Anatomical relationship between the foramen ovale and the lateral plate of the pterygoid process: application to percutaneous treatments of trigeminal neuralgia
AbstractOur aim was to clarify the variations in the positional relationship between the base of the lateral plate of the pterygoid process and the foramen ovale (FO), which block inserted needles during percutaneous procedures to the FO usually used for the treatment of trigeminal neuralgia. Ninety skulls were examined. The horizontal relationship between the FO and the posterior border of the base of the lateral plate of the pterygoid process was observed in an inferior view of the skull base. Skulls that showed injury to either the FO or the lateral plate of the pterygoid process on either side were excluded. One hundre...
Source: Neurosurgical Review - January 15, 2022 Category: Neurosurgery Source Type: research

Clinical outcomes of first- and second-generation hydrogel coils compared with bare platinum coils: a systematic literature review
AbstractEndovascular coiling has revolutionized intracranial aneurysm treatment; however, recurrence continues to represent a major limitation. The hydrogel coil was developed to increase packing density and improve neck healing and therefore decrease recurrence rates. In this paper, we review treatment outcomes of first- (1HCs) and second-generation (2HCs) hydrogel coils and compare them to those of bare platinum coils (BPC). A query of multiple databases was performed. Articles with at least 10 aneurysms treated with either 1HC or 2HC were selected for analysis. Collected data included aneurysm size, rupture status, init...
Source: Neurosurgical Review - January 15, 2022 Category: Neurosurgery Source Type: research

Neuromonitoring of the language pathways using cortico-cortical evoked potentials: a systematic review and meta-analysis
AbstractCortico-cortical evoked potentials (CCEPs) are a surge in activity of one cortical zone caused by stimulation of another cortical zone. Recording of CCEP may be a useful method of intraoperative monitoring of the brain pathways, particularly of the language-related tracts. We aimed to conduct a systematic review and meta-analysis, dedicated to the clinical question: Does the CCEP recording effectively predict the postoperative speech deficits in neurosurgical patients? We conducted language-restricted PubMed, Google Scholar, Scopus, and Cochrane database search for eligible studies of CCEP published until March 202...
Source: Neurosurgical Review - January 15, 2022 Category: Neurosurgery Source Type: research

Assessing the reliability of zygomatic bone landmarks as guides to reach the inferior orbital fissure in orbitozygomatic osteotomy: anatomical study of 83 human skulls
AbstractTo perform an adequate orbitozygomatic craniotomy, it is very important that the bone cut which passes through the body of the zygoma reaches the inferior orbital fissure (IOF). To reach the IOF, two surface landmarks on the body of the zygoma are described: a point located directly superior to the malar eminence and the zygomaticofacial foramen. The article explores the reliability of these landmarks and three other alternative points to reach the IOF. Eighty-three adult skulls were used in this study. The IOF dimensions and the relationship with the malar eminence, the point superior to the malar eminence, the zy...
Source: Neurosurgical Review - January 13, 2022 Category: Neurosurgery Source Type: research

Evaluation of multimodal intraoperative neurophysiologic monitoring during supratentorial aneurysm surgery: a comparative study
The objective of this study is to determine the role of multimodal intraoperative neurophysiologic monitoring (IONM) in the overall outcome of intracranial aneurysms surgery, and the risk factors associated with ischemic complications. We grouped 268 ruptured and unruptured intracranial aneurysms surgically treated at our institution into 2 cohorts, based on the use of IONM (180; 67.16%) or non-use of IONM (88; 32.84%). The IONM technique used was multimodal: electroencephalogram (EEG), somatosensory evoked potentials (SSEPs), transcranial (TES), and direct cortical (DCS) stimulation motor evoked potentials (MEPs). There w...
Source: Neurosurgical Review - January 13, 2022 Category: Neurosurgery Source Type: research

Can C1 lateral mass and C3 pedicle screw fixation be used as an option for atlantoaxial reduction and stabilization in Klippel-Feil patients? A study of its morphological feasibility, technical nuances, and clinical efficiency
AbstractIn Klippel-Feil patients with atlantoaxial dislocation, narrow C2 pedicles are often encountered preventing pedicle screw placement. Alternative techniques, including translaminar screws, pars screws, and inferior process screws could not achieve 3-column rigid fixation, and have shown inferior biomechanical stability. The present study aimed to evaluate the feasibility, safety, and efficacy of C3 pedicle screws (C3PSs) as an option for atlantoaxial stabilization in Klippel-Feil patients, and to introduce a freehand technique, the “medial sliding technique,” for safe and accurate C3PS insertion. Thirty-...
Source: Neurosurgical Review - January 13, 2022 Category: Neurosurgery Source Type: research

