Lumbar disk herniation during pregnancy: a review on general management and timing of surgery
ConclusionSpine surgery during pregnancy is a rare scenario but can be performed safely when needed if providers adhere to general guidelines. Surgical approaches and overall management are influenced by the stage of pregnancy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Completion of Gamma Knife radiosurgery for AVM treatment after unplanned interruption —technical note
ConclusionOur technique involves integration of scans and coordinate systems from two imaging sessions using the composite isodose line to resolve translational differences, thereby limiting delivery of remaining shots to the untreated region of the lesion. MRI follow-up at 13  months showed a reduction in the nidus size with no evidence of any radiation injury to the surrounding brain parenchyma. We believe this technique will allow care teams to effectively salvage interrupted Gamma Knife procedures and reduce progression to more invasive treatment options. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Intracranial glioependymal (neuroglial) cysts: a systematic review
ConclusionsThe data collected from this review shows that GECs are rare and very often are erroneously named. They are congenital benign lesions with a neuroectodermal origin that share many radiological characteristics with a variety of intracranial benign cysts. The definite diagnosis of GECs is confirmed by the presence of a glial layer in the cyst wall at histological examination. The appropriate surgical technique should be selected according to the location of the cyst and its proximity to the ventricles or subarachnoid space. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Visualizing protoporphyrin IX formation in the dura tail of meningiomas by mass spectrometry imaging
ConclusionMALDI-MS/MS visualized a selective accumulation of PpIX within the tumor tissue including the dura tail. Thus, absence of fluorescence in the dura tail as visualized by the operating microscope is not caused by the lack of PpIX formation. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Hyperbaric oxygen therapy of air embolus in the cerebral venous sinuses after intracranial surgery: a case report
AbstractA case with cerebral venous air embolism (CVAE) after neurosurgery and treated with hyperbaric oxygen therapy (HBOT) is presented. This is a rare and potentially fatal complication that neurosurgeons should be aware of. A 52-year-old male was diagnosed with an intracerebral hematoma. An emergency evacuation of the hematoma was performed with a craniotomy and the postoperative CT scan showed a complete evacuation of the hematoma, but it also revealed a CVAE. The patient was immediately referred to HBOT and received three sessions within 48  h. The CT scan after the first HBOT showed no CVAE, venous thrombosis, ...
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Predicting factors for shunt-dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage
AbstractBackgroundChronic hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH) is a major complication that leads to a medical burden and poor clinical outcomes. The aim of this study was to evaluate the predictive factors of shunt-dependent hydrocephalus focusing on postoperative fever and infection.MethodA total of 418 patients were included in this study and the patient demographic features, radiologic findings, days of fever burden, and infection were compared between the shunt (n = 72) and no shunt group (n = 346). Days of fever burden was defined as the total number of days with th...
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Vasospasm-related complications after subarachnoid hemorrhage: the role of patients ’ age and sex
AbstractBackgroundOutcome of aneurysmal subarachnoid hemorrhage (SAH) depends strongly on occurrence of symptomatic vasospasm (SV) leading to delayed cerebral ischemia (DCI). Various demographic, radiographic, and clinical predictors of SV have been reported so far, partially with conflicting results. The aim of this study was to analyze the role of patients ’ age and sex on SV/DCI risk, especially to identify age and sex-specific risk groups.MethodsAll patients admitted with acute SAH during a 14-year-period ending in 2016 were eligible for this study. The study endpoints were the following: SV requiring spasmolysis...
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Total en-bloc spondylectomy through a posterior approach: technique and surgical outcome in thoracic metastases
ConclusionThis surgery is technically demanding so the patient ’s selection requires a careful pre-operative evaluation. However, it can be suggested for patients affected by intracompartmental lesions with a good prognosis since the tumor’s progression is “limited” by local barriers as demonstrated by histological studies. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Transfer of obturator nerve for femoral nerve injury: an experiment study in rats
AbstractBackgroundQuadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method.MethodsSixty Sprague –Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, ...
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Radiation therapy rather than prior surgery reduces extent of resection during endonasal endoscopic reoperation for craniopharyngioma
In this study, we sought to analyze whether a history of previous radiation therapy (RT) affected extent of resection in patients with recurrent craniopharyngiomas subsequently treated with reoperation via endoscopic endonasal approach (EEA).MethodsThe authors reviewed a prospectively acquired database of EEA reoperations of craniopharyngiomas over 13  years at Weill Cornell, NewYork-Presbyterian Hospital. All procedures were performed by the senior author. The operations were separated into two groups based on whether the patient had surgery alone (group A) or surgery and RT (group B) prior to recurrence.ResultsA tot...
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Red blood cell transfusion probability and associated costs in neurosurgical procedures
AbstractBackgroundThe extent of red blood cell units (RBC) needed for different neurosurgical procedures and the time point of their administration are widely unknown, which results in generously cross-matching prior to surgery. However, RBC are increasingly requested in the aging western populations, and blood donations are significantly reduced. Therefore, the knowledge of the extent and time point of administration of RBC is of major importance.MethodsThis is a retrospective single center analysis. The incidence of RBC transfusion during surgery or within 48  h after surgery was analyzed for all neurosurgical patie...
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Electromagnetic neuronavigation for the percutaneous treatment of trigeminal neuralgia with balloon compression: technical note and cadaveric validation study
ConclusionEM-based targeting of the foramen ovale and balloon inflation within Meckel ’s cave is a quick, reproducible and straightforward technique for the percutaneous treatment of trigeminal neuralgia. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Deep brain stimulation of the thalamic ventral intermediate nucleus for Benedikt ’s syndrome mainly present as tremor: a long-term case observation
We report a successful case report of thalamic ventral intermediate (VIM) nucleus DBS for a patient with BS. During follow-up of 3 years, DBS successfully control the tremor and greatly improve his living and working quality. We consider that VIM DBS may have sustained benefit for refr actory BS that mainly presents as tremor. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

