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Neurosurgical Review

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https://www.readbyqxmd.com/read/28819802/significance-of-human-chorionic-gonadotropin-as-a-predictor-of-resistance-to-standard-chemo-radiotherapy-for-pure-germinoma
#1
Akihiro Inoue, Takanori Ohnishi, Shohei Kohno, Shiro Ohue, Shinji Iwata, Shirabe Matsumoto, Masahiro Nishikawa, Saya Ozaki, Yawara Nakamura, Yosuke Mizuno, Riko Kitazawa, Takeharu Kunieda
Intracranial pure germinomas in children generally respond well to standard chemo-radiotherapy. However, some patients are refractory to standard therapy and require additional treatment. To investigate the characteristics of this subgroup, we retrospectively analyzed the clinical features and treatment outcomes of a cohort of 21 patients with intracranial pure germinomas who were diagnosed between April 2002 and December 2016 at Ehime University Hospital in Japan. Pure germinoma diagnosis was verified by histological examination of the tumor after surgery, and all patients received standard chemo-radiotherapy...
August 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819885/adenosine-assisted-clipping-of-intracranial-aneurysms
#2
Torstein R Meling, Luis Romundstad, Geir Niemi, Jon Narum, Per Kristian Eide, Angelika G Sorteberg, Wilhelm A Sorteberg
Temporary parent vessel clip occlusion in aneurysm surgery is not always practical or feasible. Adenosine-induced transient cardiac arrest may serve as an alternative. We retrospectively reviewed our clinical database between September 2011 and July 2014. All patients who underwent microsurgical clipping of intracranial aneurysms under adenosine-induced asystole were included. A total of 18 craniotomies were performed, and 18 aneurysms were clipped under adenosine-induced asystole (7 basilar arteries, 8 internal carotid arteries, 1 middle cerebral artery, and 1 anterior communicating artery) in 16 patients (10 females, 6 males)...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819834/recurrence-of-endovascularly-and-microsurgically-treated-intracranial-aneurysms-review-of-the-putative-role-of-aneurysm-wall-biology
#3
REVIEW
Serge Marbacher, Mika Niemelä, Juha Hernesniemi, Juhana Frösén
Although endovascular therapy has been proven safe and has become in many centers the primary method of treatment for intracranial aneurysms, the long-term durability of endovascular embolization remains a concern; at least for some aneurysms despite initial good result. While healing after clipping relies on mechanical occlusion, restoration after endovascular occlusion mainly requires the induction of a biological response. Healing after embolization depends on the growth of new tissue over the thrombus formed by the embolization material, or alternatively, on the organization of thrombus into fibrous tissue...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819696/what-are-the-treatment-options-for-blister-like-aneurysms
#4
REVIEW
Torstein R Meling
Treatment of blood blister-like aneurysms (BBAs) of the supraclinoidal internal carotid artery (ICA) is challenging and the optimal treatment is yet to be defined. The treatment options for ICA BBAS are microsurgery, endovascular therapy, or a combination of the two. The microsurgical armamentarium consists mainly of direct aneurysm clipping with or without protective EC-IC bypass, clip-wrapping, or trap ligation with ICA sacrifice with or without EC-IC bypass. The endovascular treatment options are mainly endovascular ICA ligation, multiple overlapping stents (≥ 3) with or without coiling, covered stents, or flow diverters...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#5
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28815322/headache-in-patients-with-chronic-subdural-hematoma-analysis-in-1080-patients
#6
Shoko M Yamada, Yusuke Tomita, Hideki Murakami, Makoto Nakane, So Yamada, Mineko Murakami, Katsumi Hoya, Tadayoshi Nakagomi, Akira Tamura, Akira Matsuno
Headache is a major symptom in chronic subdural hematoma (CSDH) patients. However, some CSDH patients do not complain headache although the hematoma is thick with definite midline shift. This clinical study was performed to identify the mechanism of headache in CSDH patients. We compiled clinical data of 1080 surgically treated CSDH patients (711 males and 369 females), and in 54 cases, the pressure of hematoma was measured during burr hole surgery using a glass-stick manometer. Headache was recognized in 22...
August 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28815312/trilateral-retinoblastoma-a-systematic-review-of-211-cases
#7
REVIEW
Ryuya Yamanaka, Azusa Hayano, Yasuo Takashima
We conducted a systematic review of 72 studies to characterize trilateral retinoblastomas. Kaplan-Meier analysis was used to estimate survival, and statistical significance was assessed by using a log-rank test. We analyzed 211 cases of trilateral retinoblastomas. The average age of onset of retinoblastoma was 0.79 ± 1.38 years, and the average latency period between the onset of retinoblastomas and trilateral retinoblastomas was 1.49 ± 1.76 years. The brain tumors were found before the retinoblastoma diagnosis in 6 cases (3...