Deep brain stimulation for chorea-acanthocytosis: a systematic review
AbstractDeep brain stimulation (DBS) is a reversible treatment for chorea-acanthocytosis (ChAc). Its safety and efficacy remain elusive due to the low prevalence of ChAc. We aimed to investigate the safety and efficacy of DBS for ChAc by systematically reviewing literature through PubMed and EMBASE. Inclusion criteria were reports on the efficacy or safety of DBS for ChAc and English language articles, and exclusion criteria were other movement disorders, non-human subjects, and studies without original data. Most studies were published as case reports, and we therefore pooled these cases in one cohort. Twenty studies with...
Source: Neurosurgical Review - January 12, 2022 Category: Neurosurgery Source Type: research

Perioperative myocardial injury after elective neurosurgery: incidence, risk factors, and effects on mortality
AbstractPerioperative myocardial injury is an important reason of mortality and morbidity after neurosurgery. It usually is missed due to its asymptomatic character. In the present study, we investigated myocardial injury after noncardiac surgery (MINS) incidence, the risk factor for MINS, and association of MINS with 30-day mortality in neurosurgery patients. Patients with cardiac risk who underwent elective neurosurgery were enrolled to present prospective cohort study. The patients ’ demographics, comorbidities, medications used, medical history, and type of operation were recorded. The high-sensitivity cardiac tr...
Source: Neurosurgical Review - January 11, 2022 Category: Neurosurgery Source Type: research

Cerebrospinal fluid predictors of shunt-dependent hydrocephalus after hemorrhagic stroke: a systematic review and meta-analysis
AbstractHydrocephalus is a common complication of hemorrhagic stroke and has been reported to contribute to poor neurological outcomes. Herein, we aimed to investigate the validity of cerebrospinal fluid (CSF) data in predicting shunt-dependent hydrocephalus (SDHC) in patients with hemorrhagic stroke. PubMed, CENTRAL, and Embase databases were searched for relevant studies published through July 31, 2021. The 16 studies with 1505 patient included those in which CSF data predicted risk for SDHC and reports on CSF parameters in patients in whom SDHC or hydrocephalus that was not shunt-dependent developed following hemorrhagi...
Source: Neurosurgical Review - January 11, 2022 Category: Neurosurgery Source Type: research

Long-term surgical oncological and functional outcome of large spetroclival and cerebellopontine angle epidermoid cysts: a multicenter study
AbstractCranial nerve (CN) disorders are the foremost symptoms in cerebellopontine angle (CPA) and petroclival area (PCA)  epidermoid cysts (EC).The aim of this work was to  assess the long-term surgical results on CN function and tumor control in these patients EC. We performed a retrospective cohort study about 56 consecutive patients operated on for a CPA or PCA EC between January 2001 and July 2019 in six parti cipating French cranial base referral centers. Sixteen patients (29%) presented a PCA EC and 40 a CPA EC (71%). The median clinical and radiological follow-up was 46 months (range 0–409...
Source: Neurosurgical Review - January 10, 2022 Category: Neurosurgery Source Type: research

Predictors of visual function after resection of skull base meningiomas with extradural anterior clinoidectomy
AbstractSkull base meningiomas threatening the optic nerves may require performing an extradural anterior clinoidectomy (EAC) to optimally decompress the optic pathways. The present study evaluated the functional results and morbidity after surgical resection of skull base meningiomas including EAC, focusing on visual acuity (VA) and oculomotricity. Eighty-seven consecutive patients harboring skull base meningiomas who underwent surgical resection that included an EAC between 2003 and 2020 were retrospectively analyzed (86% women, median age 53  years). Decreased visual acuity (DVA) was graded as functional (VA&thinsp...
Source: Neurosurgical Review - January 10, 2022 Category: Neurosurgery Source Type: research

