Is surgery effective for treating hypothalamic hamartoma causing isolated central precocious puberty? A systematic review
AbstractThe aim of this review was to determine the role of surgery in treating hypothalamic hamartoma (HH) causing isolated central precocious puberty (CPP). Literature review was done according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Patients with isolated CPP due to HH, managed with surgical resection, were included. We found 33 studies, reporting 103 patients (76 pedunculated, 27 sessile). Patients were considered “cured” if the symptoms of PP had regressed and the hormone profile had normalized after surgery. Indications for surgery included hamartoma deem...
Source: Neurosurgical Review - February 28, 2021 Category: Neurosurgery Source Type: research

Surgical management of choroid plexus papilloma of the cerebellopontine and cerebellomedullary angle: classification and strategy
In this study, we present 12 patients with CPP arising from the cerebellopontine angle (CPP-CPA) and/or of the cerebellomedullary angle (CPP-CMA) that were treated in our department. Patients who underwent surgery for the treatment for CPP-CPA/CMA from January 2004 to March 2020 were identified by a computer search of their files from the Department of Neurosurgery, T übingen. CPPs were classified according to their location into type 1 (tumor portion only in the CPA,), type 2 (tumor portions only in the CMA), and type 3 (tumor portions both in the CPA and CMA). Patients were evaluated for initial symptoms, previous t...
Source: Neurosurgical Review - February 24, 2021 Category: Neurosurgery Source Type: research

The role of the Liliequist membrane in the third ventriculostomy
The objective of this study was to characterize the LM anatomically from a neuroendoscopic perspective to better understand the impact of anatomical features during LM ostomy and the ETV success rate. Additionally, the ETV success score was tested to predict patient outcome after the intraoperatively difficult opening of LM. Fifty-four patients who underwent ETV were prospectively analyzed with a mean follow-up of 53.1 months (1 –90 months). The ETV technical parameters of difficulty were validated by seven expert neurosurgeons. The pediatric population (44) of this study represents the majority of patients (81.4%). ...
Source: Neurosurgical Review - February 23, 2021 Category: Neurosurgery Source Type: research

Correction to: Endoscopic versus stereotactic biopsies of intracranial lesions involving the ventricles
A correction to this paper has been published:https://doi.org/10.1007/s10143-021-01497-2 (Source: Neurosurgical Review)
Source: Neurosurgical Review - February 23, 2021 Category: Neurosurgery Source Type: research

A systematic review and meta-analysis of factors affecting the outcome of the epidural blood patching in spontaneous intracranial hypotension
AbstractSpontaneous intracranial hypotension (SIH) is an often misdiagnosed condition resulting from non-iatrogenic cerebrospinal fluid (CSF) hypovolemia, typically secondary to spinal CSF leakage. Patients commonly present with posture-related headache, nausea, and vomiting. Following failure of conservative measures, epidural blood patching (EBP) is the most commonly performed intervention for spinal CSF leaks. The authors performed a systematic review and meta-analysis of existing literature to evaluate the role of different factors possibly affecting the efficacy of the EBP procedure. In accordance with the PRISMA guid...
Source: Neurosurgical Review - February 21, 2021 Category: Neurosurgery Source Type: research

An institutional review of hospital resource utilization and patient radiation exposure in shunted idiopathic intracranial hypertension
AbstractPatients with idiopathic intracranial hypertension (IIH) frequently utilize healthcare services and undergo radiological studies to assess refractory headache symptoms despite cerebrospinal fluid diversion. To delineate the clinical utility of different imaging modalities and to estimate cumulative patient radiation exposure in shunted patients with IIH, we retrospectively reviewed 100 randomly selected patients with IIH and a prior cerebrospinal fluid diversion procedure treated at our institution between July 2010 and August 2018. Patients had an average of 16.3 office (SD ± 13.8), 12.4 emergency departmen...
Source: Neurosurgical Review - February 21, 2021 Category: Neurosurgery Source Type: research

