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World Neurosurgery

Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. METHODS: We retrospectively reviewed medical records of 55 patients with giant pituitary adenomas (> 4 cm in maximum diameter) that underwent an EEA from 2008 - 2016. Factors affecting the extent of resection (EOR) were evaluated. RESULTS: Mean age was 55.5 years. All tumors were non-functional except in four patients (GH-secreting [2], ACTH-secreting [1], prolactinoma [1])...
March 12, 2018: World Neurosurgery
Joonho Byun, Seok Ho Hong, Young-Hoon Kim, Jeong Hoon Kim, Chang Jin Kim
No abstract text is available yet for this article.
March 12, 2018: World Neurosurgery
Olabisi R Sanusi, Omar Arnaout, Rudy J Rahme, Craig Horbinski, James P Chandler
OBJECTIVE: Chordomas are rare tumors of notochordal origin that are known to be locally aggressive and are often treated with surgical resection followed by adjuvant radiotherapy. The accepted standard of treatment for chordomas of the mobile spine which includes en-bloc resection with wide margins cannot be easily applied to the chordomas of the skull base given their proximity to critical neurovascular structures. We describe our experience with the role of surgery and adjuvant radiation in the treatment of chordomas over 16 years...
March 12, 2018: World Neurosurgery
Sharad Rajpal, Colson Tomberlin, Andrew Bauer, Robert C Forsythe, Sigita Burneikiene
BACKGROUND: The variety of diagnostic characteristics associated with neurocysticercosis have been well studied, however, its potential to be implicated in other differential diagnosis has not been well demonstrated. CASE DESCRIPTION: We report the case of a 55-year-old Hispanic man who underwent a Chiari decompression surgery, which was complicated with hydrocephalus. Despite a ventriculoperitoneal (VP) shunt placement, he continued to have headaches and was soon found to have several skull base subarachnoid lesions, which were later diagnosed as the sequelae of an active neurocysticercosis infection...
March 12, 2018: World Neurosurgery
Jang W Yoon, Sara Ganaha, Clarence Watridge
BACKGROUND: Congenital agenesis of the inferior vena cava (IVC) can lead to the development of a prominent venous collateral system within and around the spine due to the development of venous collaterals. Surgery on such patients can harbor the risk of catastrophic bleeding or decompensation of a delicate venous drainage pattern during spinal manipulation or even epidural exploration. CASE DESCRIPTION: A 49-year old man with a congenital agenesis of the IVC presented with signs and symptoms of an L5 radiculopathy...
March 12, 2018: World Neurosurgery
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
Andrew Nyangau, Nickalus Khan, Mario Teo
No abstract text is available yet for this article.
March 12, 2018: World Neurosurgery
Min-Qing Wang, Xu Zhao, Xiao-Fei Wang, Chao Han, De-Guang Xing, Cheng-Wei Wang
BACKGROUND: The purpose of this study was to assess the outcomes in aggressively treated patients with aneurysmal intracerebral hematoma (ICH) and signs of brain herniation, and to investigate possible predictive factors. METHODS: This retrospective study included 43 patients with aneurysmal ICH who presented with brain herniation at emergency department (ED) admission and received aggressive surgical treatment between 2008 and 2016. Emergency surgical clipping, removal of hematoma, and external decompression were combined as an aggressive surgical treatment...
March 12, 2018: World Neurosurgery
David P Darrow, Coridon Quinn, Huy T Donguyen, Matthew Hunt, Stephen Haines
INTRODUCTION: External ventricular drains can pose a serious source of morbidity and mortality. Interventions proven to reduce the risk of infections are lacking. Single center studies limit the study of procedures that mitigate infection, but bundled protocols have demonstrated utility. A collaborative EVD registry was designed to facilitate local quality improvement projects to be implemented at any location using standardized data collection instruments through resident collaboration to reduce and study EVD infection and prevention...
March 12, 2018: World Neurosurgery
Narayanam Anantha Sai Kiran, Veldurti Ananta Kiran Kumar, Laxminadh Sivaraju, Valluri Anil Kumar, Chintakunta Rajesh Reddy, Amit Agrawal
BACKGROUND: Aberrant medial retropharyngeal prevertebral course of internal carotid arteries (ICAs) is extremely uncommon. In oropharyngeal surgeries like trans oral odontoidectomy (TOO) this unrecognized aberrant retropharyngeal course of ICAs can result in devastating complications secondary to inadvertent injury of ICAs. Authors describe this aberrant course of ICAs in a patient with craniovertebral junction (CVJ) anomaly with dysmorphic C1 lateral mass on one side and discuss in detail various management issues in this complex case...
March 12, 2018: World Neurosurgery
Harnarayan Singh, Rana Patir, Sandeep Vaishya, Rahul Miglani, Amandeep Kaur
No abstract text is available yet for this article.
March 10, 2018: World Neurosurgery
Robert Ecker
No abstract text is available yet for this article.