Microsurgical anatomy and surgical exposure of the cerebellar peduncles
AbstractA better understanding of the surgical anatomy of the cerebellar peduncles in different surgical approaches and their relationship with other neural structures are delineated through cadaveric dissections. We aimed to revisit the surgical anatomy of the cerebellar peduncles to describe their courses along the brain stem and the cerebellum and revise their segmental classification in surgical areas exposed through different approaches. Stepwise fiber microdissection was performed along the cerebellar tentorial and suboccipital surfaces. Multiple surgical approaches in each of the cerebellar peduncles were compared i...
Source: Neurosurgical Review - January 8, 2022 Category: Neurosurgery Source Type: research

Hakuba ’s triangle: a cadaveric study detailing its anatomy and neurovascular contents with vascular and skull base implications
This study provides cadaveric measurements of the borders of Hakuba’s triangle and describes its neurovascular contents in order to enrich the available litera ture. The anatomical borders of the Hakuba’s triangle (lateral, medial, and posterior borders) were defined based on Hakuba’s description and identified. Then the triangle was dissected to reveal its morphology and relationship with adjacent neurovascular structures in Embalmed Caucasian cadaver ic specimens. The oculomotor nerve occupied roughly one-third of the area of the triangle and the nerve was more or less parallel to its medial border. The...
Source: Neurosurgical Review - January 7, 2022 Category: Neurosurgery Source Type: research

Three-dimensional printing-assisted precision microcatheter shaping in intracranial aneurysm coiling
AbstractOptimal microcatheter shaping is essential for successful endovascular coiling procedures which is sometimes challenging. Our aim was not only to introduce a new shaping method using three-dimensional (3D) printed vessel models but also to prove its feasibility, efficiency and superiority. This was a retrospective cohort study. From September 2019 to March 2021, 32 paraclinoid aneurysms managed with endovascular coiling were retrospectively included and identified. Sixteen aneurysms were coiled using 3D microcatheter shaping method (3D shaping group), and traditional manual shaping method using shaping mandrels was...
Source: Neurosurgical Review - January 6, 2022 Category: Neurosurgery Source Type: research

Complete seizure-free rates following interventional treatment of intracranial arteriovenous malformations: a systematic review and meta-analysis
AbstractSeizures are common presenting symptoms of intracranial arteriovenous malformations (AVMs). This systematic review and meta-analysis aims to assess the current evidence regarding complete seizure freedom rates following surgical resection, stereotactic radiosurgery (SRS), and/or endovascular embolization of intracranial AVMs. A systematic review of PubMed, Ovid MEDLINE, and Ovid EMBASE was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included manuscripts were methodically scrutinized for quality, spontaneous AVM-associated or hemorrhage-associated seizures, ...
Source: Neurosurgical Review - January 6, 2022 Category: Neurosurgery Source Type: research

Surgical management and clinical outcomes of cerebellar liponeurocytomas —a report of seven cases and a pooled analysis of individual patient data
AbstractCerebellar liponeurocytomas (CLPNs) are very rare, with very few studies on this disease. Their treatment protocol also remains unclear. To better understand the disease, we reviewed the clinical features and outcomes, and proposed a treatment protocol based on previously reported cases as well as cases from our institute. The clinical data were obtained from seven patients with pathologically confirmed CLPNs, who underwent surgical treatment at our institute between November 2011 and June 2021. We also reviewed the relevant literature and 75 patients with CLPNs were identified between September 1993 and June 2021....
Source: Neurosurgical Review - January 4, 2022 Category: Neurosurgery Source Type: research

Two-stage endoscopic assisted approach for large pineal region and falcotentorial meningioma: first stage paramedian supracerebellar infratentorial approach, second stage interhemispheric occipital transtentorial approach: surgical cases and anatomical study
AbstractResection of complex falcotentorial meningiomas, growing along the pineal region (PR), and posterior incisural space (PIS) represents a neurosurgical challenge. Here, we present our strategy for effective resection of large falcotentorial meningiomas applying a paramedian supracerebellar infratentorial and interhemispheric occipital transtentorial approach in staged surgeries. We further systematically compared the effectiveness of midline (MSIA) and paramedian (PSIA) supracerebellar infratentorial, as well as interhemispheric occipital transtentorial approaches (IOTA) to operate along the PR and PIS in 8 cadaveric...
Source: Neurosurgical Review - January 4, 2022 Category: Neurosurgery Source Type: research