Efficacy of Gamma Knife radiosurgery in the management of multiple sclerosis-related trigeminal neuralgia: a systematic review and meta-analysis
AbstractTrigeminal neuralgia (TN) is the most frequent craniofacial pain condition, which commonly affects patients suffering from multiple sclerosis (MS). Stereotactic radiosurgery, especially Gamma Knife radiosurgery (GKRS), represents a safe and effective treatment for TN, and it has been adopted also for MS-TN, with a lower success rate. Therefore, we aimed to analyze the outcome of GKRS for MS-TN. PubMed, Web of Science, and Google Scholar and the reference list of relevant articles were searched for GKRS in MS-TN. Two investigators independently identified the articles, assessed the study quality, and extracted the d...
Source: Neurosurgical Review - February 20, 2021 Category: Neurosurgery Source Type: research

Different criteria for defining “spot sign” in intracerebral hemorrhage show different abilities to predict hematoma expansion and clinical outcomes: a systematic review and meta-analysis
AbstractThe “spot sign” is a well-known radiological marker used for predicting hematoma expansion and clinical outcomes in patients with intracerebral hemorrhage (ICH). We performed a meta-analysis to assess the predictive accuracy of spot sign, depending on the criteria used to identify them.We conducted a systematic review of clinical studies that clearly stated their definition of spot sign and that were indexed in the Cochrane Library, MEDLINE, EMBASE, and the China National Knowledge Infrastructure databases. We collected data on computed tomography (CT) parameters, spot sign diagnostic criteria, hematoma...
Source: Neurosurgical Review - February 19, 2021 Category: Neurosurgery Source Type: research

The impact of preoperative anxiety on patients undergoing brain surgery: a systematic review
AbstractPreoperative anxiety is a common reaction exhibited by up to 80% of patients who are scheduled for surgical procedures and characterized by psychological and physical changes which may affect their perioperative period. Our aim is to report the most up-to-date evidence on preoperative anxiety in brain surgery patients through a systematic analysis of the studies produced in the last decades. We performed a systematic review of literature by searching PubMed, Embase, and Cochrane Library databases. Data were extracted using the Population, Intervention, Comparison, Outcome framework and critically analyzed. PRISMA g...
Source: Neurosurgical Review - February 19, 2021 Category: Neurosurgery Source Type: research

Koos grade IV vestibular schwannomas: considerations on a consecutive series of 60 cases —searching for the balance between preservation of function and maximal tumor removal
AbstractKoos grade IV vestibular schwannomas (VS) (maximum diameter> 3 cm) compress the brainstem and displace the fourth ventricle. Microsurgical resection with attention to the right balance between preservation of function and maximal tumor removal is the treatment of choice. Our series consists of 60 consecutive patients with unilateral VS, operated on from December 2010 to July 2019. All patients underwent microsurgical removal via the retrosigmoid approach. The adherence of VS ’ capsule to the surrounding nervous structures and the excessive tendency of tumor to bleed during debulking, because of a redundant...
Source: Neurosurgical Review - February 18, 2021 Category: Neurosurgery Source Type: research

Clinicopathological characteristics and treatment outcomes of epithelioid glioblastoma
AbstractEpithelioid glioblastoma is a new variant of glioblastoma that has been recently recognized in the 2016 WHO classification of brain tumors. Given the rarity of epithelioid glioblastoma, the clinical characteristics, pathological features, radiological findings, and treatment outcomes are still not well characterized. Therefore, we identified eighty-four epithelioid glioblastoma cases to investigate these characteristics and identify the possible prognostic factors of survival. There were 55 male and 29 female patients with a mean age of 33.6 years. Headache (77.3%) was the most common clinical symptom, and other co...
Source: Neurosurgical Review - February 17, 2021 Category: Neurosurgery Source Type: research

The impact of diabetes mellitus on carotid artery stenting: a meta-analysis
This study may be used to guide carotid artery stenosis patients with diabetes to choose the optimal treatment option. However, due to the limited number of studies and the different technical levels of institutions, the results should be interpreted caution. (Source: Neurosurgical Review)
Source: Neurosurgical Review - February 16, 2021 Category: Neurosurgery Source Type: research

Surgical approaches for resection of third ventricle colloid cysts: meta-analysis
This study demonstrates that microsurgical approaches are associated with a greater extent of resection compared to endoscopic approaches; however, best results are likely achieved based on the surgeon ’s expertise, flexibility, and case review. (Source: Neurosurgical Review)
Source: Neurosurgical Review - February 15, 2021 Category: Neurosurgery Source Type: research

