Aimee Goel, Luke Galloway, Suhaib Abualsaud, Yasir Chowdhury, Peter Gan, Graham Flint, Georgios Tsermoulas
BACKGROUND: Endoscopic third ventriculostomy (ETV) is a standard treatment in hydrocephalus of certain aetiologies. The most widely used predictive model is the ETV success score. This is frequently used to predict outcomes following ETV in adult patients; however, this was a model developed in paediatric patients with often distinct aetiologies of hydrocephalus. The aim of this study was to assess the predictive value of the model and to identify factors that influence ETV outcomes in adults...
November 29, 2023: Acta Neurochirurgica
Takuro Inoue, Yukihiro Goto, Yasuaki Inoue, Peter Adidharma, Mustaqim Prasetya, Takanori Fukushima
BACKGROUND: To examine the factors contributing to persistent and recurrent hemifacial spasms (HFS) following a microvascular decompression (MVD) procedure and to suggest technical improvements to prevent such failures. METHODS: A retrospective review was conducted on fifty-two cases of repeat surgery. The extent of the previous craniotomy and the location of neurovascular compression (NVC) were investigated. The operative findings were categorized into two groups: "Missing Compression" and "Teflon Contact"...
November 28, 2023: Acta Neurochirurgica
Arthur Hosmann, Subhashree Hari, Basant K Misra
BACKGROUND: Stereotactic radiosurgery effectively controls vestibular schwannoma (VS). However, in certain cases, microsurgical resection may be necessary for post-radiosurgery tumour progression. The characteristics and microsurgical challenges of uncommon cystic recurrences post-radiosurgery are rarely addressed. METHOD: We retrospectively analysed 24 consecutive patients who underwent microsurgical intervention for recurrent VS post-radiosurgery by the senior author...
November 27, 2023: Acta Neurochirurgica
Sol Hooy Oh, Jai Ho Choi, Bum Soo Kim, Yong Sam Shin
PURPOSE: This study aimed to investigate the efficacy and safety of an intraprocedural image fusion technique using flat-panel detector computed tomography-based rotational angiography (FDCT-RA) and image fusion (IF) for the transvenous approach in treating intracranial dural arteriovenous fistulas (dAVFs). METHODS: A retrospective review was conducted on patients who underwent transvenous embolization for dural AVFs. The patients were classified into two groups according to the treatment technique used: the FDCT-RA and IF technique group and the conventional technique group...
November 27, 2023: Acta Neurochirurgica
Peter Hastreiter, Olga Maliachova, Rudolf Fahlbusch, Arnd Doerfler, Michael Buchfelder, Ramin Naraghi
BACKGROUND: Neurovascular relationships in the posterior fossa are more frequently investigated due to the increasing availability of 3.0 Tesla MRI. For an assessment with 3D visualization, no systematic analyzes are available so far and the question arises as to whether 3.0 Tesla MRI should be given preference over 1.5 Tesla MRI. METHODS: In a prospective study, a series of 25 patients each underwent MRI investigations with 3D-CISS and 3D-TOF at 1.5 and 3.0 Tesla...
November 24, 2023: Acta Neurochirurgica
Jie Yin, Yihao Wu, Zhe Zhang, Yu Zhang, Junhua He, Zhijun Yang, Bo Wang, Xinchao Wang, Gemingtian Liu, Zhixu Bie, Pinan Liu
BACKGROUND: Advances in microscopic and endoscopic surgical techniques have outpaced traditional classification and transcranial surgical strategies, especially with reference to the treatment of trigeminal schwannomas (TSs). A modified TS classification is proposed and appropriate surgical strategies are discussed. METHODS: The cases of 93 patients who underwent surgical treatment in Beijing Tiantan Hospital in the previous 6 years were analyzed retrospectively, and a literature review was conducted...
November 24, 2023: Acta Neurochirurgica
Lara Maria Höbner, Victor E Staartjes, Elisa Colombo, Martina Sebök, Luca Regli, Giuseppe Esposito
BACKGROUND: Perfused placentas provide an excellent and accessible model for microvascular dissection, microsuturing and microanastomosis training - particularly in the early microsurgical learning curve. This way, a significant amount of live animals can be spared. METHOD: We present the Zurich Microsurgery Lab protocol, detailing steps for obtaining, selecting, cleaning, flushing, cannulating, and preserving human placentas - as well as microsurgical training examples - in a tried-and-true, safe, cost-effective, and high-yield fashion...