Possible donor nerves for axillary nerve reconstruction in dual neurotization for restoring shoulder abduction in brachial plexus injuries: a systematic review and meta-analysis
AbstractRestoring shoulder abduction is one of the main priorities in the surgical treatment of brachial plexus injuries. Double nerve transfer to the axillary nerve and suprascapular nerve is widely used and considered the best option. The most common donor nerve for the suprascapular nerve is the spinal accessory nerve. However, donor nerves for axillary nerve reconstructions vary and it is still unclear which donor nerve has the best outcome. The aim of this study was to perform a systematic review on reconstructions of suprascapular and axillary nerves and to perform a meta-analysis investigating the outcomes of differ...
Source: Neurosurgical Review - January 3, 2022 Category: Neurosurgery Source Type: research

A novel anatomo-physiologic high-grade spondylolisthesis model to evaluate L5 nerve stretch injury after spondylolisthesis reduction
AbstractL5 nerve palsy is a well-known complication following reduction of high-grade spondylolisthesis. While several mechanisms for its occurrence have been proposed, the hypothesis of L5 nerve root strain or displacement secondary to mechanical reduction remains poorly studied. The aim of this cadaveric study is to determine changes in morphologic parameters of the L5 nerve root during simulated intraoperative reduction of high-grade spondylolisthesis. A standard posterior approach to the lumbosacral junction was performed in eight fresh-frozen cadavers with lumbosacral or lumbopelvic screw fixation. Wide decompressions...
Source: Neurosurgical Review - December 29, 2021 Category: Neurosurgery Source Type: research

Stimulated Raman histology in the neurosurgical workflow of a major European neurosurgical center — part A
AbstractHistopathological diagnosis is the current standard for the classification of brain and spine tumors. Raman spectroscopy has been reported to allow fast and easy intraoperative tissue analysis. Here, we report data on the intraoperative implementation of a stimulated Raman histology (SRH) as an innovative strategy offering intraoperative near real-time histopathological analysis. A total of 429 SRH images from 108 patients were generated and analyzed by using a Raman imaging system (Invenio Imaging Inc.). We aimed at establishing a dedicated workflow for SRH serving as an intraoperative diagnostic, research, and qu...
Source: Neurosurgical Review - December 16, 2021 Category: Neurosurgery Source Type: research

Neuropathological interpretation of stimulated Raman histology images of brain and spine tumors: part B
AbstractIntraoperative histopathological examinations are routinely performed to provide neurosurgeons with information about the entity of tumor tissue. Here, we quantified the neuropathological interpretability of stimulated Raman histology (SRH) acquired using a Raman laser imaging system in a routine clinical setting without any specialized training or prior experience. Stimulated Raman scattering microscopy was performed on 117 samples of pathological tissue from 73 cases of brain and spine tumor surgeries. A board-certified neuropathologist — novice in the interpretation of SRH — assessed image quality by...
Source: Neurosurgical Review - December 10, 2021 Category: Neurosurgery Source Type: research

Clipping versus coiling for aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of prospective studies
AbstractNeurosurgical clipping and endovascular coiling are both standard therapies to prevent rebleeding after aneurysmal subarachnoid hemorrhage (aSAH). However, controversy still exists about which is the optimal treatment. This meta-analysis aims to assess the effectiveness and safety of two treatments with high-quality evidence. Web of Science, Cochrane Library, EMBASE, Pubmed, Sinomed, China National Knowledge Infrastructure, and Wanfang Data databases were systematically searched on August 5, 2021. Randomized controlled trials (RCTs) and prospective cohort studies that evaluated the effectiveness and safety of clipp...
Source: Neurosurgical Review - December 6, 2021 Category: Neurosurgery Source Type: research

Surgical revascularization vs. conservative treatment for adult hemorrhagic moyamoya disease: analysis of rebleeding in 322 consecutive patients
This study mainly aims at the comparison of treatment effect between surgical revascularization and conservative treatment of adult HMD patients. We retrospectively enrolled 322 adult HMD patients, including 133 in revascularization group and 189 in conservative group. The revascularization group included patients who underwent combined (n = 97) or indirect revascularization alone (n = 36). Ninety-two and forty-one patients underwent unilateral and bilateral revascularization respectively. The modified Rankin scale (mRS) was used to assess the functional status. The comparison was made based on ...
Source: Neurosurgical Review - December 3, 2021 Category: Neurosurgery Source Type: research

