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World Neurosurgery

Rui-Hui Wu, Dong-Hai Deng, Xing-Qiu Huang, Cheng-Long Shi, Xu-Qiang Liao
BACKGROUND: Transforaminal percutaneous endoscopic lumbar discectomy (TF-PELD) is a minimally invasive technique with high radiation exposure. The purpose of this study was to compare radiation exposure of ultrasound-guided TF-PELD with fluoroscopy-guided TF-PELD. METHODS: In this prospective randomized controlled clinical trial, 60 patients with lumbar disc herniation were enrolled and randomly assigned to two groups (30 cases in each group): ultrasound-guided group or fluoroscopy-guided group...
January 12, 2019: World Neurosurgery
Yongpeng Lin, Siyuan Rao, Yongjin Li, Shuai Zhao, Bolai Chen
PURPOSE: Cervical stenosis with myelopathy caused by ossification of the ligamentum flavum is relatively rare, and surgical treatment is the preferred option. Previous surgical procedures usually require assisted internal fixation, while some problems may occur, such as large trauma, intraoperative bleeding, wound infection and internal fixation failure. The aim of this paper is to introduce a new minimally invasive surgical procedure for the treatment of upper cervical spinal stenosis complicated with myelopathy...
January 12, 2019: World Neurosurgery
Kern H Guppy, Darrin J Lee, Jessica Harris, Harsimran S Brara
No abstract text is available yet for this article.
January 11, 2019: World Neurosurgery
Omar Tanweer, Monica C Mureb, Donato Pacione, Rajeev Sen, Jafar J Jafar, Howard A Riina, Paul P Huang
BACKGROUND: Neurovascular training models include animal models, synthetics, or computer simulation. In vivo models are expensive and require significant resources. Synthetic/computer models do not reflect the elasticity of fresh vessels. We describe an endovascular and microsurgical training model using a chicken thigh/leg. METHODS: 20 chicken thigh/leg models were obtained. Angiography was utilized to understand the anatomy. Proximal cannulation with a 5-French catheter was achieved and connected to a hemostatic valve with a pump to simulate pulsatile flow...
January 11, 2019: World Neurosurgery
Isabel Graul, Timo Zippelius, Alexander Hölzl, Patrick Strube
BACKGROUND: Both progression of scoliosis following completion of growth, and the combination of low mental retardationand the conspicuous sagittal clinical and radiographic abnormalities suggest a secondary genesis of the scoliosis according to a genetic aberration. CASE DISCRIPTION: In the outpatient department, an 18-year-old girl presents with scoliosis and mild mental retardation. Radiography findings demonstrate a sacral agenesis and the consecutively performed MRI a conus depression...
January 11, 2019: World Neurosurgery
Mark A Davison, Shyam A Desai, Daniel T Lilly, Victoria D Vuong, Jessica Moreno, Carlos Bagley, Owoicho Adogwa
No abstract text is available yet for this article.
January 11, 2019: World Neurosurgery
Debra Nana Yeboa, Kia-Ping Liao, Beverly Ashleigh Guadagnolo, Ganesh Rao, Andrew Bishop, Caroline Chung, Jing Li, Claudio Esteves Tatsui, Laurence D Rhines, Sherise Ferguson, Arnold de la Cruz Paulino, Amol Jitendra Ghia
BACKGROUND: Spinal ependymomas are rare with an incidence of 1 per 100,000. Given the paucity of data for higher grade II and III disease, the management and patterns of care require further investigation. METHODS: Our study of 1,345 patients with higher grade spinal ependymoma utilized chi-square tests, simple and multivariable logistic regression models to assess demographic and clinical factors associated with therapy. Kaplan Meier and log-rank test were used to assess overall survival (OS)...
January 11, 2019: World Neurosurgery
Khoi D Nguyen, Vamsi Reddy, Scott Y Rahimi
OBJECT: Hemicraniectomy is a commonly performed neurosurgical procedure used in the setting of medically refractory malignant intracranial hypertension. Complications from cranioplasty following hemicraniectomy can be significant, including infection and wound issues. Difficulty with scar tissue during exposure for cranioplasty can be challenging and can lead to prolonged surgical time and increased bleeding. We describe a surgical technique, termed the "dural sandwich", that could provide a significant benefit during cranioplasty as compared to traditional single-layered dural closure...