Intraventricular infusion test accuracy in predicting short- and long-term outcome of iNPH patients: a 10-year update of a three-decade experience at a single institution
ConclusionsIEI ≥0.3 predicts outcomes at both short- and long-term, with more than 50% of patients being able to look after themselves after 6 years from treatment. (Source: Neurosurgical Review)
Source: Neurosurgical Review - February 15, 2021 Category: Neurosurgery Source Type: research

Is neutrophil-lymphocyte ratio a useful tool for predicting outcome in subarachnoid hemorrhage? A systematic review
AbstractRuptured intracranial aneurysms, as the leading cause of spontaneous subarachnoid hemorrhage (aSAH), represents an emergency with high morbi-mortality. The comprehension of the underlying pathology that involves inflammatory and immune responses, through the neutrophil-to-lymphocyte ratio (NLR), could help to predict complications such as delayed cerebral ischemia (DCI) or rebleeding and the functional outcome. Systematic review of English-based literature through PubMed and Biblioteca Vitural em Sa úde (BVS) to find papers discussing the use of NLR in the aSAH setting. Area-under-curve (AUC) of receiver ope...
Source: Neurosurgical Review - February 15, 2021 Category: Neurosurgery Source Type: research

Virtual reality-based evaluation of neurovascular conflict for the surgical planning of microvascular decompression in trigeminal neuralgia patients
ConclusionsIn patients with TN caused by NVC, the reconstruction of conventional preoperative MRI scans and the spatial and anatomical presentation in 3D-VR models offers the possibility of increased understanding of the anatomy and even more the underlying pathology, and thus influences operation planning and strategy. (Source: Neurosurgical Review)
Source: Neurosurgical Review - February 13, 2021 Category: Neurosurgery Source Type: research

The brainstem and its neurosurgical history
AbstractBrainstem is one of the most complex structures of the human body, and has the most complex intracranial anatomy, which makes surgery at this level the most difficult. Due to its hidden position, the brainstem became known later by anatomists, and moreover, brainstem surgery cannot be understood without knowing the evolution of ideas in neuroanatomy, neuropathology, and neuroscience. Starting from the first attempts at identifying brainstem anatomy in prehistory and antiquity, the history of brainstem discoveries and approach may be divided into four periods: macroscopic anatomy, microscopic anatomy and neurophysio...
Source: Neurosurgical Review - February 12, 2021 Category: Neurosurgery Source Type: research

The corticotegmental connectivity as an integral component of the descending extrapyramidal pathway: novel and direct structural evidence stemming from focused fiber dissections
This study opts to investigate the thus far ill-defined intra-hemispheric topography, morphology, and connectivity of the extrapyramidal fibers that originate from the frontoparietal cortex and project to the tegmental area and to explore structural correlations to the pyramidal pathway. To this end, twenty normal adult, formalin-fixed cerebral hemispheres were studied through the fiber micro-dissection technique. Stepwise and in-tandem medial to lateral and lateral to medial dissections were carried out in all specimens. The cortical termination of the fibers under investigation was carefully defined, and their entry zone...
Source: Neurosurgical Review - February 10, 2021 Category: Neurosurgery Source Type: research

Endoscopic sublabial transmaxillary approach to the inferior orbit: pearls and pitfalls —A comparative anatomical study
We described the ESTMax step-by-step, underlining its advantages and pitfalls in comparison with EETEth and ELO. Then, we assessed surgical measurements and operability in ESTMax, EETEth, and ELO.ResultsThe ESTMax provided the most favorable operative window (278.9 ± 43.8 mm2; EETEth: 240.8 ± 21.5 mm2,p
Source: Neurosurgical Review - February 10, 2021 Category: Neurosurgery Source Type: research

Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications —a multicenter study
This study did not show a clear survival difference between gross total and subtotal ISCM tumor resection. Patients who underwent gross total resection had a worse functional outcome with respect to patients with only partial resection. Gross total resection with low morbidity must be the surgical target, but when not possible, subtotal resection and adjuvant therapy are a valid therapeutic option. (Source: Neurosurgical Review)
Source: Neurosurgical Review - February 9, 2021 Category: Neurosurgery Source Type: research