Characterization of tumor remnants in intraoperative MRI-assisted microscopic and endoscopic transsphenoidal resection of less invasive pituitary adenomas
ConclusionTumor volume, recurrence, and microscopic technique were identified as independent predictors for additional resection in patients with Knosp 0 –2 adenomas. iMRI might increase the extent of resection (EOR) safely even after the endoscopic visualization of the sella with very low risk for false-positive findings. Remnants of tumors hidden within the diaphragmic folds, intrathecally, or behind the infiltrated wall of cavernous sinus not re cognized on preoperative MRI were the most common findings in iMRI. (Source: Neurosurgical Review)
Source: Neurosurgical Review - December 2, 2021 Category: Neurosurgery Source Type: research

Correction to: Post ‑traumatic intracranial pseudo‑aneurysms of posterior circulation: a comprehensive review of an under‑diagnosed and rare entity
(Source: Neurosurgical Review)
Source: Neurosurgical Review - December 2, 2021 Category: Neurosurgery Source Type: research

Correction to: Assessment of the efficacy of teriparatide treatment for osteoporosis on lumbar fusion surgery outcomes: a systematic review and meta-analysis
(Source: Neurosurgical Review)
Source: Neurosurgical Review - November 13, 2021 Category: Neurosurgery Source Type: research

Interplay between vascular hemodynamics and the glymphatic system in the pathogenesis of idiopathic normal pressure hydrocephalus, exploring novel neuroimaging diagnostics
AbstractAs the aging population continues to grow, so will the incidence of age-related conditions, including idiopathic normal pressure hydrocephalus (iNPH). The pathogenesis of iNPH remains elusive, and this is due in part to the poor characterization of cerebral spinal fluid (CSF) dynamics within the brain. Advancements in technology and imaging techniques have enabled new breakthroughs in understanding CSF physiology, and therefore iNPH pathogenesis. This includes understanding the hemodynamic and microvascular components involved in CSF influx and flow. Namely, the glymphatic system appears to be the great mediator, f...
Source: Neurosurgical Review - November 13, 2021 Category: Neurosurgery Source Type: research

Retraction Note to: Correlation of hydromyelia with subarachnoid hemorrhage –related hydrocephalus: an experimental study
(Source: Neurosurgical Review)
Source: Neurosurgical Review - November 13, 2021 Category: Neurosurgery Source Type: research

The relationship between the apparent diffusion coefficient and the Ki-67 proliferation index in intracranial solitary fibrous tumor/hemangiopericytoma
This study evaluated the value of the apparent diffusion coefficient (ADC) in distinguishing grade II and III intracranial solitary fibrous tumors/hemangiopericytomas and explored the correlation between ADC and Ki-67. The preoperative MRIs of 37 patients treated for solitary fibrous tumor/hemangiopericytoma (grade II,n = 15 and grade III,n = 22) in our hospital from 2011 to October 2020 were retrospectively analyzed. We compared the difference between the minimum, average, maximum, and relative ADCs based on tumor grade and examined the correlation between ADC and Ki-67. Receiver operating char...
Source: Neurosurgical Review - November 11, 2021 Category: Neurosurgery Source Type: research

Intracranial aneurysm wall (in)stability –current state of knowledge and clinical perspectives
AbstractIntracranial aneurysm (IA), a local outpouching of cerebral arteries, is present in 3 to 5% of the population. Once formed, an IA can remain stable, grow, or rupture. Determining the evolution of IAs is almost impossible. Rupture of an IA leads to subarachnoid hemorrhage and affects mostly young people with heavy consequences in terms of death, disabilities, and socioeconomic burden. Even if the large majority of IAs will never rupture, it is critical to determine which IA might be at risk of rupture. IA (in)stability is dependent on the composition of its wall and on its ability to repair. The biology of the IA wa...
Source: Neurosurgical Review - November 6, 2021 Category: Neurosurgery Source Type: research

Letter to the editor: “Microsurgical suturing assessment scores: a systematic review”
(Source: Neurosurgical Review)
Source: Neurosurgical Review - November 5, 2021 Category: Neurosurgery Source Type: research

