Restoration of periventricular vasculature after direct bypass for moyamoya disease: intra-individual comparison
AbstractBackgroundWhile periventricular anastomosis, a unique abnormal vasculature in moyamoya disease, has been studied in relation to intracranial hemorrhage, no study has addressed its change after bypass surgery. The authors sought to test whether direct bypass surgery could restore normal periventricular vasculature.MethodsPatients who had undergone direct bypass surgery for moyamoya disease at a single institution were eligible for the study. Baseline, postoperative, and follow-up magnetic resonance angiography (MRA) scans were scheduled before surgery, after the first surgery, and 3 to 6  months after contralat...
Source: Acta Neurochirurgica - March 18, 2019 Category: Neurosurgery Source Type: research

Current accuracy of surface matching compared to adhesive markers in patient-to-image registration
AbstractObjectIn the past, the accuracy of surface matching has been shown to be disappointing. We aimed to determine whether this had improved over the years by assessing application accuracy of current navigation systems, using either surface matching or point-pair matching.MethodsEleven patients, scheduled for intracranial surgery, were included in this study after a power analysis had shown this small number to be sufficient. Prior to surgery, one additional fiducial marker was placed on the scalp, the “target marker,” where the entry point of surgery was to be expected. Using one of three different navigat...
Source: Acta Neurochirurgica - March 16, 2019 Category: Neurosurgery Source Type: research

Pseudoaneurysm of a segmental lumbar artery following a full-endoscopic transforaminal lumbar discectomy: a rare approach-related complication
This report identifies a rare complication of transforaminal full-endoscopic surgery in the treatment of a herniated lumbar disc. To our knowledge this is the first case of pseudoaneurysm formation of the lumbar artery following a full-endoscopic transforaminal lumbar discectomy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 16, 2019 Category: Neurosurgery Source Type: research

Differences in neurosurgical treatment of intracerebral haemorrhage: a nation-wide observational study of 578 consecutive patients
AbstractBackgroundSupratentorial intracerebral haemorrhage (ICH) carries an excessive mortality and morbidity. Although surgical ICH treatment can be life-saving, the indications for surgery in larger cohorts of ICH patients are controversial and not well defined. We hypothesised that surgical indications vary substantially among neurosurgical centres in Sweden.ObjectiveIn this nation-wide retrospective observational study, differences in treatment strategies among all neurosurgical departments in Sweden were evaluated.MethodsPatient records, neuroimaging and clinical outcome focused on 30-day mortality were collected on e...
Source: Acta Neurochirurgica - March 15, 2019 Category: Neurosurgery Source Type: research

Traumatic brachial plexus injury: a study of 510 surgical cases from multicenter services in Guangxi, China
ConclusionsBrachial plexus injury is still a challenging trauma for surgeons, and traffic accidents are the dominant cause. Timely and effective surgery is important for functional limb recovery. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 15, 2019 Category: Neurosurgery Source Type: research

Cerebral metastases: do size, peritumoral edema, or multiplicity predict infiltration into brain parenchyma?
ConclusionsBased on the post hoc analysis of our prospective trial data, we could not confirm the hypothesis that infiltration of brain parenchyma beyond the glial pseudocapsule is associated with the MR imaging parameters tumor size, extent of edema, or multiplicity of metastases. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 15, 2019 Category: Neurosurgery Source Type: research

Fluorescence imaging of meningioma cells with somatostatin receptor ligands: an in vitro study
ConclusionsThis study demonstrates the use of FAM-TOC in the selective fluorescent identification of meningioma cells in vitro. Further evaluation of the chemical kinetics of the applied somatostatin receptor ligand and fluorescence dye is warranted. As a next step, an experimental animal model is needed to evaluate these promising results in vivo. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 15, 2019 Category: Neurosurgery Source Type: research

Univariate comparison of performance of different cerebrovascular reactivity indices for outcome association in adult TBI: a CENTER-TBI study
ConclusionsPRx, PAx, and RAC appear similar in their associations with 6- to 12-month outcome in moderate/severe adult TBI, with RAC showing tendency to achieve stronger associations. Further work is required to determine the role for each of these cerebrovascular indices in monitoring of TBI patients. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 15, 2019 Category: Neurosurgery Source Type: research

“Warning” to postoperative complications when using hemostatic agents!
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 15, 2019 Category: Neurosurgery Source Type: research