Is the pre-operative lateral spread response on facial electromyography a valid diagnostic tool for hemifacial spasm?
In this study, we evaluated the patients who did not exhibit LSR on preoperative EMG but underwent microvascular decompression (MVD) for hemifacial spasm. We searched for patients who underwent MVD for HFS but had an absence of LSR on preoperative EMG between January 2016 and June 2018. Surgical outcomes were evaluated at 1, 3, and 6  months after surgery. Follow-up facial EMG was performed 3 months after surgery. Results were divided into two categories: (1) spasm relief within 24 h of surgery and (2) spasm was observed immediately post-operation. The following parameters were analyzed when comparing betwee...
Source: Neurosurgical Review - February 9, 2021 Category: Neurosurgery Source Type: research

Prevalence of high-riding vertebral arteries and narrow C2 pedicles among Central-European population: a computed tomography-based study
AbstractHigh-riding vertebral artery (HRVA) and narrow C2 pedicles (C2P) pose a great risk of injuring the vessel during C2 pedicle or transarticular screw placement. Recent meta-analysis revealed a paucity of European studies regarding measurements and prevalence of these anatomical variants. Three hundred eighty-three consecutive cervical spine CT scans with 766 potential screw insertion sites were analyzed independently by two trained observers. C2 internal height (C2InH), C2 isthmus height (C2IsH), and C2P width were measured. Kappa statistics for inter- and intraobserver reliability as well as for inter-software agree...
Source: Neurosurgical Review - February 9, 2021 Category: Neurosurgery Source Type: research

Anterior perforated substance region aneurysms: review of a series treated with microsurgical technique
AbstractAneurysms arising from the distal carotid, proximal A1, and proximal M1 that project posteriorly and superiorly toward the anterior perforated substance (APS) are rare. Their open surgical treatment is particularly difficult due to poorly visualized origin of the aneurysm and the abundance of surrounding perforators. We sought to analyze the anatomical and clinical characteristics of APS aneurysms and discuss surgical nuances that can optimize visualization, complete neck clip obliteration, and preservation of adjacent perforators. Thirty-two patients with 36 APS aneurysms were surgically treated between November 2...
Source: Neurosurgical Review - February 4, 2021 Category: Neurosurgery Source Type: research

Mucosal thickening of the maxillary sinus is frequently associated with diffuse glioma patients and correlates with poor survival prognosis of GBM patients: comparative analysis to meningioma patients
This study included 343 patients with newly diagnosed diffuse gliomas and 218 patients with meningioma treated at our institution between 2015 and 2018. As control, 201 patients with headache who did not have an intracranial organic lesion were included. Using three-axis MR images, we evaluated the incidence of MTMS in all patients. Additionally, we investigated the relationship between MTMS and OS. The incidence of MTMS in patients with diffuse glioma was significantly higher than that in the meningioma (p
Source: Neurosurgical Review - February 3, 2021 Category: Neurosurgery Source Type: research

Impact of combined use of intraoperative MRI and awake microsurgical resection on patients with gliomas: a systematic review and meta-analysis
AbstractMicrosurgical resection of primary brain tumors located within or near eloquent areas is challenging. Primary aim is to preserve neurological function, while maximizing the extent of resection (EOR), to optimize long-term neurooncological outcomes and quality of life. Here, we review the combined integration of awake craniotomy and intraoperative MRI (IoMRI) for primary brain tumors, due to their multiple challenges. A systematic review of the literature was performed, in accordance with the Prisma guidelines. Were included 13 series and a total number of 527 patients, who underwent 541 surgeries. We paid particula...
Source: Neurosurgical Review - February 3, 2021 Category: Neurosurgery Source Type: research

Comparison between retrosigmoid and translabyrinthine approaches for large vestibular schwannoma: focus on cerebellar injury and morbidities
This study aimed to compare the surgical outcomes and morbidities of retrosigmoid and translabyrinthine approaches for large vestibular schwannoma (VS), with a focus on cerebellar injury and morbidities. Eighty-six consecutive patients with large VS, with a maximal extrameatal diameter> 3.0 cm, were reviewed between August 2010 and September 2018. The surgical outcomes, operating time, volume change of perioperative cerebellar edema, and inpatient rehabilitation related to cerebellar morbidities were compared between the two approaches. In total, 53 and 33 patients underwent the retrosigmoid and translabyrinthine approa...
Source: Neurosurgical Review - February 1, 2021 Category: Neurosurgery Source Type: research

