British Journal of Neurosurgery

No abstract text is available yet for this article.

INTRODUCTION: Paediatric brain tumours (PBT) are the most common cause of death among all childhood cancers. The neutrophil to lymphocyte ratio (NLR) has been shown to prognosticate many adult cancers. There is a paucity of literature on the NLR in PBTs. This study aims to study the link between PBTs and the NLR by comparing the preoperative serum NLR in children under 16 with brain tumours with their outcome in terms of grade of brain tumour and overall survival. METHODS: This is a retrospective case control study...

PURPOSE: Meningiomas are the most common type of primary brain tumour. Hyperostosis is commonly associated but remains incompletely understood. This study aimed to evaluate the relationship between meningioma-associated hyperostosis and other tumour variables. MATERIALS AND METHODS: We retrospectively analysed 245 patients with 263 cranial meningiomas (202 CNS WHO grade 1, 53 grade 2, and 8 grade 3) who underwent surgery over a three-year period. Meningiomas adjacent to the skull were included...

BACKGROUND: Bilateral, biventricular lesions present a challenging scenario in neurosurgery, often requiring complex surgical techniques for management. Gangliogliomas (GG), while typically indolent, can manifest as anaplastic variants (AGG), necessitating comprehensive treatment strategies. This case study explores a unique surgical approach for a patient with bilateral, intra-extraventricular lesions infiltrating the corpus callosum, highlighting the complexities of managing such cases...

OBJECTIVE: This study aimed to evaluate the demographics and outcomes of major paediatric head trauma managed in our Paediatric Intensive Care Unit (PICU) in South Wales and comparison is made with the existing published literature. DESIGN AND SETTING: A retrospective review of medical records and imaging of patients identified from the paediatric neurosurgical trauma database at University Hospital Wales (UHW) from March 2013 to July 2021. We assessed the GCS at admission, mechanism of injury, CT scan, type of surgery required and GOS after 12 months...

BACKGROUND: The guidance for clinicians on who requires further investigation when suspecting cauda equina syndrome has become clearer in England following the publication of the national recommendations. This does not have specific advice for those patients who have had recent imaging with no compression, returning to a healthcare provider with a change in symptoms. These cases can cause difficulty for clinicians with limited access to imaging who can often be reassured by previous imaging...

BACKGROUND: Cardiac myxoma is a rare, benign tumour that commonly originates in the left atrium and may lead to embolic events. Parenchymal brain metastases represent a rare neurological manifestation. While surgical intervention is commonly used, there is limited information on long-term outcomes after radiotherapy treatment. This report describes a case of successful treatment of haemorrhagic brain metastases with radiotherapy and offers a literature review of long-term results after radiotherapy treatment...

AIM: A case of Eustachian tube dysfunction following percutaneous balloon compression (PBC) of the trigeminal ganglion led us to investigate aural complications of PBC and similar procedures. We aimed to clarify both the physiological effects of compression of the trigeminal ganglion on aural function and the possibility of puncture of the Eustachian tube during placement of the needle. METHODS: We reviewed the anatomy of the Eustachian tube in relation to the foramen ovale and the aural structures supplied by the trigeminal nerve through cadaveric study...

BACKGROUND: Primary pituitary lymphoma (PPL) is a rare finding in immunocompetent patients, with only 54 patients reported to date (including ours). It presents most often with headache and hypopituitarism, with MRI findings comparable to more common pituitary tumours, making the diagnosis challenging. There is no consensus on the ideal management for these lesions with the role of surgical resection not clearly established. CASE REPORT: We present here a 49-year-old female who presented with acute vision loss and was found to have PPL of diffuse large B-cell lymphoma, non-germinal centre type...

PURPOSE: We present our analysis of the existing Paediatric High Dependency Unit (HDU) admission policy at our institution and discuss our thoughts for its revision in the context of paediatric supratentorial tumour surgery. MATERIALS AND METHODS: We screened our prospectively maintained database of all children undergoing supratentorial craniotomy for resection of paediatric brain tumours over a fifteen-year period. The post-operative course of each patient was reviewed, assessing the number of patients who had true HDU needs in the immediate post-operative period, and the relative depth of input from paediatric HDU specialists that each patient received...

No abstract text is available yet for this article.