Topical hemostatic agents in neurosurgery, a comprehensive review: 15  years update
AbstractHemostasis in neurosurgery is of utmost importance. Bleeding management is one of the crucial steps of each neurosurgical procedure. Several strategies, namely thermal, mechanical, electric, and chemical, have been advocated to face blood loss within the surgical field. Over time, countless hemostatic agents and devices have been proposed. Furthermore, the ever-growing recent technological innovation has made available several novel and interesting tools. Pursuant to their impact on surgical practice, we perceived the imperative to update our previous disclosure paper. Therefore, we reviewed the literature and anal...
Source: Neurosurgical Review - November 4, 2021 Category: Neurosurgery Source Type: research

Advantages of petrosectomy for superficial temporal artery to superior cerebellar artery bypass based on three-dimensional distance measurements using cadaver heads
The objective of this study is to establish evidence for selecting the approach by using cadaver heads to measure the three-dimensional distances that represent the operative field size for STA –SCA bypass. Ten sides of 10 cadaver heads were used to perform the four approaches: StA, ApA with and without zygomatic arch osteotomy (ApA-ZO− and ApA-ZO+), and CpA. For each approach, the major-axis length and the minor-axis length at the anastomosis site (La-A and Li-A), the major-axis length and the minor-axis length at the brain surface (La-B and Li-B), the depth from the brain surface to the anastomosis site (Dp),...
Source: Neurosurgical Review - November 4, 2021 Category: Neurosurgery Source Type: research

Challenging direct bypass surgery for very young children with moyamoya disease: technical notes
AbstractCerebral revascularization for moyamoya disease (MMD) is an effective treatment for improving cerebral ischaemia and preventing rebleeding. Although direct bypass surgery is commonly performed on older children and adults, it is challenging in very young children due to the high difficulty level of the procedure. The subjects were MMD patients under 3  years of age on whom surgery was performed by a single surgeon (Y.A.). Preoperative clinical findings, information related to direct bypass surgery, bypass patency, and the incidence of postoperative stroke were investigated. Combined revascularization, includin...
Source: Neurosurgical Review - October 31, 2021 Category: Neurosurgery Source Type: research

Computer vision coaching microsurgical laboratory training: PRIME (Proficiency Index in Microsurgical Education) proof of concept
AbstractComputer vision (CV) feedback could be aimed as a constant tutor to guide ones proficiency during microsurgical practice in controlled environments. Five neurosurgeons with different levels of microsurgical expertise performed simulated vessel dissection and micro-suture in an ex vivo model for posterior computer analysis of recorded videos. A computer program called PRIME (Proficiency Index of Microsurgical Education) used in this research recognized color-labeled surgical instruments, from downloading videos into a platform, with a range of motion greater than 3  mm, for objective evaluation of number of rig...
Source: Neurosurgical Review - October 31, 2021 Category: Neurosurgery Source Type: research

Systemic immune-inflammation index predicts the outcome after aneurysmal subarachnoid hemorrhage
AbstractSystemic inflammatory response is closely related to the pathogenesis and prognosis in critical patients. Recently, systemic immune-inflammation index (SII), an indicator of systemic inflammatory response, was proved to predict the outcome in cancerous and non-cancerous diseases. The aim of this study is to investigate the association between SII on admission and 6-month outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). The clinical data and prognosis of 76 patients with aSAH were analyzed. The 6-month outcome was assessed by the modified Rankin scale(mRS). The unfavorable outcome was defined as m...
Source: Neurosurgical Review - October 31, 2021 Category: Neurosurgery Source Type: research

The role of systemic inflammatory cells in meningiomas
AbstractThe aim of this review is to describe the inflammatory systemic cell infiltrate and its role in pathophysiology and prognostic implications of meningiomas. Articles from PubMed describing inflammation and immune cells in meningioma were systematically selected and reviewed. Infiltrating inflammatory cells are common in meningiomas and correlate with tumor behavior and peritumoral edema. The immune cell infiltrate mainly comprised macrophages, CD4  + T cells of the Th1 and Th2 subtype, CD8 + cytotoxic T cells, mast cells, and to a lesser degree B cells. The polarization of macrophages to ...
Source: Neurosurgical Review - October 30, 2021 Category: Neurosurgery Source Type: research