Technical limitations and pitfalls of diffusion-weighted imaging in intraoperative high-field MRI
This study aims to analyze intraoperatively acquired DWI to identify the main factors for susceptibility, to compare results with postoperative images and to identify technical aspects for improvement of intraoperative DWI.Methods: 100 patients with intraaxial lesions operated in a high-field iMRI were analyzed retrospectively for the quality of intraoperative DWI in comparison to the postoperative scan. General quality of the MR scan, individual diffusion restrictions, artifacts, and their causes were analyzed.Results: Inclusion criteria were met in 78 patients, 124 diffusion restrictions were included in the comparative ...
Source: Neurosurgical Review - February 1, 2021 Category: Neurosurgery Source Type: research

The 100 most-cited articles on vestibular schwannoma: historical perspectives, current limitations, and future research directions
AbstractThere has been a steady increase of vestibular schwannoma (VS) research in the body of literature. To delineate the most impactful works on VS, a bibliometric analysis is warranted. The Thomson Reuters Web of Sciences database was queried to identify all articles on VS published to June 2020. The articles were sorted in descending order of the number of citations. Titles and abstracts of the top 100 most-cited articles were screened to identify the research area, publication year, author, and country of publication. Our query yielded 6477 research publications. The 100 most-cited articles were cited 15804 times. Th...
Source: Neurosurgical Review - February 1, 2021 Category: Neurosurgery Source Type: research

Foramen magnum meningiomas: a systematic review and meta-analysis
AbstractForamen magnum meningiomas (FMMs) account for 1.8 –3.2% of all meningiomas. With this systematic review and meta-analysis, our goal is to detail epidemiology, clinical features, surgical aspects, and outcomes of this rare pathology. Using PRISMA 2015 guidelines, we reviewed case series, mixed series, or retrospective observational cohorts with de scription of surgical technique, patient and lesion characteristics, and pre- and postoperative clinical status. A meta-analysis was performed to search for correlations between meningioma characteristics and rate of gross total resection (GTR). We considered 33 retr...
Source: Neurosurgical Review - January 28, 2021 Category: Neurosurgery Source Type: research

Diffusion-weighted imaging for predicting tumor consistency and extent of resection in patients with pituitary adenoma
This study aimed to investigate the role of diffusion-weighted imaging (DWI) in predicting tumor consistency, extent of surgical resection, and recurrence in pituitary adenoma (PA). We reviewed a prospectively collected database of surgically treated PA between March 2016 and October 2017. Predictors for extent of resection and recurrence/progression were assessed with logistic and Cox regression analysis. Of the 183 patients, the tumor consistency was found soft in 107 (58.5%) patients, intermediate in 41 (22.4%) patients, and hard in 35 (19.1%) patients. The mean of ADC ratio was 0.92 ± 0.22 for hard tumor, 1.03 &...
Source: Neurosurgical Review - January 28, 2021 Category: Neurosurgery Source Type: research

Hyperhomocysteinemia is a risk factor for postoperative ischemia in adult patients with moyamoya disease
AbstractGrowing evidence has suggested that hyperhomocysteinemia (HHcy) is a risk factor for cerebral infarction. However, the effect of HHcy on postoperative cerebral ischemia is still unclear. We aim to investigate the relationship between HHcy and postoperative ischemia of adult patients with moyamoya disease (MMD). A total of 138 adult patients with MMD were prospectively recruited from July 1 to December 31, 2019. After excluding 14 patients accepting conservative therapy, all 124 patients who underwent surgical treatment were enrolled. Patients were grouped according to postoperative ischemia and HHcy presentation, r...
Source: Neurosurgical Review - January 27, 2021 Category: Neurosurgery Source Type: research

Low-dose antiplatelet therapy survey after intracerebral hemorrhage in China: a retrospective hospital-based study
AbstractRestarting of antiplatelet therapy (AT) for patients with a history of intracerebral hemorrhage (ICH) is still a clinical dilemma in China. We aimed to investigate the association between low-dose AT and the long-term clinical outcome in Chinese ICH patients. A total of 312 patients with a history of ICH were retrospectively enrolled and followed. The ischemic vascular events, recurrent ICH, and all-cause death were reviewed retrospectively. We explored the predictors of ischemic vascular events and recurrent ICH from all patients using Cox proportional hazard regression model. One hundred fifty-one (48.4%) patient...
Source: Neurosurgical Review - January 27, 2021 Category: Neurosurgery Source Type: research