An unusual surgical indication for cerebral tuberculosis: status dystonicus. Case report
We report on a child affected by post-tubercular generalized dystonia, who progressed to status dystonicus (SD) and underwent stereotactic bilateral pallidotomy. After surgery, SD resolved, and drugs were rapidly tapered. The successful reversal of SD and the motor improvement observed in our patient demonstrate the safety, feasibility, and clinical efficacy of pallidotomy in post-tuberculous-meningoencephalitis dystonia and SD. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Correction to: Assessing size of pituitary adenomas: a comparison of qualitative and quantitative methods on MR
We have incorrectly described the ellipsoid equation as being calculated using maximal diameters. It is in fact calculated using half the maximal diameter, i.e. the maximal radii. The diameter is initially recorded on the MRI images (as per Fig.  1), as the lesions do not have a defined midpoint. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

A. S. Dumont, G. Lanzino, J. P. Sheehan (eds): Brain arteriovenous malformations and arteriovenous fistulas
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 11, 2018 Category: Neurosurgery Source Type: research

Cranial nerve deficits in giant cavernous carotid aneurysms and their relation to aneurysm morphology and location
ConclusionsDistinguishing between medial versus lateral location of mass effect may be more helpful than measuring aneurysm volumes or examining aneurysm thrombosis in understanding why some patients with GCCA present with CND while others do not.Clinical trial registration no.NCT02066493 (clinicaltrials.gov) (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 9, 2018 Category: Neurosurgery Source Type: research

Website-visibility of Neurosurgical Centers in Europe. A necessary tool for enhancing scientific network cooperation and information distribution: letter to the editor
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 8, 2018 Category: Neurosurgery Source Type: research

Letter to the editor of Acta Neurochirurgica: Endplate changes after lumbar discectomy with and without implantation of an annular closure device
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 8, 2018 Category: Neurosurgery Source Type: research

Reply to the letter to the editor of E. Shiban and B. Meyer regarding “Endplate changes after lumbar discectomy with and without implantation of an annular closure device” by Barth M et al., (Acta Neurochir (Wien) 2018 Apr;160(4):855–862)
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 7, 2018 Category: Neurosurgery Source Type: research

Non-operative meningiomas: long-term follow-up of 136 patients
ConclusionsOne hundred and nine (80%) patients remained stable at the end of FU. Peritumoural oedema was predictive of meningiomas progression. Further prospective study is needed to identify the combination of factors which can predict the meningioma progression for an early surgery or early discharge. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 6, 2018 Category: Neurosurgery Source Type: research

Plasma-rich fibrin in neurosurgery: a feasibility study
ConclusionL-PRF is safe, inexpensive, and completely autologous and can be rapidly and non-invasively harvested to aid in dural closure. Theoretical advantages include a regenerative bioactive potential, which could lead to improved wound healing and reduced infection rates. These findings warrant larger prospective studies to determine the potential role of L-PRF in neurosurgery. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 6, 2018 Category: Neurosurgery Source Type: research

Neurosurgery and pregnancy
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 5, 2018 Category: Neurosurgery Source Type: research

An anatomical study of so-called fibrous bands around the ulnar nerve distal to the cubital tunnel
ConclusionsOur study identified FB in 50% of the dissected limbs, all within 3 –11 cm of the CT, though their number and location varied. Further studies are necessary to describe FB variations associated with compressive neuropathies of the UN distal to the CT. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 4, 2018 Category: Neurosurgery Source Type: research

