A M M van der Stouwe, A Jameel, W Gedroyc, D Nandi, P G Bain
BACKGROUND: neurosurgical interventions such as MR-guided focused ultrasound (MRgFUS) are increasingly deployed for treatment of essential tremor. OBJECTIVE: to make recommendations for monitoring treatment effects during and after MRgFUS based on our investigation of correlations between different scales of tremor severity. METHODS: twenty-five clinical assessments were collected from thirteen patients before and after unilateral MRgFUS sequential lesioning of the thalamus and posterior subthalamic area for alleviating essential tremor...
February 20, 2023: British Journal of Neurosurgery
Radek Frič, Marton König, Bernt J Due-Tønnessen, Jon Ramm-Pettersen, Jon Berg-Johnsen
PURPOSE: Treatment of craniopharyngiomas (CP) is challenging due to their proximity to critical neural structures, risk of serious complications and impaired quality of life after treatment. Recurrences may occur many years after surgical resection. However, long-term outcome data are still scarce. The purpose of this retrospective study was therefore to assess the long-term results after treatment of patients with CP. MATERIAL AND METHOD: Patients surgically treated for a histologically verified CP at Oslo University Hospital between 1992 and 2015 and with at least a 5-year follow-up were included...
February 17, 2023: British Journal of Neurosurgery
Paul Vincent Naser, Daniel Haux-Nettesheim, Ramin Rahmanzade, Pavlina Lenga, David Reuss, Andreas W Unterberg, Christopher Beynon
Accessory nerve schwannoma is a rare entity in patients presenting with cranial nerve (CN) deficits. Most of these tumours arise from the cisternal segment of the eleventh CN and extend caudally. Herein, we report the third case of an accessory schwannoma extending cranially into the fourth ventricle. A 61-year-old female presented with a history of variable headaches. Cerebral magnetic resonance imaging (cMRI) revealed a large inhomogeneous contrast-enhancing lesion at the craniocervical junction extending through the foramen of Magendi and concomitant hydrocephalus due to obstruction of the foramina of Luschkae...
February 17, 2023: British Journal of Neurosurgery
Melinda Jiang, Antoinette Lam, Lydia Lam, Joshua Kovoor, Joshua Inglis, Sepehr Shakib, William Smith, Amal Abou-Hamden, Stephen Bacchi
PURPOSE OF THE ARTICLE: Patients with penicillin allergy labels are more likely to have postoperative wound infections. When penicillin allergy labels are interrogated, a significant number of individuals do not have penicillin allergies and may be delabeled. This study was conducted to gain preliminary evidence into the potential role of artificial intelligence in assisting with perioperative penicillin adverse reaction (AR) evaluation. MATERIAL AND METHODS: A single-centre retrospective cohort study of consecutive emergency and elective neurosurgery admissions was conducted over a two-year period...
February 16, 2023: British Journal of Neurosurgery
Patrick Holton, Ardalan Zolnourian, Diederik Bulters
Purpose : Patients with Extradural (EDH) and Acute Subdural Haematomas (ASDH) represent a subgroup of head-injured patients that gain the most from timely treatment. While treatment times for head injury overall improved since the introduction of Major Trauma Centres (MTCs), no data exists describing how the time to treatment of EDH and ASDH has changed. We, therefore, compared the evacuation of ASDH and EDH before and after the implementation of a major trauma network. Methods : Data was collected prospectively between 1 May 2006 to 31 May 2007 and 1 March 2014 to 31 March 2016...
February 7, 2023: British Journal of Neurosurgery
William K Gray, Annakan V Navaratnam, Catherine Rennie, Nigel Mendoza, Tim W R Briggs, Nick Phillips
BACKGROUND: Setting minimum annual volume thresholds for pituitary surgery in England is seen as one way of improving outcomes for patients and service efficiency. However, there are few recent studies from the UK on whether a volume-outcome effect exists, particularly in the era of endoscopic surgery. Such data are needed to allow evidence-based decision making. The aim of this study was to use administrative data to investigate volume-outcome effects for endoscopic transsphenoidal pituitary surgery in England...
February 5, 2023: British Journal of Neurosurgery
Simon Lammy, Rory Piper, Nitin Mukerji
No abstract text is available yet for this article.
