Gary L Gallia, Abhay Moghekar, Brian K Owler, Marc-Antoine Labeyrie, C Matthew Stewart, Masaru Ishii, Philippe Gailloud
No abstract text is available yet for this article.
June 25, 2024: Acta Neurochirurgica
Meng Zhang, Kaiming Gao, Xiangchen Wu, Xingdong Wang, Zhiqiang Wang, Xiaoguang Tong
PURPOSE: The purpose of this study was to describe the effectiveness and evaluation of open surgical treatment of basilar artery aneurysms in the context of interventional therapy era, including surgical clipping and blood reconstruction, by retrospectively analyzing the clinical data of basilar artery aneurysms in our center. METHODS: Patients with basilar artery aneurysms who were treated at our center were retrospectively included according to the inclusion and exclusion criteria...
June 24, 2024: Acta Neurochirurgica
Per Kristian Eide
The discovery of the glymphatic system has fundamentally altered our comprehension of cerebrospinal fluid transport and the removal of waste from brain metabolism. In the past decade, since its initial characterization, research on the glymphatic system has surged exponentially. Its potential implications for central nervous system disorders have sparked significant interest in the field of neurosurgery. Nonetheless, ongoing discussions and debates persist regarding the concept of the glymphatic system, and our current understanding largely relies on findings from experimental animal studies...
June 21, 2024: Acta Neurochirurgica
Daniele Starnoni, Roy T Daniel, Mahmoud Messerer
BACKGROUND: Invasion of the CS is one of the limiting factors for total resection for PitNet tumors with cure rates less than 30%. Extended approaches may be considered in selective and well-studied cases of secreting adenomas. METHOD: We describe the key steps of the endoscopic transcavernous approach for functional pituitary adenomas with a video illustration. The surgical anatomy is described along with the advantages and limitations of this approach. CONCLUSION: A detailed knowledge of CS anatomy and familiarity with this surgical approach acquired in the laboratory is essential...
June 19, 2024: Acta Neurochirurgica
Aryan Wadhwa, Emmanuel Mensah, Michael Young, Christopher S Ogilvy
This comprehensive review delves into the evolving field of neurointervention for intracranial aneurysms, exploring the critical adjunct of Dual Antiplatelet Therapy (DAPT) to endovascular coiling, stent-assisted coiling (SAC), flow-diversion stents, and flow-disruption (intrasaccular) devices. Despite growing evidence supporting the success of DAPT in reducing thromboembolic events, the lack of consensus on optimal regimens, doses, and duration is evident. Factors contributing to this variability include genetic polymorphisms affecting treatment response and ongoing debates regarding the clinical significance of hemorrhagic complications associated with DAPT...
June 18, 2024: Acta Neurochirurgica
Noriya Enomoto, Kazuhito Matsuzaki, Tomohiro Matsuda, Tadashi Yamaguchi, Takeshi Miyamoto, Mami Hanaoka, Natsumi Teshima, Ayato Kageyama, Yuichi Satoh, Tatsuya Haboshi, Masaaki Korai, Kenji Shimada, Hitoshi Niki, Koichi Satoh, Yasushi Takagi
BACKGROUND: Acute subdural hematoma (ASDH) is a life-threatening condition, and hematoma removal is necessary as a lifesaving procedure when the intracranial pressure is highly elevated. However, whether decompressive craniectomy (DC) or conventional craniotomy (CC) is adequate remains unclear. Hinge craniotomy (HC) is a technique that provides expansion potential for decompression while retaining the bone flap. At our institution, HC is the first-line operation instead of DC for traumatic ASDH, and we present the surgical outcomes...
June 18, 2024: Acta Neurochirurgica
Nathalie Zimmermann, Mahmoud Messerer, Alberto Vandenbulcke
BACKGROUND: Myelocele is a rare form of open spina bifida. Surgical repair is recommended prenatally or in the first 48 h. In some cases, the repair may be delayed, and specific surgical factors need to be considered. METHOD: We give a brief overview of the surgical anatomy, followed by a description of the surgical repair of a thoracolumbar Myelocele in an 11-month-old child. CONCLUSION: Surgical repair of the Myelocele stabilizes the neurological status, prevents local and central nervous system infections...
June 17, 2024: Acta Neurochirurgica
Paolo Frassanito, Marco Obersnel, Gianmarco Saponaro, Massimiliano Visocchi, Gianpiero Tamburrini, Mario Rigante
BACKGROUND: Velopharyngeal insufficiency (VPI) is a known complication of transoral surgery, with a reported incidence of 8.1%. The main factor related to VPI is the split of the soft palate. However, dead space resulting from transoral decompression may play a pivotal role in the pathogenesis of the dysfunction. In our experience, functionally significant dead space is almost constantly present after transoral decompression. This is probably due to malformation in children and postoperative scarring, thus configuring a nosological entity that we could define as "syndrome of the nasopharyngeal dead space...