Outcome after surgery in supratentorial and infratentorial solitary brain metastasis
ConclusionsThis study identified factors that play a role in the outcome after surgery in patients with ISM and SSM on MRI. Postoperative complications seemed to be higher in ISM and CM was more often seen in ISM, but the worse prognosis in patients with ISM compared with SSM could not be confirmed. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 12, 2019 Category: Neurosurgery Source Type: research

Combined supra-infrasellar approach to pituitary macroadenoma with oculomotor cistern extension: surgical strategy and experience
ConclusionsPituitary macroadenomas with OMCE are a newly recognized form of progression with important implications for surgical strategy. The combined supra-infrasellar approach performed with the transcranial microscopic transsylvian anterior temporal approach using electrical nerve stimulation and the nasal endoscopic approach may be useful for this type of multi-lobulated pituitary adenoma. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 12, 2019 Category: Neurosurgery Source Type: research

Posterior fossa meningiomas: perioperative predictors of extent of resection, overall survival and progression-free survival
AbstractBackgroundPosterior fossa meningiomas (PFMs) often represent surgical challenges due to their proximity to neurovascular structures. Factors predicting the extent of resection (EOR), overall survival (OS), and progression-free survival (PFS) were identified and integrated in a prediction tool to offer evidence-based personalized therapeutic strategies.MethodsAll meningiomas managed surgically from 1990 to 2010 from a single-center were reviewed. A classification tree was created using the classification and regression tree recursive partitioning analysis that incorporated patient and tumor data available before sur...
Source: Acta Neurochirurgica - March 11, 2019 Category: Neurosurgery Source Type: research

Screening spreading depolarizations during epilepsy surgery
ConclusionsSDs were not detected during intraoperative recordings of epilepsy surgery using AC- or DC-amplifiers. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 9, 2019 Category: Neurosurgery Source Type: research

Best zero level for external ICP transducer
ConclusionsEAM and glabella are defined anatomical structures representing BC when strict supine or lateral but with 12  mmHg variation with different head positions used in clinical practice. The OM line follows Monro at head elevation, but not when the head is turned. When the highest external point on the head is used, ICP values at brain surface as well as Monro and BC are underestimated. This underestimation is fairly constant and, when corrected for, provides the most exact ICP reading. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 8, 2019 Category: Neurosurgery Source Type: research

Middle cluneal nerve entrapment mimics sacroiliac joint pain
ConclusionsIn patients with suspected SIJ-related pain, the presence of MCN-E must be considered when the effect of SIJ block is unsatisfactory. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 4, 2019 Category: Neurosurgery Source Type: research

Transjugular transsigmoid approach for triple dumbbell-shaped jugular foramen schwannomas
ConclusionThe infralabyrinthine transjugular transsigmoid approach with high cervical exposure under continuous vagus nerve monitoring enables gross total resection of triple dumbbell-shaped jugular foramen schwannomas, aiming at surgical cure of these benign tumors for appropriately selected patients. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 4, 2019 Category: Neurosurgery Source Type: research

“Warning” to postoperative complications when using hemostatic agents!
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - March 1, 2019 Category: Neurosurgery Source Type: research

Univariate comparison of PRx, PAx, and RAC —much ado about what?
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 28, 2019 Category: Neurosurgery Source Type: research

Correction to: Preservation of olfaction in anterior midline skull base meningiomas: a comprehensive approach
Result is incorrect. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 26, 2019 Category: Neurosurgery Source Type: research

Response to: “No doubt: the invasion of the cavernous sinus is the limiting factor for complete resection in pituitary adenomas”
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 26, 2019 Category: Neurosurgery Source Type: research

Bridging vein and tentorial sinus in the subtemporal corridor during the anterior transpetrosal approach
ConclusionsWe showed classification of the BV, and preservation of the BV and TenS during the ATPA. Furthermore, we found that the interdural sinus was significantly flatter than the intradural veins. Measuring the flattening rate by CPR may be useful to identify BVs preoperatively. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 23, 2019 Category: Neurosurgery Source Type: research