Systematic review of brain arteriovenous malformation grading systems evaluating microsurgical treatment recommendation
This study systematically reviews the literature in order to identify and assess the quality of grading systems with regard to microsurgical bAVM treatment. A systematic literature review was performed to provide an overview of all available bAVM grading systems relevant for microsurgical treatment evaluation and to assess the most comprehensive grading system specifically for each subgroup of bAVM (i.e., unruptured, ruptured, and posterior fossa). Screening of 865 papers revealed thirteen grading systems for bAVM microsurgical risk stratification. Among them, two systems were specifically developed for ruptured bAVM and o...
Source: Neurosurgical Review - January 27, 2021 Category: Neurosurgery Source Type: research

Endogenous animal models of intracranial aneurysm development: a review
AbstractThe pathogenesis and natural history of intracranial aneurysm (IA) remains poorly understood. To this end, animal models with induced cerebral vessel lesions mimicking human aneurysms have provided the ability to greatly expand our understanding. In this review, we comprehensively searched the published literature to identify studies that endogenously induced IA formation in animals. Studies that constructed aneurysms (i.e., by surgically creating a sac) were excluded. From the eligible studies, we reported information including the animal species, method for aneurysm induction, aneurysm definitions, evaluation met...
Source: Neurosurgical Review - January 26, 2021 Category: Neurosurgery Source Type: research

Impact of acetylsalicylic acid in patients undergoing cerebral aneurysm surgery – should the neurosurgeon really worry about it?
AbstractThere has been an increase in the use of acetylsalicylic acid (ASA, Aspirin ®) among patients with stroke and heart disease as well as in aging populations as a means of primary prevention. The potentially life-threatening consequences of a postoperative hemorrhagic complication after neurosurgical operative procedures are well known. In the present study, we evaluate the risk of continued ASA use as it relates to postoperative hemorrhage and cardiopulmonary complications in patients undergoing cerebral aneurysm surgery. We retrospectively analyzed 200 consecutive clipping procedures performed between 2008 and ...
Source: Neurosurgical Review - January 25, 2021 Category: Neurosurgery Source Type: research

Effects of post-interventional antiplatelet therapy on angiographic vasospasm, delayed cerebral ischemia, and clinical outcome after aneurysmal subarachnoid hemorrhage: a single-center experience
AbstractPlatelet activation has been postulated to be involved in the pathogenesis of delayed cerebral ischemia (DCI) and cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to investigate potentially beneficial effects of antiplatelet therapy (APT) on angiographic CVS, DCI-related infarction and functional outcome in endovascularly treated aSAH patients. Retrospective single-center analysis of aSAH patients treated by endovascular aneurysm obliteration. Based on the post-interventional medical regime, patients were assigned to either an APT group or a control group not recei...
Source: Neurosurgical Review - January 25, 2021 Category: Neurosurgery Source Type: research

Clinical management and outcome of adult patients with extracorporeal life support device –associated intracerebral hemorrhage—a neurocritical perspective and grading
AbstractIntracerebral hemorrhage (ICH) is a devastating complication in patients treated with extracorporeal membrane oxygenation (ECMO) due to respiratory or cardiac issues. Neurosurgical evaluation and management of such cases has only insufficiently been studied. We conducted a retrospective, cohort study of adult patients treated with ECMO between January 2007 and January 2017 in a tertiary healthcare center. Demographics, clinical data, coagulation status, ICH characteristics, and treatment modalities were analyzed. The primary outcome parameter was defined as mortality caused by ICH during ECMO. 525 patients with ECM...
Source: Neurosurgical Review - January 23, 2021 Category: Neurosurgery Source Type: research

Evaluation of the ventriculocholecystic shunt —an overview of present practice in adult and pediatric hydrocephalus
AbstractIn the context of hydrocephalus, there are a multitude of therapeutic options that can be explored in order to improve patient outcomes. Although the peritoneum is the current elected clinical solution, various receptacles have been utilized when experiencing contraindications. Along with the ventriculoatrial or ventriculopleural, the ventriculocholecystic shunt was also described as an alternative. In order to make a decision on a place for drainage, the surgeon must be knowledgeable on details from modern literature. The main target of this review was to summarize the currently available information on this topic...
Source: Neurosurgical Review - January 22, 2021 Category: Neurosurgery Source Type: research