November 23, 2023: Acta Neurochirurgica
M Soler-Rico, M Di Santo, G Vaz, V Joris, E Fomekong, S Guillaume, M Van Boven, C Raftopoulos
PURPOSE: This study is aimed at analyzing clinical outcome, absence of stroke recurrence, revascularization, and complications and long-term follow-up in the surgical treatment of moyamoya angiopathy (MMA) using the multiple burr holes (MBH) technique with dura opening and arachnoid preservation as a single procedure. To the best of our knowledge, this is the first to describe an MBH technique with arachnoid preservation. METHOD: We retrospectively reviewed all patients operated from June 2001 to March 2021, for a symptomatic and progressive MMA operated with opening of the dura but arachnoid preservation...
November 22, 2023: Acta Neurochirurgica
Omaditya Khanna, Adam Barsouk, Arbaz A Momin, Aria Mahtabfar, Carrie E Andrews, Karim Hafazalla, Matthews Lan, Pious D Patel, Michael P Baldassari, David W Andrews, James J Evans, Christopher J Farrell, Kevin D Judy
PURPOSE: Owing to their vicinity near the superior sagittal sinus, parasagittal and parafalcine meningiomas are challenging tumors to surgically resect. In this study, we investigate key factors that portend increased risk of recurrence after surgery. METHODS: This is a retrospective study of patients who underwent resection of parasagittal and parafalcine meningiomas at our institution between 2012 and 2018. Relevant clinical, radiographic, and histopathological variables were selected for analysis as predictors of tumor recurrence...
November 21, 2023: Acta Neurochirurgica
Hyuk Jang, Byung-Rae Cho, Dong-Kyu Jang, Dong-Sub Kim
OBJECTIVE: This study aimed to evaluate the feasibility and safety values of activated clotting time (ACT)-guided systemic heparinization in reducing periprocedural thrombosis and bleeding complications during coil embolization of unruptured intracranial aneurysms. METHODS: A total of 228 procedures performed on 213 patients between 2016 and 2021 were included in the retrospective analysis. The target ACT was set at 250 s. Logistic regression was performed to assess predictors for the occurrence of thrombosis and bleeding...
November 20, 2023: Acta Neurochirurgica
Mairead Skally, Maeve Leonard, Philip J O'Halloran, Ben Husien, Kathleen Bennett, Karen Burns, Binu Dinesh, Hilary Humphreys, Fidelma Fitzpatrick
BACKGROUND: Clostridioides difficile infection (CDI) is a leading cause of healthcare-associated (HA) diarrhoea, contributing to patient morbidity and prolonged length-of-stay (LOS). We retrospectively assessed CDI over a decade in a national neurosurgical centre, with a multi-disciplinary approach to CDI surveillance and antimicrobial stewardship, by comparing CDI patients with other patient groups. METHODS: Data on CDI in neurosurgical inpatients between January 2012 and December 2021 were collated...
November 16, 2023: Acta Neurochirurgica
Ann-Kathrin Joerger, Xhimi Laho, Victoria Kehl, Bernhard Meyer, Sandro M Krieg, Sebastian Ille
PURPOSE: The use of intraoperative MRI (ioMRI) contributes to an improved extent of resection. Hybrid operating room MRI suites have been established, with the patient being transferred to the MRI scanner. In the present descriptive analysis, we compared the rate of surgical site infections (SSI) after intracranial tumor surgery with and without the use of ioMRI. METHODS: In this retrospective study, we included 446 patients with open craniotomy performed for brain tumor surgery...
November 16, 2023: Acta Neurochirurgica
Jack Henry, Mohammed O Dablouk, Dhruv Kapoor, Stavros Koustais, Paula Corr, Deirdre Nolan, Deirdre Coffey, John Thornton, Alan O'Hare, Sarah Power, Daniel Rawluk, Mohsen Javadpour
BACKGROUND: Up to 35% of aneurysmal subarachnoid haemorrhage (aSAH) cases may present as poor grade, defined as World Federation of Neurosurgical Societies (WFNS) grades IV and V. In this study, we evaluate functional outcomes and prognostic factors. METHODS: This prospective study included all patients referred to a national, centralized neurosurgical service with a diagnosis of poor-grade aSAH between 01/01/2016 and 31/12/2019. Multivariable logistic regression models were used to estimate probability of poor functional outcomes, defined as a Glasgow Outcome Scale (GOS) of 1-3 at 3 months...