January 11, 2019: World Neurosurgery
Ning Luo, Xia He, Guangzhou Li, Yehui Liao, Qiang Tang, Rupei Ye, Dejun Zhong
BACKGROUND: Dumbbell-shaped tumor is a type of the inner and outer cervical spinal canal tumor, and most of them are neurogenic tumors. Desmoid tumor is a rare tumor, and no case of them involving intervertebral foramen formed dumbbell-shaped in cervical spine have been reported before in English literature. Here we report a case of desmoid tumor arising in the cervical spine which is presented as typical dumbbell-shaped tumor. CASE DESCRIPTION: A 47-year-old female was admitted to our department with a mass in her left neck...
January 10, 2019: World Neurosurgery
Jonathan D Breshears, Alexander F Haddad, Jennifer Viner, Johnny Rau, Sujatha Sankaran, Michael W McDermott
BACKGROUND: Dexamethasone is a standard treatment for cerebral edema following brain tumor surgery. However its side effects can negatively impact the quality and safety of care provided to patients. Sparse evidence exists in the literature regarding postoperative steroid dosing to guide clinicians. OBJECTIVE: To determine if a new reduced exogenous steroid taper (REST) protocol would effectively treat postoperative cerebral edema while reducing the incidence of steroid related side effects including diabetes, hypertension, and insomnia...
January 10, 2019: World Neurosurgery
Amir Goodarzi, Bart Thaci, Atrin Toussi, Tejas Karnati, Kee Kim, Ruben Fragoso
Primary spinal glioblastoma multiforme (GBM) of the conus medullaris is a rare and devastating pathology. Presenting symptoms commonly include progressive neurologic deficits in the lower extremities, bowel and bladder dysfunction, and low back pain. Histologically, these tumors have high-grade features similar to their intracranial counterparts, however, recent advancements in the field of molecular oncology are beginning to elucidate a unique molecular blueprint for these spinal gliomas. Given the lack of standardized treatment strategies, we present our institutional experience in treating a small series of patients suffering from conus medullaris GBM and review the literature on relevant molecular markers, management strategies, and complication avoidance for this malignant pathology...
January 10, 2019: World Neurosurgery
Jakub Polak, Szymon Ciuk, Iwona Kucybała, Jakub Giliavas, Anna Gajdosz, Andrzej Urbanik
OBJECTIVE: Vascular anatomic variations are very common in the population, but their coexistence with life-threating vascular malformations remains unclear. The objective of the study was to assess the correlation between the presence of anatomic variants of both carotid and main cerebral arteries and the occurrence of cerebral aneurysms. METHODS: We analyzed examinations of 194 patients who underwent CT angiography of head and neck between September of 2016 and November of 2017...
January 10, 2019: World Neurosurgery
Sajjad Muhammad, Rokuya Tanikawa, Mika Niemelä
OBJECTIVES: Cochleovestibular nerve compression syndrome due to intrameatal anterior inferior cerebellar artery (AICA) that causes tinnitus is an extremely rare condition with special therapeutic challenges and implications. Here we present the first surgically treated paediatric case of tinnitus showing microvascular conflict of cochleovestibular nerve and intrameatal AICA loop. METHODS: A paediatric case of tinnitus is described and a surgical technique is elaborated with video material...
January 10, 2019: World Neurosurgery
Tarek Y El Ahmadieh, Aaron Plitt, Benjamin Kafka, Salah G Aoun, Jack M Raisanen, Brent Orr, Edward Pan, Zabi Wardak, Lucien A Nedzi, Toral R Patel
BACKGROUND: The revised WHO classification of central nervous system tumors, published in 2016, has recognized the H3 K27M mutation as a critical genetic signature defining a new group of infiltrative astrocytomas designated "diffuse midline glioma, H3 K27M mutant". Although the majority of H3 K27M mutations arise in the setting of diffusely infiltrative tumors, there are rare reports of compact tumors with low-grade histologic features harboring this mutation. The prevalence and clinical significance of this mutation in pilocytic astrocytomas remain unclear...