Transorbital endoscopic approaches to the skull base: a systematic literature review and anatomical description
In conclusion, transorbital endoscopic approaches are promising and appear as feasible techniques for the surgical treatment of skull base lesions. Surgical anatomy of transorbital endoscopic approaches can be mastered through knowledge of a number of anatomical landmarks. Based on data available in the literature, transorbital endoscopic approaches represent an important complementary that should be included in the armamentarium of a skull base team. (Source: Neurosurgical Review)
Source: Neurosurgical Review - January 22, 2021 Category: Neurosurgery Source Type: research

Outcome prediction in aneurysmal subarachnoid hemorrhage: a comparison of machine learning methods and established clinico-radiological scores
In this study, we aimed to examine whether a machine learning (ML) approach using variables available on admission may improve outcome prediction in aSAH compared to established scoring systems. Combined clinical and radiographic features as well as standard scores (Hunt& Hess, WFNS, BNI, Fisher, and VASOGRADE) available on patient admission were analyzed using a consecutive single-center database of patients that presented with aSAH (n = 388). Different ML models (seven algorithms including three types of traditional generalized linear models, as well as a tree bosting algorithm, a support vector machine classifier (S...
Source: Neurosurgical Review - January 20, 2021 Category: Neurosurgery Source Type: research

Good clinical outcomes in nonunion cases after facet fusion with a percutaneous pedicle screw system for degenerative lumbar spondylolisthesis
AbstractThere are many satisfactory long-term outcomes after posterolateral fusion (PLF) for degenerative lumbar spondylolisthesis (DLS); nonunion cases have also achieved good clinical outcomes. Facet fusion (FF), a minimally invasive evolution of PLF, also resulted in good clinical outcomes. We aimed to assess the course of nonunion cases after FF and determine whether the  nonunion cases achieved good clinical outcomes. We retrospectively reviewed the records of 136 patients who underwent FF for DLS. Range of motion (ROM) at the fused level was measured using a flexion-extension lateral radiograph preoperatively an...
Source: Neurosurgical Review - January 20, 2021 Category: Neurosurgery Source Type: research

Interhemispheric transcallosal approach: going further based on the vascular anatomy
AbstractPreserving cortical frontal bridging veins draining into the superior sagittal sinus is a factor of good neurological outcome in anterior interhemispheric transcallosal approaches, classically performed to reach intraventricular tumors. Challenging the idea that veins are utterly variable, we propose a statistical analysis of 100 selective cerebral angiographies to determine where to place the craniotomy in order to expose the most probable vein-free area. The mean distance to the first pre-coronal vein was 6.66 cm ( ± 1.73, 1.80 to 13.00) and to the first post-coronal vein 0.94 cm (± 0.92, 0 to 3.00) (p
Source: Neurosurgical Review - January 19, 2021 Category: Neurosurgery Source Type: research

Clinical features of ischemic complications after unruptured middle cerebral artery aneurysm clipping: patients and radiologically related factors
AbstractPostoperative ischemic complication results in neurological sequelae and longer hospitalization after unruptured middle cerebral artery (MCA) aneurysm clipping surgery. We evaluated the radiological and patient-related factors associated with ischemic complications after unruptured MCA aneurysm clipping surgery. Patient demographics, radiological findings, and intraoperative factors were compared between patients with and without postoperative ischemic complications. The clinical courses and outcomes of postoperative ischemic complications were compared according to the types of ischemic complication. Forty-two out...
Source: Neurosurgical Review - January 19, 2021 Category: Neurosurgery Source Type: research

High-frequency spinal cord stimulation in failed back surgery syndrome patients with predominant low back pain —single-center experience
AbstractTreatment of patients with failed back surgery syndrome (FBSS) with predominant low back pain (LBP) remains challenging. High-frequency spinal cord stimulation (HF10 SCS) is believed to achieve significant pain reduction. We aimed to evaluate the real-life efficacy of HF-10 SCS in a tertiary spine center. A prospective observational study of all patients with FBSS and predominant LBP who underwent HF-10 SCS surgery was performed between 2016 and 2018. Patients>  18 years with Visual Analogue Scale (VAS) scores of ≥ 5 for LBP and pain duration>  6 months under stable medicatio...
Source: Neurosurgical Review - January 17, 2021 Category: Neurosurgery Source Type: research

