Finger, Petra Heiden, Nazli Esfahani-Bayerl, Christopher Topar, Vincent Prinz, Johannes Woitzik, Julius Dengler, Peter Vajkoczy
The radiofrequency treatment (RFD) for sacroiliac joint pain (SIP) is well-established, but there is still scarce evidence on its clinical outcome. The classical monopolar RFD is limited by a high recurrence rate. This might be caused by an incomplete denervation of the dorsal rami. The Simplicity III probe was invented to optimise pain fibre recruitment by its multi-electrode design. However, the clinical superiority of this procedure was never proven. The aim of this study was to illustrate the effectiveness of RFD and to compare both denervation techniques...
July 31, 2018: Neurosurgical Review
Mustafa Aziz Hatiboglu, Kerime Akdur, Raymond Sawaya
Brain metastasis is a serious complication in patients with systemic cancer. The main goal of the treatment in patients with brain metastasis is to control the disease in the brain, to prevent death from neurological disease and provide a satisfactory quality of life. Management of a patient with brain metastasis is important and sometimes demanding, and several factors such as tumor histology, status of primary disease, number of brain lesions, size of lesions, and performance status may influence the decision making process...
July 29, 2018: Neurosurgical Review
Marc Valera Melé, Anna Puigdellívol-Sánchez, Marija Mavar-Haramija, Juan A Juanes-Méndez, Luis San Román, Matteo De Notaris, Giuseppe Catapano, Alberto Prats-Galino
The course of the internal carotid artery (ICA) and its segment classifications were reviewed by means of a new and freely available 3D interactive model of the artery and the skull base, based on human neuroimages, that can be freely downloaded at the Public Repository of the University of Barcelona ( ) and runs under Acrobat Reader in Mac and Windows computers and Windows 10 tablets. The 3D-PDF allows zoom, rotation, selective visualization of structures, and a predefined sequence view...
July 26, 2018: Neurosurgical Review
Ruth Prieto, José María Pascual, Verena Hofecker, Eduard Winter, Inés Castro-Dufourny, Rodrigo Carrasco, Laura Barrios
Craniopharyngioma (CP) adherence represents a most baffling problem for the neurosurgeon. The highest priority of current surgical treatment is to maximize tumor removal without compromising the patients' long-term functional outcome. Surgical damage to the hypothalamus may be avoided or at least ameliorated with a precise knowledge regarding the type of adherence for each case. This article presents a comprehensive review of the pathological, surgical, and radiological sources of evidence supporting that CP adherence, despite being heterogenous, is characterized by repeating patterns...
July 24, 2018: Neurosurgical Review
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