August 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28799142/what-to-do-in-failed-hemispherotomy-our-clinical-series-and-review-of-the-literature
#8
REVIEW
Andrea Bartoli, Y El Hassani, B Jenny, S Momjian, C M Korff, M Seeck, S Vulliemoz, K Schaller
Hemispherotomy is an established surgical technique to cure or palliate selected, mostly young patients suffering from refractory epilepsy. However, a few patients continue to have seizures despite the surgical hemispherical disconnection. We present a case series of patients who underwent redo hemispherotomy after a first unsuccessful hemispherical disconnection and provide a roadmap for subsequent workup and treatment. The institutional database of epilepsy surgery was reviewed. Twenty-four patients who underwent hemispherotomies for refractory epilepsy were identified between 2007 and 2016...
August 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28766173/clinical-features-and-long-term-outcomes-of-pediatric-intraventricular-meningiomas-data-from-a-single-neurosurgical-center
#9
Zhicen Li, Hao Li, Yuming Jiao, Ji Ma, Shuo Wang, Yong Cao, Jizong Zhao
The purpose of this study is to investigate the clinical characteristics and long-term outcomes of pediatric patients with intraventricular meningioma. We retrospectively analyzed a total of 30 pediatric patients with intraventricular meningiomas who were surgically treated at our department between January 2005 and June 2016 and analyzed their clinical characteristics and surgical outcomes. Among the 160 pediatric patients with intracranial meningioma, 33 (20.6%) had intraventricular lesions. However, only 30 patients had complete demographic and clinical data...
August 2, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28756589/crosstalk-between-the-angiotensin-and-endothelin-system-in-the-cerebrovasculature-after-experimental-induced-subarachnoid-hemorrhage
#10
Stefan Wanderer, Jan Mrosek, Hartmut Vatter, Volker Seifert, Juergen Konczalla
Under physiologic conditions, losartan showed a dose-dependent antagonistic effect to the endothelin-1 (ET-1)-mediated vasoconstriction. This reduced vasoconstriction was abolished after preincubation with an endothelin B1 receptor (ET(B1)-receptor) antagonist. Also, an increased ET(B1)-receptor-dependent relaxation to sarafotoxin S6c (S6c; an ET(B1)-receptor agonist) was detected by preincubation with losartan. Investigations after experimental induced subarachnoid hemorrhage (SAH) are still missing. Therefore, we analyzed losartan in a further pathological setup...
July 29, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28748271/the-emerging-role-of-gamma-knife-radiosurgery-in-the-management-of-glossopharyngeal-neuralgia
#11
REVIEW
Alfio Spina, Nicola Boari, Filippo Gagliardi, Michele Bailo, Carlotta Morselli, Sandro Iannaccone, Pietro Mortini
Glossopharyngeal neuralgia (GPN) represents a rare craniofacial disorder accounting for about 1% of all craniofacial pain syndromes. GPN shares several pathophysiologic and clinical features with the more common trigeminal neuralgia. Medical therapy and microvascular decompression, in case of vascular nerve compression, represented the mainstay of GPN management. Other ablative therapies have been reported to date; however, few data are available because of the rarity of this pain syndrome. Among the ablative procedures, gamma knife radiosurgery (GKRS) has been recently introduced in the management of GPN with good pain control and low complication rates...
July 26, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28744773/alveolar-soft-part-sarcoma-the-new-primary-intracranial-malignancy-a-case-report-and-review-of-the-literature
#12
REVIEW
Aditaya Kumar, B Alrohmain, W Taylor, P Bhattathiri
The purpose of this paper is to serve as a reference to aid in the management of this poorly understood intracranial malignancy. The authors report their experience treating the eighth ostensible case of a primary intracranial alveolar soft part sarcoma (ASPS). A 21-year-old man presented to hospital after collapsing. He gave a 1-year history of headache, a 2-month history of reduced visual acuity and on examination had left facial paraesthesia with left-sided incoordination. MRI of the brain revealed a large left posterior fossa mass...
July 26, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28741220/independent-impact-of-plasma-homocysteine-levels-on-neurological-outcome-following-head-injury
#13
Sivashanmugam Dhandapani, Ankur Bajaj, Chandrasekar Gendle, Inderjeet Saini, Irwanjeet Kaur, Isha Chaudhary, Jasandeep, Jaspinder Kaur, Geetanjali Kalyan, Manju Dhandapani, Sunil K Gupta
Homocysteine (tHcy) has been hardly studied among patients with head injury. This study was to evaluate whether there is any independent impact of tHcy levels on neurological outcome following head injury in a multivariate model. Patients admitted within 24 h of injury were included in the study, along with 20 age- and gender-matched controls. Plasma levels of tHcy were measured at admission using direct immunoassay. All the variables were analyzed with respect to tHcy levels and outcome according to Glasgow Outcome Score (GOS) at 3 months...
July 24, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28741219/in-vitro-analysis-of-platelet-function-in-acute-aneurysmal-subarachnoid-haemorrhage
#14
Christian von der Brelie, Alexander Subai, Verena Limperger, Veit Rohde, Astrid Dempfle, Azize Boström
Platelet function might play an essential role in the pathogenesis of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH). Thus, impaired platelet function and disturbed primary haemostasis induced by intake of acetylsalicylic acid (ASA) might influence the rate of DCI. Primary haemostasis and platelet function can be measured with in vitro diagnosis (platelet function analyser test, PFA 100). The aim of this study is to evaluate the rate of DCI, haemorrhagic complications and the neurological outcome...