June 17, 2024: Acta Neurochirurgica
Paula Palomäki, Tiina Sairanen, Mika Niemelä, Johan Marjamaa
BACKGROUND: Radiofrequency thermocoagulation (RFT) is a treatment used to relieve symptoms of cranial nerve disorders. The current study is the first to describe the results of hemifacial spasm (HFS) patients with a history of repeated RFT in the second-largest consecutive single-center patient series with long-term follow-up. METHOD: This retrospective study was conducted in the largest hospital district in Finland (Helsinki and Uusimaa). Consecutive HFS patients who had an RFT to treat HFS in the Hospital District of Helsinki and Uusimaa between 2009-2020 were included...
June 15, 2024: Acta Neurochirurgica
Giuseppe Corazzelli, Giulio Di Noto, Antonio Ciardo, Manuel Colangelo, Sergio Corvino, Settimio Leonetti, Alessandro D'Elia, Francesco Ricciardi, Andrea Bocchino, Sergio Paolini, Vincenzo Esposito, Gualtiero Innocenzi
OBJECTIVE: To compare the costotransversectomy (CTV) and transpedicular (TP) approaches versus the transfacet (TF) approach for the surgical treatment of calcific thoracic spine herniations (cTDH), in terms of surgical and clinical outcomes. BACKGROUND: Surgical approaches for cTDH are debated. Anterior approaches are recommended, while posterolateral approaches are preferred for non-calcific, paramedian, and lateral hernias. Currently, there is limited evidence about the superiority of a more invasive surgical approach, such as CTV or TP, over TF, a relatively less invasive approach, in terms of neurological outcome, pain, and surgical complications, for the treatment of cTDH...
June 14, 2024: Acta Neurochirurgica
Mira C Hasner, Mark P van Opijnen, Filip Y F de Vos, Edwin Cuppen, Marike L D Broekman
Increased use of whole genome sequencing (WGS) in neuro-oncology for diagnostics and research purposes necessitates a renewed conversation about informed consent procedures and governance structures for sharing personal health data. There is currently no consensus on how to obtain informed consent for WGS in this population. In this narrative review, we analyze the formats and contents of frameworks suggested in literature for WGS in oncology and assess their benefits and limitations. We discuss applicability, specific challenges, and legal context for patients with (recurrent) glioblastoma...
June 14, 2024: Acta Neurochirurgica
Changwen Li, Tao Yang, Nan Zhang, Chengyu Xia
BACKGROUND: Samii Type-D jugular foramen schwannomas (JFSs) are the most challenging for neurosurgeons because of anatomical complexity. Various neurosurgical approaches have been described to gain access to JF. METHODS: We present a female with incidental diagnosis of the Type-D JFS. Complete radical resection was achieved via the carotid triangle approach without any bony structure removal. And the patient was discharged asymptomatic and without new-developed neurological deficits...
June 14, 2024: Acta Neurochirurgica
Linda Oberle, Marcos Tatagiba, Georgios Naros, Kathrin Machetanz
BACKGROUND: The management of perioperative venous thrombembolism (VTE) prophylaxis is highly variable between neurosurgical departments and general guidelines are missing. The main issue in debate are the dose and initiation time of pharmacologic VTE prevention to balance the risk of VTE-based morbidity and potentially life-threatening bleeding. Mechanical VTE prophylaxis with intermittend pneumatic compression (IPC), however, is established in only a few neurosurgical hospitals, and its efficacy has not yet been demonstrated...
June 14, 2024: Acta Neurochirurgica
Sogo Oki, Yukitomo Ishi, Ryosuke Sawaya, Michinari Okamoto, Hiroaki Motegi, Zen-Ichi Tanei, Masumi Tsuda, Takashi Mori, Kentaro Nishioka, Hiromi Kanno-Okada, Hidefumi Aoyama, Shinya Tanaka, Shigeru Yamaguchi, Miki Fujimura
BACKGROUND: With the recent advent of genetic testing, IDH-mutant glioma has been found among adult brainstem gliomas. However, the clinical outcome and prognosis of IDH-mutant brainstem gliomas in adults have not been elucidated. This study aimed to investigate the clinical outcome, radiological findings, and genetic features of adult patients with IDH-mutant diffuse brainstem gliomas. METHODS: Data from adult patients with brainstem glioma at Hokkaido University Hospital between 2006 and 2022 were retrospectively analyzed...