March 10, 2018: World Neurosurgery
James R van Dellen
No abstract text is available yet for this article.
March 10, 2018: World Neurosurgery
Rachid Madkouri, David Brauge, Anthony Vidon-Buthion, Elie Fahed, Klaus-Luc Mourier, Jacques Beaurain, Mickael Grelat
OBJECTIVE: The aim of this study was to evaluate modifications in static spinal status after posterior decompression surgery without fusion in patients with symptomatic central canal stenosis. MATERIAL & METHODS: From November 2014 to May 2016, 72 patients who underwent isolated decompression for lumbar spinal stenosis were prospectively enrolled in this monocentric study. All of the patients had lateral full-body x-rays using the EOS system (EOS Imaging, Paris, France) before surgery and after 12 months of follow-up...
March 9, 2018: World Neurosurgery
Taichi Ishiguro, Masayuki Nitta, Takashi Komori, Takashi Maruyama, Yoshihiro Muragaki, Takakazu Kawamata
BACKGROUND: Transient focal MRI abnormalities after status epilepticus (SE) are rarely seen in patients with benign brain tumors, and the underlying mechanism is still unknown. We report a rare case of cerebral cavernous malformation with transient focal MRI abnormalities around the tumor and accumulation of 11C-methionine on PET after SE. These findings mimicked those of a glioma because the MRI and methionine PET findings were similar. We also speculate about the cause of this phenomenon in relation to pathological findings of this case...
March 9, 2018: World Neurosurgery
Ken Kazumata, Haruto Uchino, Kikutaro Tokairin, Masaki Ito, Tohru Shiga, Toshiya Osanai, Masahito Kawabori
BACKGROUND: Cerebral hyperperfusion complicates the postoperative course of patients with moyamoya disease (MMD) following direct revascularization surgery. There is no clear distinction between cerebral hyperperfusion syndrome and benign postoperative increase in regional cerebral blood flow (rCBF). OBJECTIVE: The present study aimed to determine clinically relevant changes in rCBF, anatomical correlations, and factors associated with transient neurological symptoms following revascularization surgery in MMD...
March 9, 2018: World Neurosurgery
Shuangxiang Xu, Jianjian Zhang, Sheng Wang, Zhengwei Li, Zhongwei Xiong, Xiaolin Wu, Can Xin, Hao Wang, Yu Wang, Jincao Chen
BACKGROUND: It is still controversial whether surgery should be performed on patients suffering from acute onset of moyamoya disease (MMD). The present study aims at determining an optimum operative time for the patients with MMD. METHODS: We retrospectively analyzed 57 patients with MMD admitted between January 2016 and June 2017. All of them consented to combined revascularization. Considering the time interval between acute onset and surgery, we accordingly divided all patients into the early group and the later group if the latter exceeded 90 days...
March 9, 2018: World Neurosurgery
Waleed Brinjikji, Vitor M Pereira, Rujimas Khumtong, Alex Kostensky, Michael Tymianski, Timo Krings, Ivan Radovanovich
BACKGROUND AND PURPOSE: Understanding risk factors for intracranial aneurysm growth is important for patient management. We performed a retrospective study examining risk factors for growth of unruptured intracranial aneurysms followed at our institution examining both traditional risk factors and the PHASES score. MATERIALS AND METHODS: We retrospectively reviewed a consecutive series of unruptured intracranial aneurysms followed at our institution for a minimum of six months over a 15-year period...
March 9, 2018: World Neurosurgery
Maria Punchak, Jihad Abdelgadir, Oscar Obiga, Martha Itait, Josephine N Najjuma, Michael M Haglund, David Kitya
BACKGROUND: RTIs, falls and violence contribute to more than two thirds of pediatric TBIs in SSA. In this study, we sought to assess mechanisms of pediatric TBI in an effort to propose interventions for more effective pediatric head injury prevention. METHODS: A cohort of 100 patients who were <18 years treated at MRRH between November 2016 and June 2017 were enrolled in the study. Information on etiology of injury was obtained via a questionnaire administered to patient caretakers at the time of admission...
March 9, 2018: World Neurosurgery
Hongli Wang, Chi Sun, Shuo Yang, Jianyuan Jiang, Feizhou Lu, Xiaosheng Ma, Xinlei Xia
OBJECTIVE: To evaluate the cervical spine alignment and range of motion (ROM) of neck flexion in patients with Hirayama disease (HD). METHODS: A total of 50 male patients were included, with dynamic radiographs and MRI analyzed retrospectively. The Cobb angles for the entire cervical spine (C2-7) and each level (C2/3-C6/7) were measured, and the neck flexion ROM was defined as the neutral Cobb angle minus the flexion Cobb angle. Paired t-tests and Wilcoxon's sign rank tests were used to compare the Cobb angles and ROM between radiographs and MRI...
March 9, 2018: World Neurosurgery
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