Lipomatosis of nerve and overgrowth: is there a preference for motor (mixed) vs. sensory nerve involvement?
AbstractBackgroundLipomatosis of nerve (LN) is a peripheral nerve disorder characterized by fibroadipose proliferation within the epineurium. It has been associated with nerve-territory overgrowth affecting soft tissue and/or bony structures. We sought to understand if there is an anatomical relationship associated with nerve-territory overgrowth.MethodsA review of the literature and our institutional LN cases was performed to determine the prevalence of nerve-territory overgrowth. Only cases with sufficient clinical and/or imaging data were selected. The cases were then subdivided into two groups and analyzed: (1) motor (...
Source: Acta Neurochirurgica - February 23, 2019 Category: Neurosurgery Source Type: research

Randomized controlled trials comparing surgery to non-operative management in neurosurgery: a systematic review
This study set out to assess trial design and quality and identify their influence on outcomes in recent neurosurgical trials that compare surgery to non-operative treatment.MethodsFrom 2000 to 2017, PubMed and Embase databases and four trial registries were searched. RCTs were evaluated for study design, funding, adjustments to reported outcome measures, accrual of patients, and academic impact.ResultsEighty-two neurosurgical RCTs were identified, 40 in spine disorders, 19 neurovascular and neurotrauma, 11 functional neurosurgery, ten peripheral nerve, and two pituitary surgery. Eighty-four RCTs were registered, of which ...
Source: Acta Neurochirurgica - February 23, 2019 Category: Neurosurgery Source Type: research

Randomized controlled trials in surgery and the glass ceiling effect
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 23, 2019 Category: Neurosurgery Source Type: research

Correction to: Ruptured posterior circulation aneurysms: epidemiology, patterns of care, and outcomes from the Swiss SOS national registry
The name of Roy Thomas Daniel was incorrectly captured in the original manuscript. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 23, 2019 Category: Neurosurgery Source Type: research

Hemorrhagic burden in poor-grade aneurysmal subarachnoid hemorrhage: a volumetric analysis of different bleeding distributions
ConclusionsVolumetric assessment of aneurysmal bleeding has the potential for identifying cutoff values that independently predict outcome. Further insights into the relative importance of different bleeding volumes may be implicated in better tailoring the management of this dismal aSAH population. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 21, 2019 Category: Neurosurgery Source Type: research

Lausanne checklist for safe stereotactic radiosurgery
ConclusionThe use of a safety checklist for SRS procedures promotes a zero-tolerance attitude for errors. This can lower the complications and is of major help in promoting multidisciplinary cooperation. We highly recommend the use of such tool, especially in the context of the increased use of SRS in the neurosurgical field. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 21, 2019 Category: Neurosurgery Source Type: research

Fraction of anisotropy and apparent diffusion coefficient as diagnostic tools in trigeminal neuralgia
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 21, 2019 Category: Neurosurgery Source Type: research

Chronic subdural cortical stimulation for phantom limb pain: report of a series of two cases
AbstractPhantom limb pain is a complex, incompletely understood pain syndrome that is characterized by chronic painful paresthesias in a previous amputated body part. Limited treatment modalities exist that provide meaningful relief, including pharmacological treatments and spinal cord stimulation that are rarely successful for refractory cases. Here, we describe our two-patient cohort with recalcitrant upper extremity phantom limb pain treated with chronic subdural cortical stimulation. The patient with evidence of cortical reorganization and almost 60  years of debilitating phantom limb pain experienced sustained an...
Source: Acta Neurochirurgica - February 21, 2019 Category: Neurosurgery Source Type: research

Comparative study of single and dual nerve transfers for repairing shoulder abduction
AbstractObjectiveThe purpose of this study was to compare the effects of single and dual nerve transfer for the repair of shoulder abduction in patients with upper or upper and middle trunk root avulsion.MethodsWe carried out a retrospective analysis of 20 patients with C5-C6 or C5-C7 root avulsion treated by nerve transfer in our hospital. The patients were divided into two groups according to the different operation methods. In group A, ten patients had transferred the spinal accessory nerve to the suprascapular nerve. Ten patients in group B underwent dual nerve transfer to reconstruct shoulder abduction, including the ...
Source: Acta Neurochirurgica - February 20, 2019 Category: Neurosurgery Source Type: research