July 24, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28741218/asymmetric-pedicle-subtractionosteotomy-apso-guided-by-a-3d-printed-model-to-correct-a-combined-fixed-sagittal-and-coronal-imbalance
#15
Pierre-Pascal Girod, S Hartmann, P Kavakebi, J Obernauer, M Verius, C Thomé
Surgical correction of fixed thoracolumbar deformity is usually achieved by estimating the preoperatively planned correction angles during surgery and is therefore prone to inaccuracy. This is particularly problematic in biplanar deformities. To overcome these difficulties, 3D model for planning, preparation, and simulation of an asymmetric pedicle subtraction osteotomy (aPSO) was printed and used to realign coronal and sagittal balance in case of rigid degenerative kyphoscoliosis. A 59-year-old woman presented with severe back pain and spinal claudication and was diagnosed with a rigid kyphoscoliosis with multilevel spinal stenosis...
July 24, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28735438/adenosine-assisted-neurovascular-surgery-initial-case-series-and-review-of-literature
#16
REVIEW
Alaa Al-Mousa, Gahan Bose, Katharine Hunt, Ahmed K Toma
Cerebral aneurysms in complex anatomical locations and intraoperative rupture of aneurysms are challenging for neurosurgeons and anaesthetists alike. Mechanical and non-mechanical methods to reduce blood flow into aneurysms are well-recognised techniques to facilitate aneurysm exclusion from the circulation. Mechanical methods like temporary clipping of parent arteries, carotid artery ligation and endovascular balloon occlusion are commonly used in clinical practice. However, non-mechanical techniques such as rapid ventricular pacing and adenosine-induced cardiac standstill with hypotension are still emerging strategies...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28735437/prospective-and-retrospective-study-of-videoconference-telemedicine-follow-up-after-elective-neurosurgery-results-of-a-pilot-program
#17
Melissa Reider-Demer, Pushpa Raja, Neil Martin, Mariel Schwinger, Diana Babayan
Existing literature suggests that use of telemedicine during postoperative appointments can increase access to care and is valued by patients and providers alike. While research examining the clinical equivalency of telemedicine visits for postoperative care has been growing, few studies have reported on telemedicine follow-up after neurosurgery. This study examined if a videoconferencing visit could substitute for an in-person clinic visit for elective neurosurgical cases in the USA. This was a single-center prospective study of patients who underwent elective neurosurgical procedures (aneurysm clipping, resection of cavernous angiomas, resection of arterial venous malformation, microvascular decompression for trigeminal neuralgia and hemifacial spasm, and certain benign brain tumors) and were offered telemedicine follow-up care by an allied health professional during the first 90 days after neurosurgery...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28726010/robot-guidance-for-percutaneous-minimally-invasive-placement-of-pedicle-screws-for-pyogenic-spondylodiscitis-is-associated-with-lower-rates-of-wound-breakdown-compared-to-conventional-fluoroscopy-guided-instrumentation
#18
Awad Alaid, Kajetan von Eckardstein, Nicolas Roydon Smoll, Volodymyr Solomiichuk, Veit Rohde, Ramon Martinez, Bawarjan Schatlo
Postoperative wound healing can pose a problem in patients undergoing instrumented surgery for pyogenic spondylodiscitis. Robotic guidance allows the minimally invasive placement of pedicle screws in the thoracolumbar spine. We assessed whether using this technique to perform minimally invasive surgery had an impact on wound healing in patients with pyogenic spondylodiscitis when compared to conventional open fluoroscopy-guided surgery. We reviewed charts of 206 consecutive patients who underwent instrumentation for pyogenic spondylodiscitis...
July 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28717892/a-population-based-study-of-injuries-to-the-brachial-plexus-and-to-the-peripheral-nerves-of-the-shoulder-girdle-and-upper-limb-in-the-italian-region-friuli-venezia-giulia
#19
Francesca Valent, Roberto Eleopra, Paolo Manganotti, Paolo Passadore
The aim of this study was to estimate the incidence, identify the causes, and explore treatments of the injuries to the brachial plexus and peripheral nerves of the shoulder girdle and upper limb in the 1,220,000-inhabitant Italian region Friuli Venezia Giulia.We linked at the individual patient level various administrative databases using an anonymous stochastic key: list of residents, hospital discharge, emergency department, and outpatient care prescriptions database. We abstracted hospital discharge records with at least one discharge diagnosis code ICD-9-CM 953...
July 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28717891/surgery-for-spinal-intramedullary-tumors-technique-outcome-and-factors-affecting-resectability
#20
Sherif Rashad, Amr Elwany, Ahmed Farhoud
Intramedullary spinal cord tumors (IMSCTs) are relatively infrequent lesions with ependymomas and astrocytomas representing the most common types. Microsurgical resection is established as the treatment of choice for these challenging lesions. We reviewed the surgical outcome of 29 cases operated for IMSCTs by the same surgeon between 2009 and 2015. The median follow-up period was 31 months, and all patients were followed up at least for 1 year. Among these 29 cases, 5 patients were previously operated for partial resection elsewhere...
July 17, 2017: Neurosurgical Review
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