January 10, 2019: World Neurosurgery
Gabriele Rocca, Fiorella Caputo, Claudio Terranova, Stefano Alice, Francesco Ventura
BACKGROUND: An intracranial dural arteriovenous fistula (DAVF) consists of a meshwork of arteriovenous shunts. Drainage of the fistula may be into a dural sinus or directly into cortical veins. Rarely, DAVFs drain exclusively into perimedullary veins. Prompt diagnosis is important as the clinical course is potentially life-threatening. CASE DESCRIPTION: A 67-year-old man presented with difficulties in walking and bladder retention. Magnetic resonance imaging (MRI) revealed central myelopathy, edema from C6 to T8, and dilated posterior medullary veins...
January 10, 2019: World Neurosurgery
Halil Olgun Peker, Haydar Gok, Tamer Altay
No abstract text is available yet for this article.
January 10, 2019: World Neurosurgery
Douglas J Weaver, Azeem Tariq Malik, Nikhil Jain, Elizabeth Yu, Jeffery Kim, Safdar N Khan
BACKGROUND: The modified 5-item frailty index (mFI-5) is a concise co-morbidity based risk stratification tool that has been shown to predict the occurrence of adverse outcomes following various orthopaedic surgeries. METHODS: The 2012-2016 American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) dataset was used to identify patients undergoing an elective 1-to-2 level posterior lumbar fusion for degenerative lumbar pathology. The mFI-5 score was calculated on the basis of the presence of the five co-morbidities - congestive heart failure within 30 days prior to surgery, insulin-dependent or non-insulin dependent diabetes mellitus, chronic obstructive pulmonary disease or pneumonia, partially dependent or totally dependent functional health status at time of surgery and hypertension requiring medication...
January 10, 2019: World Neurosurgery
Jonathan J Liu, Troels H Nielsen, Kumar Abhinav, Justin Lee, Summer S Han, Michael P Marks, Huy M Do, Robert L Dodd, Gary K Steinberg
BACKGROUND: Endovascular treated cerebral aneurysms have a greater recurrence rate compared to microsurgical clip ligation. Despite recent endovascular advances, microsurgical clip ligation might be the treatment of choice for certain previously endovascular treated recurrent aneurysms. We report on our single-center experience with 76 previously coiled and/or stent-coiled aneurysms. OBJECTIVE: To analyse the surgical and radiological outcome after clipping of previous endovascular treated recurrent cerebral aneurysms...
January 10, 2019: World Neurosurgery
S M Son, S H Choi, T S Goh, W Park, J S Lee
OBJECTIVE: The aim of this study was to compare the outcomes of scoliosis correction with direct vertebral rotation (DVR) and without DVR (N-DVR) through meta-analysis. METHODS: The MEDLINE and EMBASE database, from the earliest available date of indexing through April 10, 2018, were searched for studies evaluating outcomes of DVR and N-DVR in scoliosis. Two authors performed the data extraction independently. Any discrepancies were resolved by a consensus. RESULTS: Seven comparative studies were identified...
January 10, 2019: World Neurosurgery
Hendrik-Jan Mijderwijk, Igor Fischer, Angelika Zhivotovskay, Richard Bostelmann, Hans-Jakob Steiger, Jan F Cornelius, Athanasios K Petridis
BACKGROUND: Patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) are at risk for the development of chronic shunt-dependent hydrocephalus. Identification of shunt-dependent patients remains challenging. OBJECTIVE: To develop a prognostic model that identifies aSAH patients at risk for chronic shunt-dependent hydrocephalus. In addition to the well-known prognostic variables, blood clearance in the cerebrospinal fluid (CSF) spaces was considered. METHODS: We retrospectively analyzed 227 patients treated at our institution from January 2012 to January 2016...
January 10, 2019: World Neurosurgery
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