Long-term outcome after carpal tunnel release and identification of prognostic factors
AbstractBackgroundThe effectiveness of the surgical treatment of carpal tunnel syndrome (CTS) is well known on short term. However, limited data is available about long-term outcome after carpal tunnel release (CTR). The aims of this study were to explore the long-term outcome after CTR and to identify prognostic factors for long-term outcome.MethodsPatients with clinically defined CTS underwent CTR and completed the Boston Carpal Tunnel Questionnaire at baseline (T0), at about 8  months (T1), and after a median follow-up of 9  years (T2), as well as a 6-point scale for perceived improvement (atT1 andT2). Potenti...
Source: Acta Neurochirurgica - February 19, 2019 Category: Neurosurgery Source Type: research

Spontaneous regression of meningiomas after interruption of nomegestrol acetate: a series of three patients
ConclusionWe report the first cases of meningiomas responsiveness to discontinuation of hormonal therapy with NOMAC. Similarly to cases associated with long-term CPA intake, tumor reduction, and improvement of clinical symptoms can be observed after cessation of NOMAC. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 19, 2019 Category: Neurosurgery Source Type: research

Evaluation of the yield of post-clipping angiography and nationwide current practice
ConclusionsThere is lack of consensus regarding the post-clipping imaging strategy in the Netherlands. Since intraoperative assessment is shown to be insufficient to predict postoperative aneurysm residuals, we advocate routine postoperative imaging after aneurysm clipping unless this is not warranted on the basis of patient age, clinical condition, and/or comorbidity. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 19, 2019 Category: Neurosurgery Source Type: research

Management of choroid plexus tumors —an institutional experience
ConclusionsWe could confirm that GTR is crucial for treatment of choroid plexus tumors. Parenchymal tumor infiltration as detected intraoperatively was associated with the extent of resection and not limited to CPC. CSF disturbances mandating treatment may persist after resection. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 19, 2019 Category: Neurosurgery Source Type: research

Factors related to improvement of cerebrovascular reserve after superficial temporal artery to middle cerebral artery anastomosis for patients with atherosclerotic steno-occlusive disease
ConclusionsA higher eGFR might have prognostic value for improvement in CVR after EC –IC bypass surgery in patients with CASD and misery perfusion. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 18, 2019 Category: Neurosurgery Source Type: research

Aberrant trans-osseous venous drainage of the superficial middle cerebral vein: case report
AbstractThe superficial middle cerebral veins (SMCVs) are large veins to drain the brain and therefore anatomical knowledge of them is important for neurosurgeons and neuroradiologists. In a patient with a ruptured blister aneurysm, we incidentally found during angiography an aberrant drainage of the SMCVs, which penetrated the lateral part of the greater sphenoid wing and directly connected the SMCVs with the deep facial vein. Neurosurgeons usually need to remove that part of the greater sphenoid wing during the fronto-temporal approach. The existence of a well-developed current channel could be a contraindication for thi...
Source: Acta Neurochirurgica - February 18, 2019 Category: Neurosurgery Source Type: research

Fluorescence-guided neurosurgery —neuro-oncology and cerebrovascular applications (2019) by Constantinos G. Hadjipanayis and Walter Stummer (eds.)
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 14, 2019 Category: Neurosurgery Source Type: research

Postoperative subdural hematoma with blood flow from an epidural hematoma through a tear at the suture point of an artificial dura substitute
ConclusionsPostoperative epidural and subdural hematomas seem to be specific for SEAMDURA and may be caused by the weak suture strength of SEAMDURA. In cases of duraplasty, a nonabsorbable artificial dura substitute may be suitable. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 14, 2019 Category: Neurosurgery Source Type: research

Application of indocyanine green fluorescence endoscopic system in transsphenoidal surgery for pituitary tumors
ConclusionsThe ICG endoscopic system is simple, user-friendly, quick, cost-effective, and reliable. The method offered real-time information during TSS to delimit pituitary and parasellar region tumor tissue from surrounding normal structures. This method can contribute to the improvement of total removal rates of tumors, reduction of complications after TSS, saving surgical time, and preserving endocrinological functions. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 14, 2019 Category: Neurosurgery Source Type: research

Endoscopic transorbital transtentorial approach to middle incisural space: preclinical cadaveric study
ConclusionThe endoscopic transorbital transtentorial approach can be used as a minimally invasive surgery for exposure of middle incisural space. Extensive drilling of sphenoid wing and lateral mobilization of mesial temporal lobe are the main determinants of successful dissection. Further studies are needed to confirm the clinical feasibility of this novel approach. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 13, 2019 Category: Neurosurgery Source Type: research