The truths behind the statistics of surgical treatment for hypertensive brainstem hemorrhage in China: a review
AbstractHypertensive brainstem hemorrhage (HBSH) is of high morbidity and mortality rate. But many clinical studies were written in Chinese and had not been reviewed. A systemic review of Chinese clinical studies for HBSH was performed. A systemic literature search in PubMed, Web of Science, China National Knowledge Infrastructure, and Weipu database and Wanfang database up to March 2020 was performed. Clinical control studies including a surgical evacuation (SE) group and a conservative management (CM) group were included. The clinical outcome and mortality rate were compared. Ten cohort studies were included, involving 9...
Source: Neurosurgical Review - October 29, 2021 Category: Neurosurgery Source Type: research

A nomogram to predict the risk of postoperative intracranial rebleeding in patients with spontaneous intracranial hematoma
AbstractThe 30-day mortality rate of spontaneous cerebral hemorrhage (ICH) is approximately 30 –50%. Surgery may improve the prognosis of patients with severe ICH. However, ICH survivors after surgery still face the risks of postoperative intracranial rebleeding (PIB), and clinical tools that accurately predict the risk of PIB occurrence are not available. Therefore, a retrospective study w as performed. The population was divided into two groups according to the occurrence of PIB. Univariate and multivariate logistic regression analyses were performed to screen risk factors for PIB. Next, an early PIB risk nomogram ...
Source: Neurosurgical Review - October 29, 2021 Category: Neurosurgery Source Type: research

The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations
In conclusion, the proposed BSCM operating score is a clinician-f riendly tool, which may help neurosurgeons decide on the treatment for patients with BSCMs. (Source: Neurosurgical Review)
Source: Neurosurgical Review - October 29, 2021 Category: Neurosurgery Source Type: research

Long-term risk of shunt failure after brain tumor surgery
AbstractLong-term risks and survival times of ventriculoperitoneal (VP) shunts implanted due to hydrocephalus (HC) after craniotomy for brain tumors are largely unknown. The aim of this study was to establish the overall VP shunt survival rates during a decade after shunt insertion and to determine risks of shunt failure after brain tumor surgery in the long-term period. In this population-based cohort from a well-defined geographical region, all adult patients (>  18 years) from 2004 to 2013 who underwent craniotomies for intracranial tumors leading to VP shunt dependency were included. Our brain tumor data...
Source: Neurosurgical Review - October 29, 2021 Category: Neurosurgery Source Type: research

S100B, GFAP, UCH-L1 and NSE as predictors of abnormalities on CT imaging following mild traumatic brain injury: a systematic review and meta-analysis of diagnostic test accuracy
AbstractBiomarkers such as calcium channel binding protein S100 subunit beta (S100B), glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase L1 (UCH-L1) and neuron-specific enolase (NSE) have been proposed to aid in screening patients presenting with mild traumatic brain injury (mTBI). As such, we aimed to characterise their accuracy at various thresholds. MEDLINE, SCOPUS and EMBASE were searched, and articles reporting the diagnostic performance of included biomarkers were eligible for inclusion. Risk of bias was assessed using the QUADAS-II criteria. A meta-analysis was performed to assess the predictive ...
Source: Neurosurgical Review - October 28, 2021 Category: Neurosurgery Source Type: research

Application of sodium fluorescein for spinal cord lesions: intraoperative localization for tissue biopsy and surgical resection
AbstractSodium fluorescein (NaFL) has been used to aid in the resection of primary and secondary lesions within the brain. Comparatively, there is limited research on clinical applications for lesions within the spinal cord. Fluorescein-guided microsurgery may increase the ability to localize and safely surgically treat spinal lesions. Twelve patients with spinal cord lesions received fluorescein sodium 10% (Alcon Laboratories INC, Fort Worth, TX, USA) at 3  mg/kg prior to surgical resection. Intraoperative visualization of fluorescence was performed using a Zeiss Pentero (Carl Zeiss AG, Oberkochen, Germany) microscop...
Source: Neurosurgical Review - October 27, 2021 Category: Neurosurgery Source Type: research

Angiographic disease progression in medically treated adult patients with ischemic moyamoya disease without cerebral misery perfusion: supplementary analysis of a 5-year prospective cohort
AbstractAngiographic disease progression reportedly develops in adult moyamoya disease (MMD). However, more than half of patients analyzed underwent revascularization surgery. The present supplementary analysis of a 5-year prospective cohort with follow-up using magnetic resonance angiography (MRA) and cerebral blood flow (CBF) measurements was to elucidate the incidence and clinical features of angiographic disease progression in adult patients receiving medical management alone for ischemic MMD. Sixty-eight patients without misery perfusion in the symptomatic cerebral hemispheres underwent MRA and CBF measurement using b...
Source: Neurosurgical Review - October 23, 2021 Category: Neurosurgery Source Type: research