February 3, 2023: British Journal of Neurosurgery
Ankita Dey, Prasanna Udupi Bidkar, Srinivasan Swaminathan, Manoranjitha Kumari M, Jerry Jame Joy, Mukilan Balasubramanian, Sakshi Bhimsaria
BACKGROUND: Goal directed fluid therapy (GDFT) may be a rational approach to adopt in neurosurgical patients, in whom intravascular volume optimization is of utmost importance. Most of the parameters used to guide GDFT are derived invasively. We postulated that the total volume of intraoperative intravenous fluid administered during elective craniotomy for supratentorial brain tumours would be comparable between two groups receiving GDFT guided either by the non-invasively derived plethysmography variability index (PVI) or by stroke volume variation (SVV)...
February 3, 2023: British Journal of Neurosurgery
Adam J Wahba, David A Cromwell, Peter J Hutchinson, Ryan K Mathew, Nick Phillips
PURPOSE: Patterns of surgical care, outcomes, and quality of care can be assessed using hospital administrative databases but this requires accurate and complete data. The aim of this study was to explore whether the quality of hospital administrative data was sufficient to assess pituitary surgery practice in England. METHODS: The study analysed Hospital Episode Statistics (HES) data from April 2013 to March 2018 on all adult patients undergoing pituitary surgery in England...
February 2, 2023: British Journal of Neurosurgery
Oliver Richards, Fozia Saeed, Christopher Derham, Atul Tyagi
PURPOSE: Craniocervical junction instability in a paediatric population presents a formidable challenge to the neurosurgeon. With a variety of anatomical variations, diminutive bony and ligamentous structures, possible superimposed syndromic abnormalities, the craniocervical junction is a technically challenging region to operate within. We aimed to review our series of patients to identify the common pathologies necessitating craniocervical fusion along with the use of intraoperative image guidance...
February 1, 2023: British Journal of Neurosurgery
Ryutaro Suzuki, Masayuki Kanamori, Ryuta Saito, Yoshiteru Shimoda, Mika Watanabe, Teiji Tominaga
BACKGROUND: T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign is a specific imaging finding of isocitrate dehydrogenase (IDH)-mutant astrocytomas. Histologically, a hypointense area on FLAIR images indicates the presence of microcysts. Here we report a case of IDH-mutant astrocytoma that shrunk spontaneously. CASE DESCRIPTION: A 26-year-old woman presented with a complaint of headache. Her magnetic resonance (MR) images revealed a lesion mass with a T2-FLAIR mismatch sign in the left frontal lobe...
February 1, 2023: British Journal of Neurosurgery
Linda D'Antona, Claudia Louise Craven, Huzaifah Haq, Lewis Thorne, Manjit Singh Matharu, Ahmed Kassem Toma, Laurence Dale Watkins
Shunted patients often complain of headaches after flights. The effect of air travel on shunt systems is unknown. We describe the case of a patient with longstanding hydrocephalus, who suffered flight-induced clinical deterioration and shunt overdrainage in two independent occasions. The patient, clinically stable for 1.5 and 5 years before each episode, reported severe headaches starting during the descent stages of the air travel. On both occasions, brain MRI imaging demonstrated pronounced ventricular size reduction...
February 2023: British Journal of Neurosurgery
Zhishuo Wei, Shalini Jose, Hussam Abou-Al-Shaar, Hansen Deng, Diego Luy, Douglas Kondziolka, Ajay Niranjan, L Dade Lunsford
PURPOSE: Eccrine gland carcinoma (EC) is a rare skin neoplasm that uncommonly spreads to the brain or pituitary gland. We describe the role of multiple stereotactic radiosurgery (SRS) procedures to manage recurrent brain metastases of this rare disease. MATERIALS AND METHODS: Retrospective chart review was completed to obtain details for this report. The study was performed under IRB study on medical record only and was exempt from patient's consent. RESULTS AND CONCLUSIONS: A 59-year-old female underwent surgical excision of a right parietal scalp EC...