BACKGROUND: Trigeminal neuralgia is a very painful condition that may require a surgical approach as treatment, which is typically retrosigmoid craniotomy followed by microvascular decompression. Due to the limited margin for error when operating in the small triangular window of the cerebellopontine angle and the infrequency of this condition, the operating room can present a difficult learning environment for surgical trainees. Our aim is to create a synthetic, low-cost, high-fidelity, and largely reusable simulation model that will enable neurosurgical trainees to practice these procedural steps in a safe learning environment...

OBJECTIVES: To evaluate a technique of multi-layered CSF repair following endonasal anterior skull base surgery using medpor graft. DESIGN: Retrospective review of consecutive case series from a single centre. SUBJECTS: 68 cases of repair of CSF leaks utilising medpor identified from a larger prospectively maintained database of endonasal endoscopic procedures at our centre. METHODS: Retrospective review of a database of consecutive anterior skull base cases from 2016-2022, and further data collection from electronic hospital records...

PURPOSE: The aim of this study is to investigate the clinical outcomes of transforaminal lumbar endoscopic discectomy (TLED) in patients with L5-S1 lumbar disc herniation (LDH). MATERIALS AND METHODS: Seventy-five consecutive individuals with diagnosed foraminal/extraforaminal L5-S1 LDH were included in this study. All patients underwent TLED, being subsequently evaluated in a 2-year follow-up period. Assessment was performed preoperatively and at 6 weeks and 3, 6, 12 and 24 months postoperatively...

INTRODUCTION: Intracranial aneurysms (IA) are a common complication of autosomal dominant polycystic kidney disease (ADPKD). Screening protocols that exist for IA in ADPKD patients are an important component of disease monitoring to enable appropriate preventative measures and precautions to avoid IA rupture with its associated morbidly and mortality. AIMS: The aims of this review are to analyse the different types of screening protocols that exist by referencing the lead time between IA diagnosis and rupture in ADPKD patients, the purpose and importance of screening, the types of imaging modalities used, and patient outcomes...

OBJECTIVE: Pituitary neuroendocrine tumours (PitNETs) are the second most common type of intracranial tumour. Several studies have explored the prognostic factors for PitNETs. However, prognostic factors for postoperative PitNET recurrence remain not fully understood. This study aimed to explore potential prognostic factors for PitNET recurrence, such as surrounding tissue invasion and the extent of surgical resection in patients with postoperative PitNETs. METHODS: We included 106 patients who underwent PitNET surgery between 2013 and 2018, dividing them into two groups: those with recurrence and those without recurrence...

INTRODUCTION: Parkinson's disease is a common neurodegenerative disease. With an aging population, co-existent degenerative diseases of the spine in these patients will become more prevalent. RESEARCH QUESTION: This systematic review and meta-analysis aims to establish the incidence and risk of adverse outcomes following spinal surgery in patients with Parkinson's disease. Material and Methods A literature review was carried out in order to identify studies assessing the outcomes of adult patients with Parkinson's disease undergoing spinal surgery for degenerative conditions...

BACKGROUND: The essential tremor (ET) course to 54 months post-unilateral VIM/PSA magnetic resonance-guided focused ultrasound (MRgFUS) in the treated arm (TA) and non-treated arm (NTA) of 12 patients is reported. METHODS: Tremor severity was rated using Bain Findley spirography (BFS) scores in the TA and NTA. We divided follow-up into 'Early' (0-6 months) and 'Late' (6-54 months) phases, to minimise the effect of peri-lesion oedema resolution on the latter. RESULTS: The mean baseline BFS score was 6...

BACKGROUND: Ambulatory anterior cervical discectomy and fusion (ACDF) is a promising method, but not common in Poland. OBJECTIVE: That is why the purpose of this study was to demonstrate the experience of performing ACDF in patients with degenerative spinal diseases. METHODS: This study at the Spine Centre involved a single-center, multi-surgeon evaluation of 100 patients undergoing ACDF. RESULTS: Outcomes assessed included pain severity, measured by the visual analogue scale, which improved from 4...

BACKGROUND: Cervical foraminal stenosis on MRI may be assessed using the Kim, modified Kim or Siller methods. This study aimed to investigate which morphological features of cervical foraminal stenosis in patients with cervical radiculopathy correlated best with pre-operative and post-operative surgical outcome following Anterior Cervical Discectomy (ACD) or a Posterior Cervical Foraminotomy (PCF). METHODS: Pre-operative MRIs of adults with cervical radiculopathy were assessed by six raters...