Safety of urgent STA-MCA anastomosis after intravenous rt-PA treatment: a report of five cases and literature review
ConclusionsIn our consecutive cases, urgent STA-MCA anastomosis after at least 5.3  h after intravenous rt-PA was performed safely without hemorrhagic complications. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 4, 2018 Category: Neurosurgery Source Type: research

Volumetric tumor growth rates of meningiomas involving the intracranial venous sinuses
ConclusionsThis study shows that meningiomas involving the venous sinuses have a Gompertzian-type growth with early exponential growth followed by a slower growth rate that plateaus when they reach a certain size. Overall, the growth rate of the intrasinus portion is low (7.3%), which is half of the reported growth rates for other studies involving primarily extrasinus tumors. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 4, 2018 Category: Neurosurgery Source Type: research

Pediatric intracranial distal arterial aneurysms: report of 35 cases
ConclusionsPIDAAs constitute a high proportion of pediatric intracranial aneurysms. PIDAAs are associated with an increased risk of seizures, a predilection for the MCA, and a high incidence of pseudoaneurysms with head trauma history. Surgical intervention is of greater benefit than endovascular treatment in controlling the risk of seizures. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - June 2, 2018 Category: Neurosurgery Source Type: research

Psychiatric co-morbidity, distress, and use of psycho-social services in adult glioma patients —a prospective study
ConclusionsA significant proportion of glioma patients report elevated distress during the hospital stay and thereafter. Only a fraction of them receive mental health care. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection
AbstractBackgroundCarotid artery stenting (CAS) with proximal occlusion effectively prevent distal cerebral embolism by flow arrest at internal carotid artery (ICA); however, the method can expose antegrade flow at ICA due to incomplete flow arrest. The aim of this study was to identify predictors of antegrade flow during CAS with proximal protection.MethodsWe retrospectively analyzed clinical and angiographic data among 143 lesions treated with CAS with proximal protection by occluding the common carotid artery (CCA) and external carotid artery (ECA). Flow arrest or antegrade flow at ICA was confirmed by contrast injectio...
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Neurosurgical treatment of gangliogliomas in children and adolescents: long-term follow-up of a single-institution series of 32 patients
ConclusionLow-grade gangliogliomas (GGs) can be surgically treated with good long-term results including seizure and tumor control as well as school and working participation. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Chemical meningitis from a leaking craniopharyngioma: a case report
AbstractRecurrent chemical meningitis from cyclic leakage of cyst content from a craniopharyngioma is a rare phenomenon. Here, we report a case of leaking cystic craniopharyngioma presenting with recurrent episodes of sterile meningitis, depression, and paranoia. The diagnosis after an initial craniotomy and exploration was hypophysitis. Signs and symptoms were not alleviated by puncture and biopsy of the tumour but they disappeared after complete resection with a final histological diagnosis of craniopharyngioma. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Usefulness of venous catheter as an intraluminal stent for end-to-end venous anastomosis
ConclusionsAccidental venous injury can be reconstructed with the present simple technique. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Surgical treatment of a gauzoma with associated obliterative arteriopathy and review of the literature
We report a case of a 50-year-old woman whose 0.5  mm middle cerebral artery (MCA) aneurysm was treated with gauze wrapping at an outside facility. She returned 9 months later with seizures and an inflammatory process in the region of the prior aneurysm. Surgical re-exploration at that time was aborted. Two years later, she presented with a gauzo ma associated with local inflammatory response and severe narrowing of the MCA. A common carotid artery to MCA bypass was performed, followed by surgical removal of the gauze and inflammatory material. Over a 3-month period, she recovered with significant improvement in ...
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Predictive factors of neurological recovery after chronic craniovertebral brainstem compression
AbstractBackgroundNeurologic manifestations of craniovertebral junction (CVJ) disease may generate dramatic brainstem damage, which could evolve to paralysis. In most cases, patients are referred with advanced neurological symptoms such as tetraplegia/paresis. The aim of this study was to identify predictive factors of favorable neurological evolution after non-traumatic brainstem compression.MethodsA prospective study evaluated 143 consecutive patients who had undergone CVJ anterior brainstem decompression. The mean age was 45.1  ± 19.1 years. The study analyzed clinical, surgical, and imagery ch...
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Tumor-treating fields as a fourth treating modality for glioblastoma: a meta-analysis
This study reveals increased median overall survival (weighted mean difference (WMD) 3.29 [95% confidence interval (CI) 2.37, 4.21];p 
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Effect of irrigation on fibrinolytic rtPA therapy in a clot model of intracerebral haemorrhage: a systematic in vitro study