January 27, 2023: British Journal of Neurosurgery
Elizabeth Vacher, Miguel Rodriguez Ruiz, Jeremy H Rees
Brain Tumour Related Epilepsy (BTRE) has a significant impact on Quality of Life with implications for driving, employment, and social activities. Management of BTRE is complex due to the higher incidence of drug resistance and the potential for interaction between anti-cancer therapy and anti-seizure medications (ASMs). Neurologists, neurosurgeons, oncologists, palliative care physicians and clinical nurse specialists treating these patients would benefit from up-to-date clinical guidelines. We aim to review the current literature and to outline specific recommendations for the optimal treatment of BTRE, encompassing both Primary Brain Tumours (PBT) and Brain Metastases (BM)...
January 24, 2023: British Journal of Neurosurgery
Peter Y M Woo, Tiffany H P Law, Kelsey K Y Lee, Joyce S W Chow, Lai-Fung Li, Sarah S N Lau, Tony K T Chan, Jason M K Ho, Michael W Y Lee, Danny T M Chan, Wai-Sang Poon
INTRODUCTION: In contrast to standard-of-care treatment of newly diagnosed glioblastoma, there is limited consensus on therapy upon disease progression. The role of resection for recurrent glioblastoma remains unclear. This study aimed to identify factors for overall survival (OS) and post-progression survival (PPS) as well as to validate an existing prediction model. METHODS: This was a multi-centre retrospective study that reviewed consecutive adult patients from 2006 to 2019 that received a repeat resection for recurrent glioblastoma...
January 18, 2023: British Journal of Neurosurgery
Nitin Mukerji
No abstract text is available yet for this article.
January 17, 2023: British Journal of Neurosurgery
Amisha Vastani, Wisam Al-Faiadh, Dan O Chieng, Ata Siddiqui, Cristina Bleil, Rahul Singh, Bassel Zebian
The massa intermedia (MI) or interthalamic adhesion (ITA) is a band of tissue connecting the medial surfaces of the thalami and is present in the majority of healthy individuals. Its enlargement as well as its absence have been associated with some pathological states.We describe the first case report of a 3-year-old child presenting with obstructive hydrocephalus in the context of an enlarged massa intermedia. The patient's symptoms abated following an endoscopic third ventriculostomy.
January 16, 2023: British Journal of Neurosurgery
Aditya M Mittal, Edward G Andrews, Kamil W Nowicki, Daniel A Wecht, Vikas Agarwal, Edward A Monaco
An arachnoid web is a pathological formation of the arachnoid membrane. It is a rare phenomenon but is known to lead to syrinx formation in the spinal cord along with pain and neurological deficits. On imaging, the 'scalpel sign' is pathognomonic for an arachnoid web. The etiology of syrinx formation from an arachnoid web is currently unknown. This report documents the only two cases of arachnoid webs with an extensive syrinx in which a likely pathophysiologic mechanism is identified. Both cases presented with motor deficits...
January 13, 2023: British Journal of Neurosurgery
Renée R Cruickshank, Vittorio M Russo, Antonino Russo
The aim is to illustrate the modified vertebroplasty technique as a fixed marker for intraoperative thoracic spine localisation. Open and minimally invasive surgery in the thoracic spine has been correlated with a disproportionately high rate of wrong-level spinal surgery in pathologies where a focal deformity or fracture is absent. Spinal markers have evolved with time, and vertebroplasty as a spinal marker was initially described in 2008. A significant disadvantage is that the cement in the vertebral body and pedicle may preclude a more extensive osteotomy or subsequent instrumentation at the level of interest...
January 12, 2023: British Journal of Neurosurgery
Melissa Lannon, Dhuha Al-Sajee, Jacqueline Bourgeois, John Sehl, Kesava Reddy, Jian-Qiang Lu
BACKGROUND: Intracranial rhabdomyosarcomas represent a rare condition, posing a diagnostic challenge to physicians. Brain intraparenchymal rhabdomyosarcomas are exceptionally rare with poorly understood pathogenesis. METHODS: Here we report the first adult case of intraparenchymal rhabdomyosarcoma (RMS) with brainstem and cranial nerve involvement. We conducted a literature search using Embase, MEDLINE, and PubMed for published cases of patients with rhabdomyosarcoma of the brain...
January 4, 2023: British Journal of Neurosurgery
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