Toward an optimal cadaveric brain model for neurosurgical education: assessment of preservation, parenchyma, vascular injection, and imaging
ConclusionFor better-quality specimens for neurosurgical education and training, formalin preservation within ≤72 h of death was preferable, as was injection with colored latex. Formalin-flushed specimens more closely resembled live brain parenchyma. Assessment scores were lower for preparation techniques performed > 72 h postmortem and for nonformalin preservation solutions. The positive correlation between cadaver assessment scores and our novel MRI score indicates that donation organizations and institutional buyers should incorporate MRI as a screening tool for the selection of high-quality specimens. (Sour...
Source: Neurosurgical Review - April 25, 2024 Category: Neurosurgery Source Type: research
The role of surgical disconnection for posterior fossa pial arteriovenous fistulas and dural fistulas with pial supply: an illustrative case series.
ConclusionsThis illustrative case series highlights the technical difficulties and anatomical limitations of endovascular management for posterior fossa pAVFs and dAVFs with pial supply and emphasizes the relative safety and utility of microsurgical disconnection in this context. A combined approach involving partial preoperative embolization—when th e angioarchitecture is permissive—can potentially decrease surgical morbidity. Larger studies are warranted to better define the role for multimodal intervention and to assess associated long-term AVF obliteration rates in the setting of pial arterial involvement. (Sourc...
Source: Neurosurgical Review - April 25, 2024 Category: Neurosurgery Source Type: research
Letter to editor: Crucial trials in neurosurgery: A must-know for every neurosurgeon
(Source: Neurosurgical Review)
Source: Neurosurgical Review - April 25, 2024 Category: Neurosurgery Source Type: research
To be thorough or tailored: influence of the arachnoid dissection range on the surgical outcomes of microvascular decompression for hemifacial spasm
ConclusionThorough dissection as an initial aim for all cases was not recommended in MVD for HFS, arachnoid dissection should be tailored to achieving safety and effectiveness during the procedure. (Source: Neurosurgical Review)
Source: Neurosurgical Review - April 24, 2024 Category: Neurosurgery Source Type: research
Temporal lobe injury with middle fossa approach to intracanalicular vestibular schwannomas: a systematic review
AbstractThere are several surgical approaches for vestibular schwannoma (VS) resection. However, management has gradually shifted from microsurgical resection, toward surveillance and radiosurgery. One of the arguments against microsurgery via the middle fossa approach (MFA) is the risk of temporal lobe retraction injury or sequelae. Here, we sought to evaluate the incidence of temporal lobe retraction injury or sequela from a MFA via a systematic review of the existing literature. This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Re...
Source: Neurosurgical Review - April 24, 2024 Category: Neurosurgery Source Type: research
Stereotactic radiosurgery for intracranial cavernous malformations of the deep-seated locations: systematic review and meta-analysis
ConclusionSRS appears effective in reducing hemorrhage rates for deep-seated ICMs. The risk of symptomatic radiation injury is low. Given the high risk of surgical morbidity, SRS is a reasonable treatment option for patients with deep-seated ICMs with at least one prior hemorrhage. (Source: Neurosurgical Review)
Source: Neurosurgical Review - April 24, 2024 Category: Neurosurgery Source Type: research
Correspondence to C-reactive protein levels, the prognostic nutritional index, and the lactate dehydrogenase-to-lymphocyte ratio are important prognostic factors in primary central nervous system lymphoma: a single-center study of 223 patients
(Source: Neurosurgical Review)
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Proposing a sphenoid bone quality score: a novel concept for transsphenoidal surgery
AbstractTranssphenoid surgery is a common procedure for removing pituitary and other sellar tumors. The quality and density of the sphenoid bone, which serves as the access route to the sellar region, can affect the surgical outcomes and complications. However, there is no standardized method to assess sphenoid bone quality. I propose a sphenoid bone quality score, based on criteria and parameters derived from preoperative imaging techniques. This score could provide information on the bone characteristics and challenges of each case, and help to select the optimal surgical approach, instruments, grafts, and measures. This...
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Long term outcome after endovascular treatment for large ischemic core acute stroke is associated with hypoperfusion intensity ratio and onset-to-reperfusion time
ConclusionsHigher HIR and longer OTR time in large core stroke patients were independently associated with unfavorable three-month outcomes after EVT. (Source: Neurosurgical Review)
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
A light in the darkness: sodium fluorescein-assisted peripheral nerve sheath tumors resection – a comprehensive systematic review and single-arm meta-analysis
AbstractThe treatment for peripheral nerve sheath tumors (PNSTs) is based on surgical excision and the primary goal is to improve symptoms whilst preserving neurological function. In order to improve this technique, surgeons may use sodium fluorescein (SF) to help visualize the neoplasm and, consequently, facilitate its removal. Aiming to assess the efficacy of this emerging surgical strategy, we conducted a systematic review and single-arm meta-analysis. We conducted a systematic search on thePubMed,Embase, andWeb of Science databases, following thePRISMA guidelines. Studies without outcomes of interest, case series with ...
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Elevated skull fractures: an institutional experience and individual participant data meta-analysis
In this study, we present the meta-analysis of outcomes and complications within this patient cohor t, offering a comprehensive synthesis of existing literature on this pathology. However, further investigation is imperative to provide higher-quality evidence and address lingering uncertainties in the classification and management of ESFs. (Source: Neurosurgical Review)
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Imaging manifestations of papillary glioneuronal tumors
AbstractTo analyse the imaging findings of papillary glioneuronal tumors (PGNTs), in order to improve the accuracy of preoperative diagnosis of this tumor. The clinical and imaging manifestations of 36 cases of PGNT confirmed by pathology were analyzed retrospectively. A total of 17 males and 19 females, averaging 22.47 ( ± 11.23) years. Initial symptoms included epilepsy in ten, headache in seven, and others in 19 cases. 97.2% (35/36) of the lesions were located in the supratentorial area, and 80.5% (29/36) in the intraventricular or deep white matter adjacent to the lateral ventricles. Twenty-four of the lesions (66.7...
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Spontaneous acute-onset conus medullaris or cauda equina syndrome: beware of spinal acute subdural hematoma
(Source: Neurosurgical Review)
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Harnessing generative artificial intelligence for meningioma prediction: a correspondence
(Source: Neurosurgical Review)
Source: Neurosurgical Review - April 23, 2024 Category: Neurosurgery Source Type: research
Efficacy and utility of antifibrinolytics in pediatric spine surgery: a systematic review and network meta-analysis
AbstractAntifibrinolytics have gained increasing attention in minimizing blood loss and mitigating the risks associated with massive transfusions, including infection and coagulopathy in pediatric patients undergoing spine surgery. Nevertheless, the selection of optimal agent is still a matter of debate. We aim to review the utility of these agents and compare the efficacy of antifibrinolytics in pediatric and adolescent spine surgeries. A comprehensive search was performed in Scopus, Web of Science, and MEDLINE databases for relevant works. Studies providing quantitative data on predefined outcomes were included. Primary ...
Source: Neurosurgical Review - April 22, 2024 Category: Neurosurgery Source Type: research