Early postoperative MRI after resection of brain metastases —complete tumour resection associated with prolonged survival
ConclusionResidual tumour was seen on MRI after 22% of the procedures. The intraoperative assessment of EOR performed by the surgeon diverged from the early postoperative MRI in 40% of procedures. Correct assessment of residual tumour thus requires early postoperative MRI. Measurable residual tumour on early postoperative MRI was associated with shorter overall survival independent on postoperative radiotherapy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 13, 2019 Category: Neurosurgery Source Type: research

Radiology reporting of low-grade glioma growth underestimates tumor expansion
ConclusionsGiven accumulating evidence that LGG volume and growth are prognostic factors, there is a need for objective lesion measurement. Current radiological reporting workflows fail to appreciate and communicate the true expansion of LGGs. While volumetric analysis remains the gold standard for assessment of growth, careful diametric measurements in three dimensions may be an acceptable alternative. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 13, 2019 Category: Neurosurgery Source Type: research

The association between preoperative edema and postoperative cognitive functioning and health-related quality of life in WHO grade I meningioma patients
ConclusionsOur results suggest that WHO grade I meningioma patients with larger volumes of preoperative cerebral edema are more at risk of experiencing limitations in longer-term cognitive functioning than patients with no or less edema preoperatively. This is an important knowledge for neurologists and neurosurgeons treating patients with a meningioma. More studies regarding the effect of peritumoral edema on cognitive functioning in meningioma patients are necessary. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 13, 2019 Category: Neurosurgery Source Type: research

Step-wise pterional combined epidural and subdural approach to clip large carotid-ophthalmic segment aneurysms
ConclusionWe show that it is a safe way to clip large OA aneurysms through a step-wise pterional combined epidural and subdural approach, which could make a clear anatomy and a confident manipulation. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 13, 2019 Category: Neurosurgery Source Type: research

Protective distal side-to-side neurorrhaphy in proximal nerve injury —an experimental study with rats
ConclusionsProtective distal side-to-side neurorrhaphy reduced muscle atrophy and had an improving effect on the morphometric studies and walk track analysis. Distal side-to-side neurorrhaphy does not prevent the regenerating axons to grow from the proximal stump to achieve distal nerve stump. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 12, 2019 Category: Neurosurgery Source Type: research

Stabilization of vulnerable carotid plaques with proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab
We describe three patients treated with PCSK9 inhibitor alirocumab for progressive carotid stenosis despite lipid-lowering statin therapy. All three patients had vulnerable plaques on magnetic resonance (MR) plaque imaging. After alirocumab treatment initiation, no patients suffered stroke or adverse events, and the stabilization of the carotid plaques was observed on MR plaque imaging. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 7, 2019 Category: Neurosurgery Source Type: research

Delayed postoperative hyponatremia after endoscopic transsphenoidal surgery for pituitary adenoma
AbstractBackgroundHyponatremia generally occurs after transsphenoidal surgery (TSS) in a delayed fashion. Most patients with delayed postoperative hyponatremia (DPH) are asymptomatic or only express non-specific symptoms; consequently, DPH is associated with prolonged hospitalization. No consensus has been reached on which patients are at greatest risk of developing DPH. We reviewed patients with DPH and evaluated predictive factors for DPH.MethodsWe retrospectively analyzed 107 consecutive patients who underwent endoscopic TSS for pituitary adenoma (January 2010 –December 2016). Patients with DPH (hyponatremia group...
Source: Acta Neurochirurgica - February 5, 2019 Category: Neurosurgery Source Type: research

Correction to: Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study
The collaborator names are inverted. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 4, 2019 Category: Neurosurgery Source Type: research

Preservation of olfaction in anterior midline skull base meningiomas: a comprehensive approach
ConclusionThere are limited published studies evaluating olfaction in patients who undergo skull-based approaches for anterior fossa meningiomas. Our series showed the highest olfaction preservation rate (87.5%) using a comprehensive strategy and multitude of surgical approaches based on the olfactory function and tumor characteristics. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 4, 2019 Category: Neurosurgery Source Type: research

A case series of early and late cranioplasty —comparison of surgical outcomes
ConclusionWe have demonstrated the potential for early cranioplasty to be a safe and viable option, when compared to delayed cranioplasty. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - February 4, 2019 Category: Neurosurgery Source Type: research