Magnetic resonance elastography in normal pressure hydrocephalus —a scoping review
ConclusionMRE studies in NPH are still limited by few participants, variable cohorts, inconsistent methodologies, and technical challenges, but the approach shows great potential for future clinical application. (Source: Neurosurgical Review)
Source: Neurosurgical Review - October 23, 2021 Category: Neurosurgery Source Type: research

Are there predilection sites for intracranial meningioma? A population-based atlas
AbstractMeningioma is the most common benign intracranial tumor and is believed to arise from arachnoid cap cells of arachnoid granulations. We sought to develop a population-based atlas from pre-treatment MRIs to explore the distribution of intracranial meningiomas and to explore risk factors for development of intracranial meningiomas in different locations. All adults ( ≥ 18 years old) diagnosed with intracranial meningiomas and referred to the department of neurosurgery from a defined catchment region between 2006 and 2015 were eligible for inclusion. Pre-treatment T1 contrast-enhanced MRI-weighted brain...
Source: Neurosurgical Review - October 21, 2021 Category: Neurosurgery Source Type: research

Quality of life impairment in adult Moyamoya patients —preoperative neuropsychological assessment and correlation to MRI and H215O PET findings
This study examines preoperative QoL in adult patients with MMA and correlates these with findings obtained via diagnostic imaging. Sixty-seven adult Moyamoya patients underwent preoperative neuropsychological testing including questionnaires to determine QoL, as well as psychiatric and depressive symptoms. The results were checked for correlation with territorial hypoperfusions seen in H215O PET with acetazolamide (ACZ) challenge (cerebrovascular reserve) and infarction patterns observed in MRI. Each vascular territory was analyzed separately and correlated with QoL. Physical role function was restricted in 41.0% of cases...
Source: Neurosurgical Review - October 20, 2021 Category: Neurosurgery Source Type: research

Pineal parenchymal tumor of intermediate differentiation: a systematic review and contemporary management of 389 cases reported during the last two decades
AbstractPineal parenchymal tumor of intermediate differentiation (PPTID) is a WHO grade II and III tumor arising from pineal parenchymal cells. PPTID is a rare tumor accounting for less than 1% of all primary central nervous system neoplasms. Therefore, reports describing the clinical characteristics and biological features of PPTID are lacking. Moreover, the therapeutic strategy remains controversial. The current study aimed to evaluate treatment results and problems of contemporary therapeutic modalities of PPTID based on its features compared with other pineal parenchymal tumors. A comprehensive systematic literature re...
Source: Neurosurgical Review - October 20, 2021 Category: Neurosurgery Source Type: research

Prevalence of distinct types of hardware failures related to deep brain stimulation
The objective analysis of the prevalence of hardware failures showed that skin erosion and infection presented the highest prevalence in relation to other hardware failures. Despite the sophistication of the surgical technique of DBS over time, there is a considerable complication rate, about 7 per 100 individuals (\(\mathrm{prevalence}=6.67\%, CI = [2.26\%,12.49\%]\), in which CI is the confidence interval). Future research can also include correlation analysis with the aim of understanding the correlation between distinct hardware failures and variables such as gender, type of disorder, and age. (Source: Neurosurgical Review)
Source: Neurosurgical Review - October 19, 2021 Category: Neurosurgery Source Type: research

Application of the Willis covered stent in the treatment of internal carotid artery blood blister-like aneurysms
AbstractThe optimal treatment for blood blister-like aneurysm (BBA) has not yet been determined, and BBA has a high recurrence rate after stent-assisted embolization. The purpose of the present study was to evaluate the safety and feasibility of patients with BBA rupture in the acute phase or patients with BBA who have recurrence after stent-assisted coil embolization. Eight patients (8 women, mean age 50.3  ± 3.7 years) who presented with ruptured BBA or recurrence BBA that had been treated by stent-assisted embolization (5 patients after primary treatment of stent-assisted embolization) were ret...
Source: Neurosurgical Review - October 18, 2021 Category: Neurosurgery Source Type: research