AbstractObjectiveAlthough fibrinolytic therapy is an upcoming treatment for intracerebral haemorrhage (ICH), standard guidelines are lacking, and some clinical issues persist. Here, we used our recently devised clot model of ICH to systematically analyse effects of irrigation and cerebrospinal fluid (CSF) on fibrinolysis.MethodsIn vitro clots of human blood (25  ml) were generated and a catheter irrigation system was applied to deliver fluid/treatment. Clots were weighed before and after treatment and compared to rtPA treatment alone. First various drainage periods (15, 30 and 60 min;n = 3 each) and...
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Middle cranial fossa approach for the repair of superior semicircular canal dehiscence is associated with greater symptom resolution compared to transmastoid approach
ConclusionsThe literature suggests that the MCF approach for the repair of SSCD  is associated with greater symptom resolution when compared to the TM approach. This information could help facilitate patient discussions. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Endoscopic transorbital surgery for spheno-orbital lesions: how I do it
ConclusionThe endoscopic transorbital approach is useful for the treatment of selected spheno-orbital lesions and could represent an interesting option in experienced hands. More studies are needed to fully understand its potentialities and limitations. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Initial misdiagnosis of aneurysmal subarachnoid hemorrhage: associating factors and its prognosis
ConclusionsPatients with initially good HH grade, lower Fisher ’s grade, and visiting non-teaching hospital for initial contact were at risk of being misdiagnosed. Misdiagnosis of aSAH in patients with initial good HH grade did affect clinical outcomes negatively. The rebleeding rate was not significantly different between two groups. However, the mortality r ate due to rebleeding was higher in MisDx group than in non-MisDx group. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Intracranial pressure monitoring in diffuse brain injury —why the developing world needs it more?
AbstractBackgroundUse of ICP monitoring is considered to be part of “standard of care” in management of severe traumatic brain injury, but it is rarely used in developing countries. The authors present a study which evaluates the efficacy and outcomes of ICP monitoring at a high-volume trauma center in India.MethodsData on management and outcomes for 126 patients who were admitted with diffuse traumatic brain injury (GCS 3 –8) were studied prospectively over an 18-month period. These patients were treated by one of the two specific protocols: ICP monitoring-based or non-ICP monitoring-based. The primary o...
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Sigmund Freud —early network theories of the brain
This article aims to shed light on Freud’s seminal, yet oft-overlooked, early work on functional neuroanatomy and his reasons for finally abandoning the conventional neuroscientific “brain-based” reference frame in order to conceptualise the mind from a purely psychological perspective. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Response to “Neck pain and proprioception deficit influence the cervical motion assessed by instantaneous axis of rotation”
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Decompressive craniectomy in traumatic brain injury —the discussion must continue
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Neck pain and proprioception deficit influence the cervical motion assessed by instantaneous axis of rotation
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Is decision-making easier post RESCUE ICP trial?
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Systemic inflammatory response in pediatric central nervous system tumors
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Case report on the spontaneous resolution of a traumatic intracranial acute subdural haematoma: evaluation of the guidelines
We present an 88-year-old female who presents with a large left acute subdural haematoma (ASDH) measuring 18  mm in thickness with midline shift of 10.7 mm. We managed her conservatively based upon good consciousness level and absent neurological deficits. Repeat computed tomography (CT) the following day demonstrated near complete resolution of the ASDH and midline shift regression; a further CT confirm ed resolution. Most patients with large ASDH require surgical evacuation; however, in rare cases, they can resolve spontaneously with extreme rapidity. Conservative management can be a valid option in carefully s...
Source: Acta Neurochirurgica - May 11, 2018 Category: Neurosurgery Source Type: research

Effect of spinal anterior root stimulation and sacral deafferentation on bladder and sexual dysfunction in spinal cord injury
AbstractBackgroundSpinal cord injury (SCI) is a highly devastating injury with a variety of complications; among them are neurogenic bladder, bowel, and sexual dysfunction. We aimed to evaluate the effect of sacral anterior root stimulation with sacral deafferentation (SARS-SDAF) on neurogenic bladder and sexual dysfunction in a large well-defined spinal cord injury cohort.MethodsIn the manner of cross-sectional study, subjects undergone SARS-SDAF between September 1986 and July 2011 answered a questionnaire concerning conditions before and after surgery in the department of Neuro-Urology, Bad Wildungen, Germany.ResultsIn ...
Source: Acta Neurochirurgica - May 10, 2018 Category: Neurosurgery Source Type: research

Ahmed Ammar and Mark Bernstein (eds): Neurosurgical ethics in practice: value-based medicine
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 10, 2018 Category: Neurosurgery Source Type: research

Pocket Atlas of Spine Surgery. 2nd ed. (2018) by Singh K, Vaccaro AR
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - May 9, 2018 Category: Neurosurgery Source Type: research