June 12, 2024: Acta Neurochirurgica
Naokado Ikeda, Kunio Yokoyama, Yutaka Ito, Hidekazu Tanaka, Makoto Yamada, Akira Sugie, Toshihiro Takami, Masahiko Wanibuchi, Masahiro Kawanishi
PURPOSE: Each institution or physician has to decide on an individual basis whether to continue or discontinue antiplatelet (AP) therapy before spinal surgery. The purpose of this study was to determine if perioperative AP continuation is safe during single-level microsurgical decompression (MSD) for treating lumbar spinal stenosis (LSS) and lumbar disc hernia (LDH) without selection bias. METHODS: Patients who underwent single-level MSD for LSS and LDH between April 2018 to December 2022 at our institute were included in this retrospective study...
June 12, 2024: Acta Neurochirurgica
M C Hasner, M P van Opijnen, M van der Meulen, R M Verdijk, S L N Maas, L C J Te Boome, M L D Broekman
PURPOSE: The gold standard for diagnostics in primary central nervous system lymphoma (PCNSL) is histopathological diagnosis after stereotactic biopsy. Yet, PCNSL has a multidisciplinary diagnostic work up, which associated with diagnostic delay and could result in treatment delay. This article offers recommendations to neurosurgeons involved in clinical decision-making regarding (novel) diagnostics and care for patients with PCNSL with the aim to improve uniformity and timeliness of the diagnostic process for patients with PCNSL...
June 11, 2024: Acta Neurochirurgica
Neil U Barua, T R Williamson, Lydia Wiernik, Hajira Mumtaz, Sonia Mariotti, Madeleine Farrow, Raenette David, Anna E Piasecki
The aim of this case study was to describe differences in English and British Sign Language (BSL) communication caused by a left temporal tumour resulting in discordant presentation of symptoms, intraoperative stimulation mapping during awake craniotomy and post-operative language abilities. We report the first case of a hearing child of deaf adults, who acquired BSL with English as a second language. The patient presented with English word finding difficulty, phonemic paraphasias, and reading and writing challenges, with BSL preserved...
June 10, 2024: Acta Neurochirurgica
Bertrand Baussart, Benoit Hudelist, Vincent Reina, Chiara Villa, Jérôme Bertherat, Guillaume Assié, Stephan Gaillard
BACKGROUND: During pituitary surgery, CSF leaks are often treated by intrasellar packing, using muscle or fat grafts. However, this strategy may interfere with the interpretation of postoperative MRI and may impact the quality of resection in cases of second surgery, due to the existence of additional fibrous tissue. We present an alternative technique, using a diaphragm reconstruction with a heterologous sponge combining fibrinogen and thrombin (TachoSil), applied in selected patients with low-flow CSF leaks...
June 10, 2024: Acta Neurochirurgica
Rupen Desai, Zoe Kapur, Benjamin Hammond, Cátia P Dombaxe, Victor Ramzes Chavez-Herrera, Abtin Tabaee, Vijay K Anand, Ashutosh Kacker, Theodore H Schwartz
BACKGROUND: Cerebrospinal fluid leak after endoscopic skull base surgery remains a significant complication. Several investigators have suggested Hydroset cranioplasty to reduce leak rates. We investigated our early experience with Hydroset and compared the rate of nasal complications and CSF leak rates with case-controlled historic controls. METHODS: We queried a prospective database of patients undergoing first time endoscopic, endonasal resection of suprasellar meningiomas and craniopharyngiomas from 2015 to 2023...
June 8, 2024: Acta Neurochirurgica
Kuntal Kanti Das, Guramritpal Singh, Kamlesh Singh Bhaisora, Arun Kumar Srivastava
BACKGROUND: At times, a regulation internal carotid artery-posterior communicating artery junction (ICA-P-Comm) aneurysm becomes a surgical hurdle owing to its close proximity to the anterior clinoid process, an immovable ICA and a concealed dominant P-Comm artery arising from the aneurysm neck. METHOD: A 70 year old patient with a low lying ICA-P-Comm aneurysm underwent a "tailored" intradural clinoidectomy for aneurysm clipping. CONCLUSION: A tailored anterior clinoidectomy to expose "just enough" allows a proximal ICA control in a suitable area, mobility of an atherosclerotic ICA and exposes the P-Comm artery origin which are essential in safe clipping of these aneurysms...
June 8, 2024: Acta Neurochirurgica
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