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Neurosurgical Review

Takeshi Mikami, Hime Suzuki, Ryo Ukai, Katsuya Komatsu, Yukinori Akiyama, Masahiko Wanibuchi, Kiyohiro Houkin, Nobuhiro Mikuni
Extracranial-to-intracranial (EC-IC) bypass surgery is an effective treatment for patients with moyamoya disease and other conditions. Some patients with moyamoya disease have a risk of acute thrombogenesis at the anastomotic site just after bypass surgery. The purpose of this study was to study risk factors of acute thrombogenesis and determine effective countermeasures. This study included 48 patients (66 EC-IC bypass procedures) with moyamoya disease and 52 controls (54 procedures) without moyamoya disease...
February 14, 2019: Neurosurgical Review
GuoSong Shang, Tao Fan, Zhe Hou, Cong Liang, YinQian Wang, XinGang Zhao, Wayne Fan
Various techniques have been used for management of congenital atlantoaxial dislocation. Recently, the reduction of atlantoaxial dislocation through a single posterior approach has attracted more and more attention. Here, we present a modified technique including direct interfacet release and distraction between C1 and C2 by a specially designed distractor, posterior internal fixation and bone graft fusion. The illustrated technique was performed in 15 consecutive patients, and the outcomes were recorded and analyzed...
February 13, 2019: Neurosurgical Review
Yang Yang, Bas van Niftrik, Xiangke Ma, Julia Velz, Sophie Wang, Luca Regli, Oliver Bozinov
Intra-axial brainstem surgeries are challenging. Many experience-based "safe entry zones (SEZs)" into brainstem lesions have been proposed in the existing literature. The evidence for each one seems limited. English-language publications were retrieved using PubMed/MEDLINE. Studies that focused only on cadaveric anatomy were also included, but the clinical case number was treated as zero. The clinical evidence level was defined as "case report" when the surgical case number was ≤ 5, "limited evidence" when there were more than 5 but less than 25 cases, and "credible evidence" when a publication presented more than 25 cases...
February 6, 2019: Neurosurgical Review
Davide Nasi, Corrado Iaccarino, Antonio Romano, Pasquale De Bonis, Marco Farneti, Franco Servadei, Reza Ghadirpour
Post-traumatic supra and infratentorial acute extradural hematomas (SIEDHs) are an uncommon type of extradural hematoma with only few small series published. In this scenario, the purposes of the present study are to present our experience in the management of 8 patients with acute SIEDH and to perform a systematic literature review. The clinical and radiological data of 8 patients operated for SIEDH at our department were analyzed retrospectively. Using the PRISMA guidelines, we reviewed the articles published from January 1990 to January 2018 reporting data about SIEDH...
February 4, 2019: Neurosurgical Review
Vesna Malinova, Ioannis Tsogkas, Daniel Behme, Veit Rohde, Marios Nikos Psychogios, Dorothee Mielke
Early prediction of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is essential to prevent infarction. CT perfusion (CTP) is used to identify perfusion deficits and to guide treatment decisions. In this study, we aimed to evaluate CTP parameters and to establish cutoff values for DCI prediction in the early phase after aSAH. Whole-brain CTP was performed on day 3 after aSAH. These CTP parameters were analyzed: cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), time to start (TTS), and time to drain (TTD)...
February 2, 2019: Neurosurgical Review
Xiangke Ma, Yang Yang, Dongtao Liu, Yiming Zhou, Weihua Jia
The aim of this study is to characterize demographic and morphologic characteristics of aneurysms located in the anterior communicating artery (ACoA) and to investigate possible associations between these characteristics and aneurysm rupture. We investigated 112 consecutive patients (72 ruptured and 40 unruptured) with ACoA aneurysms from a single-center database. The effects of demographic and morphologic characteristics on the risk of rupture in ACoA aneurysms were tested using univariate and multivariate logistic regression analyses, respectively...
January 31, 2019: Neurosurgical Review
Kiyoshi Ito, Mitsunori Yamada, Tetsuyoshi Horiuchi, Kazuhiro Hongo
Several surgical procedures can be applied for syrinx associated with Chiari type 1 malformation; however, it remains controversial as to which approach is the most effective. Here, we evaluated the indications and limitations of foramen magnum decompression (FMD) with or without dural plasty. Forty patients with Chiari type 1 malformation were surgically treated and followed up for > 12 months. Thirty-two patients (80.0%) underwent FMD with removal of only the outer dura mater layer, while eight patients underwent FMD with dural plasty...