November 16, 2023: Acta Neurochirurgica
Caed Whittle, Milo A Hollingworth, Louise Dulhanty, Hiren C Patel
PURPOSE: Delayed Cerebral Ischaemia (DCI) remains an important preventable driver of poor outcome in aneurysmal subarachnoid haemorrhage (aSAH). Our ability to predict DCI is based on historical patient cohorts, which use inconsistent definitions for DCI. In 2010, a definition of DCI was agreed upon and published by a group of aSAH experts. The aim of this study was to identify predictors using this agreed definition of DCI. METHODS: We conducted a literature search of Medline (PubMed) to identify articles published since the publication of the 2010 consensus definition...
November 15, 2023: Acta Neurochirurgica
Bin Lu, Yu Zhang, Chenan Liu, Xin Ma, Gemingtian Liu, Zhixu Bie, Zhijun Yang, Pinan Liu
BACKGROUND: Endoscopic transsphenoidal surgery is the primary method used to treat pituitary adenomas (PAs) at present; however, this technique is associated with certain risks, including cerebrospinal fluid leakage (CFL) and residual tumors (RTs). In this study, we aimed to identify specific risk factors for intraoperative CFL (ioCFL) and postoperative RT in patients with pituitary adenoma and construct a corresponding nomogram for risk assessment. METHODS: We collected a range of information from 782 patients who underwent endoscopic transsphenoidal PA resection in the Department of Neurosurgery at Beijing Tiantan Hospital between 2019 and 2021...
November 15, 2023: Acta Neurochirurgica
Miguel Saez-Alegre, Christian I Rios-Vicil, Ana Sofia Alvarez, John Sagrati, Keaton Piper, Walter C Jean
BACKGROUND: In this morphometric study, we describe the anatomy of the TIGR triangle, which is bordered by the tentorial surface of the cerebellum, the internal cerebral vein and vein of Galen complex, and the vein of Rosenthal. These structures define the window, or deep keyhole, to access the pineal region in non-midline supracerebellar infratentorial approaches. METHODS: The posterior fossa anatomy of 16 patients was studied in virtual reality (VR), and the TIGR triangles were defined and measured with special attention on its angular orientation in the posterior fossa...
November 14, 2023: Acta Neurochirurgica
Lydia Kaoutzani, Liam V Goldman, Keaton Piper, Manish Kumar, Fernando L Vale
BACKGROUND: Epilepsy, a disease characterized by recurrent seizures, is a common chronic neurologic condition. Antiepileptic drugs (AED) are the mainstay of treatment for epilepsy. Vagus nerve stimulation (VNS) surgery is an adjuvant therapy for the treatment of drug refractory epilepsy (DRE). VNS revision and implant removal surgeries remain common. METHODS: Using a single neurosurgeon data registry for epilepsy surgery, we retrospectively analyzed a total of 824 VNS surgeries...
November 14, 2023: Acta Neurochirurgica
Gökce Hatipoglu Majernik, Filipe Wolff Fernandes, Shadi Al-Afif, Hans E Heissler, Joachim K Krauss
OBJECTIVE: Microvascular decompression (MVD) is a well-accepted treatment modality for trigeminal neuralgia (TN) with high initial success rates. The causes for recurrence of TN after previously successful MVD have not been fully clarified, and its treatment is still a matter of debate. Here, we present the surgical findings and the clinical outcome of patients with recurrent TN after MVD who underwent posterior fossa re-exploration. METHODS: Microsurgical posterior fossa re-exploration was performed in 26 patients with recurrent TN (mean age 59...
November 13, 2023: Acta Neurochirurgica
Shuo Li, Chenlong Liao, Guo Cheng, Yiwei Wu, Wenchuan Zhang
OBJECTIVE: Whether nerve atrophy can affect the prognosis of primary trigeminal neuralgia (PTN) patients undergoing percutaneous balloon compression (PBC) remains unclear. This study aimed to determine the association between nerve characteristics observed on preoperative magnetic resonance imaging (MRI) and PBC outcomes. METHODS: Between January 2019 and December 2022, a cohort of 58 patients with unilateral PTN treated with PBC were analysed retrospectively and included in this study...
November 13, 2023: Acta Neurochirurgica
Luis A Robles, Sumedh Shah, Timur Urakov
BACKGROUND: Lateral lumbar interbody fusion supplemented with insertion of pedicle screws is a surgical procedure that has gained popularity in the last years, becoming an important tool in the armamentarium of spine surgeons. In recent years, there is a trend to complete both procedures in a single position, thus avoiding flipping the patient prone to insert the pedicle screws. METHODS: We describe a step-by-step workflow of the robotic-assisted technique for multilevel lateral lumbar interbody fusion supplemented with posterior instrumentation...
November 11, 2023: Acta Neurochirurgica
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