Routine postoperative computed tomography scan after craniotomy: systematic review and evidence-based recommendations
AbstractOver the last few years, the role of early postoperative computed tomography (EPOCT) after cranial surgery has been repeatedly questioned, but there is yet no consensus on the practice. We conducted a systematic review to address the usefulness of EPOCT in association with neurological examination after elective craniotomies compared to the neurological examination alone. Studies were eligible if they provided information about the number of patients scanned, how many were asymptomatic or presented neurological deterioration before the scan and how many of each of those groups had their management changed due to im...
Source: Neurosurgical Review - January 15, 2021 Category: Neurosurgery Source Type: research

Factors affecting long-lasting pain relief after Gamma Knife radiosurgery for trigeminal neuralgia: a single institutional analysis and literature review
AbstractGamma Knife radiosurgery (GKRS) is a well-established safe and effective treatment for trigeminal neuralgia (TN) with high initial success rate (80 –90%). Why the pain relief is progressively decreased with time is a matter of considerable debate. To investigate factors related to long-lasting pain relief, the authors conducted a retrospective analysis focusing on anatomical and radiosurgical related parameters, chosen according to literature review. One hundred and twelve patients with classical trigeminal neuralgia and follow-up longer than 12 months were selected from our institutional consecutive series o...
Source: Neurosurgical Review - January 12, 2021 Category: Neurosurgery Source Type: research

Posterolateral epidural supra-C2-root approach (PESCA) for biopsy of lesions of the odontoid process in same sitting after occipitocervical fixation and decompression —perioperative management and how to avoid vertebral artery injury
This study aims to describe the posterolateral epidural supra-C2-root approach (PESCA), which might be a good alternative to the transoral, anterolateral, and other posterolateral approaches for biopsy of lesions of the odontoid process (OP). The preoperative planning of PESCA included computerized tomography (CT), CT-angiography, and three-dimensional reconstruction (if possible, even with three-dimensional print) to analyze the angle of the trajectory and the anatomy of the vertebral artery (VA). For PESCA, the patient is positioned under general anesthesia in prone position. In case of an osteolytic lesion with fracture...
Source: Neurosurgical Review - January 11, 2021 Category: Neurosurgery Source Type: research

Postoperative stroke and neurological outcomes in the early phase after revascularization surgeries for moyamoya disease: an age-stratified comparative analysis
In this study, an age-stratified comparative analysis was performed to clarify this issue. We reviewed 105 MMD patients who underwent 179 revascularization surgeries. The demographic characteristics were collected in four age groups (≤ 5 and 6–17 years for pediatric patients and 18– 49 and ≥ 50 years for adults). Additionally, we assessed the incidence of subsequent stroke and deterioration of modified Rankin Scale (mRS) score. Then, we evaluated predictors of postoperative stroke and mRS deterioration using logistic regression. The mean patient age was 26.2 ±&...
Source: Neurosurgical Review - January 8, 2021 Category: Neurosurgery Source Type: research

Papillary meningioma of the central nervous system: a SEER database analysis
AbstractPapillary meningioma (PM) is a rare central nervous system tumor. We aimed to analyze the characteristics and outcomes of patients with PM (WHO grade III) and identify risk factors that influence survival using the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics, tumor features, and outcomes of 108 PM patients included in the SEER database between 1990 and 2016 were retrieved. Risk factors related to prognosis of PM were assessed by Kaplan –Meier curves and the Cox proportional hazards model. All 108 patients, including 65 males and 43 females (1.5:1), with a median age o...
Source: Neurosurgical Review - January 8, 2021 Category: Neurosurgery Source Type: research

Anesthetic management of unruptured intracranial aneurysms : a qualitative systematic review
AbstractIntracranial aneurysms (IA) occur in 3 –5% of the general population and may require surgical or endovascular obliteration if the patient is symptomatic or has an increased risk of rupture. These procedures carry an inherent risk of neurological complications, and the outcome can be influenced by the physiological and pharmacological e ffects of the administered anesthetics. Despite the critical role of anesthetic agents, however, there are no current studies to systematically assess the intraoperative anesthetic risks, benefits, and outcome effects in this population. In this systematic review of the literat...
Source: Neurosurgical Review - January 7, 2021 Category: Neurosurgery Source Type: research