January 25, 2019: Neurosurgical Review
Tokunori Kanazawa, Yasuhiro Minami, Masahiro Jinzaki, Masahiro Toda, Kazunari Yoshida, Hikaru Sasaki
The promoter methylation status of the O6 -methylguanine-DNA methyltransferase (MGMT) gene has been described as the most important predictor of chemotherapeutic response and patients' survival in glioblastomas (GBs). Therefore, prediction of the MGMT promoter methylation status by imaging would help to preoperatively decide the overall treatment strategy as well as surgical strategy. This study aimed to detect imaging parameters to predict MGMT promoter methylation in GBs by using a commercially available software...
January 23, 2019: Neurosurgical Review
Hidetoshi Matsukawa, Kazutaka Uchida, Manabu Shirakawa, Shinichi Yoshimura
During surgical treatment of cerebral aneurysm, thin-walled or severe atherosclerotic aneurysms on the middle cerebral artery are sometimes observed. Owing to the vulnerability or stiffness of the aneurysm, simple neck clipping is usually difficult. We aimed to describe a sling-wrap clipping method using a polyglycolic acid (PGA) sheet for thin-walled or atherosclerotic middle cerebral artery aneurysms. The sling-wrap clipping method was performed in six patients with middle cerebral artery aneurysms. After the distal Sylvian approach, the aneurysm and parent artery were slung up like a baby sling by using a transparent PGA sheet...
January 21, 2019: Neurosurgical Review
Yong Jiang, Liang Lv, Jiuhong Li, Weichao Ma, Cheng Chen, Peizhi Zhou, Shu Jiang
High-grade meningiomas in ventricles are rare, where most published series only include a few patients. A retrospective analysis was performed on the clinical features, radiological findings, and treatment outcomes of 26 patients with high-grade meningiomas in lateral ventricles who were surgically treated in our hospital between July 2008 and July 2016. A female predilection (female/male = 1.4:1) was observed with a mean age of 42.4 years. Headache and/or vomiting (65.3%) were the most common initial symptom, and with symptom duration time ranging between 7 days and 5 years (mean 8...
January 16, 2019: Neurosurgical Review
Mingran Wang, Zhibao Li, Xing Fan, Xiaorong Tao, Lei Qi, Miao Ling, Dongze Guo, Hui Qiao
Although the application of somatosensory evoked potential (SSEP) in intracranial aneurysm surgery has been well demonstrated, the relationship between the duration of SSEP deterioration and postoperative neurological deficits (PNDs) is still not clear. The objectives of this study were (1) to detect the relationship between the SSEP deterioration duration and PND; and (2) detect the relationship between SSEP deterioration duration and postoperative computed tomography (CT) findings. Data from 587 patients were reviewed and 40 patients with SSEP deterioration were enrolled...
January 12, 2019: Neurosurgical Review
Fraser C Henderson, C A Francomano, M Koby, K Tuchman, J Adcock, S Patel
A great deal of literature has drawn attention to the "complex Chiari," wherein the presence of instability or ventral brainstem compression prompts consideration for addressing both concerns at the time of surgery. This report addresses the clinical and radiological features and surgical outcomes in a consecutive series of subjects with hereditary connective tissue disorders (HCTD) and Chiari malformation. In 2011 and 2012, 22 consecutive patients with cervical medullary syndrome and geneticist-confirmed hereditary connective tissue disorder (HCTD), with Chiari malformation (type 1 or 0) and kyphotic clivo-axial angle (CXA) enrolled in the IRB-approved study (IRB# 10-036-06: GBMC)...
January 9, 2019: Neurosurgical Review
Ismail Oltulu, Hemra Cil, Mustafa Onur Ulu, Vedat Deviren
Although symptomatic thoracic disk herniation (TDH) is relatively rare, its treatment is quite difficult. Our aim is to present the outcomes and complications in patients with thoracic disk herniation treated with minimally invasive lateral transthoracic approach (LTTA). Fifty-nine consecutive patients with 69 symptomatic disk herniations that underwent minimally invasive LTTA to treat TDH between 2007 and 2016 were enrolled. Medical records were reviewed retrospectively. The numbers of TDH were as follows: 41 central, 10 paracentral, and 18 both central and paracentral...
January 8, 2019: Neurosurgical Review
Alaa Eldin Elsharkawy, Anne Hagemann, Peter Douglas Klassen
Herniated disc fragments' migration to posterior epidural locations is a very rare pathological condition, and the mechanism is not well understood. Posterior epidural migration may lead to serious neurologic problems; however, its diagnosis and treatment are challenging. We searched PubMed and Google Scholar, using various keyword combinations, and found 111 cases of posterior epidural disc migration in the lumbar region reported between 1973 and 2018. There were 89 (80.2%) men and 22 (19.8%) women. The mean age at surgery was 54...
January 6, 2019: Neurosurgical Review
Yi-Jun Kim, David J Lee, Chul-Kee Park, In Ah Kim
The effect of the extent of resection (EOR) on prognosis in glioblastoma may differ depending on various conditions. We evaluated the prognostic impact of the EOR for glioblastoma according to the tumor site, extension, and size. Data from glioblastoma patients who underwent gross total resection (GTR), subtotal resection (STR), or open biopsy between 2005 and 2014 were retrieved from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses for overall survival (OS) were performed...
January 5, 2019: Neurosurgical Review
Caroline Apra, Chloé Dumot, Pierre Bourdillon, Isabelle Pelissou-Guyotat
Surgery is the only therapeutic option for cerebral cavernous malformations (CCM) and is proposed, whenever possible, after haemorrhagic events, neurological symptoms, or epilepsy, radiosurgery being a controversial alternative in some cases. However, there is no treatment for non-accessible lesions, such as brainstem CCM, multiple CCM, or those located in functional areas. Propranolol, a non-selective beta-blocker used as first-line treatment for infantile haemangiomas, has proved spectacularly effective in a few cases of adult patients with CCM...
January 4, 2019: Neurosurgical Review
Bong Ju Moon, Doyoung Kim, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Do Heum Yoon, Yoon Ha
To compare short-term and long-term surgical outcome patterns between anterior cervical corpectomy and fusion (ACCF) and laminoplasty (LP) in patients diagnosed with cervical ossification of the posterior longitudinal ligament (OPLL) and identify factors affecting surgical outcomes based on follow-up duration. During short-term follow-up period, surgical outcomes between ACCF and LP were similar. However, there were several reports that long-term surgical outcomes were superior in the ACCF compared with LP...
January 4, 2019: Neurosurgical Review
Taichi Ishiguro, Yoshikazu Okada, Tatsuya Ishikawa, Koji Yamaguchi, Akitsugu Kawashima, Takakazu Kawamata
Table 2 of the original version of this article contained an added data. Correct Table 2 is presented here.
January 4, 2019: Neurosurgical Review
Chenyang Han, Yi Yang, Shuiliang Ruan, Li Guo, Xiaoling Zhang, Qiaobing Guan
The study was designed to investigate the predictive value of phosphorylated CAMP response element binding protein (p-CREB) level in peripheral blood on secondary cognitive impairment in patients with mild-to-moderate craniocerebral trauma. A total of 107 patients with mild-to-moderate craniocerebral trauma were selected, who were admitted to the Second Affiliated Hospital of College of Jiaxing from January 2016 to January 2017. Of them, 30 patients were diagnosed with secondary mild cognitive impairment (MCI) during follow-up, who were assigned to the experimental group...
January 4, 2019: Neurosurgical Review
Jianming Li
Traumatic injury to the spinal cord remains a catastrophic event that has lifelong consequences. While decades of research have elucidated much of the pathophysiology associated with spinal cord injury (SCI), there still remains no clinically approved treatments for restoring lost sensorimotor function. The traditional dogma suggests central nervous system (CNS) neurons do not regenerate after injury but active areas of research aim to overcome this biological bottleneck. One particular approach using low-level direct current electric fields (DC EFs) appears especially promising based on a rich set of experimental data...
January 4, 2019: Neurosurgical Review
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