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World Neurosurgery

Zheng Wen-Jian, Li Liang-Ming, Hu Zi-Hui, Liao Wei, Lin Qi-Chang, Zhu Yong-Hua, Lin Shao-Hua
BACKGROUND: Hydrocephalus is a common complication following decompressive craniectomy (DC). Ventriculoperitoneal shunt (VPS) was required for some patients before receiving cranioplasty (CP). Presence of a VPS is regarded as a risk factor for overall CP complications. METHODS: A retrospective survey was conducted on the 176 cases of traumatic brain injury (TBI) patients who underwent late (> 3 months) titanium CP (Ti-CP) in our hospital from April 2014 to July 2018...
April 14, 2019: World Neurosurgery
Tomoki Sasagasako, Takeshi Funaki, Masahiro Tanji, Yoshiki Arakawa, Hime Suzuki, Akinori Miyakoshi, Susumu Miyamoto
BACKGROUND: While superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is a beneficial treatment for hemorrhagic moyamoya disease, indeterminate mechanisms can cause rebleeding even after successful bypass surgery. The authors describe a case with a prominent collateral from the lenticulostriate artery (LSA) causing multiple recurrent hemorrhages after successful STA-MCA anastomosis. CASE: Description: A 49-year-old Japanese woman with moyamoya disease was referred to our institution after suffering intracranial hemorrhage on two occasions...
April 14, 2019: World Neurosurgery
Georgios A Zenonos, Stephanie Chen, Samir Sur, Jacques J Morcos
The authors present a 3D surgical video of a half and half, trans-cavernous approach for microsurgical clipping of a giant basilar tip aneurysm that recurred twice after endovascular treatment. The case refers to a 60 year-old man who presented with subarachnoid hemorrhage and was treated with coiling and with a good clinical and radiographic outcome. At three months, he was found to have recurrent filling at the neck of the aneurysm, and was treated again endovascularly with stent coiling. Three months after his second treatment, he again was found to have filling of the base of the aneurysm and was referred for microsurgical clipping...
April 14, 2019: World Neurosurgery
Yagiz Yolcu, Waseem Wahood, Mohammed Ali Alvi, Panagiotis Kerezoudis, Scott H Okuno, Robert L Foote, Mohamad Bydon
INTRODUCTION: Chordomas are slow-growing but locally invasive tumors. Standard of care consists of surgical resection and radiotherapy when complete resection is not possible. Current literature has reached equivocal results with regards to the effect of adding radiotherapy on patient survival. Herein, we investigated the effect of adjuvant radiotherapy on patient survival. METHODS: The National Cancer Database was queried for patients diagnosed with sacral and vertebral column chordoma between 2004-2010...
April 14, 2019: World Neurosurgery
Guangfu Di, Xinyun Fang, Qianxin Hu, Wei Zhou, Xiaochun Jiang
OBJETIVE: The far-lateral approach (FLA) remains a challenge for neurosurgeons due to the complex anatomy of this region, especially in patients with anatomical variations. There is therefore an urgent need for better quantitative knowledge of the microsurgical anatomy of the FLA. METHODS: The study was performed using the dried skulls and atlas vertebrae of 50 Chinese adults, in which significant clinical parameters were measured. We further used twelve cadaveric heads to simulate the FLA to explore the step-by-step anatomy entailed by this procedure, enabling us to obtain key images and related information...
April 14, 2019: World Neurosurgery
Hussam Metwali, Amir Samii
OBJECTIVE: In this study, we are presenting our experience using resting state functional magnetic resonsce imaging (rs-fMRI) in preoperative planning. We performed goup analysis to demonestrate the effects of brain tumor on resting state networks (RSNs) METHODS: Thirty patients with supratentorial gliomas were included in the study. Preoperative rs-fMRI and structural MRI were performed in all cases. The rs-fMRI was preprocessed ( realignment, slice time correction, coregistration to structural images, normalization and smoothing)...
April 14, 2019: World Neurosurgery
Qifeng Li, Yalong Gao, Wenqiang Xin, Ziwei Zhou, Hongtao Rong, Yafei Qin, Ke Li, Yuan Zhou, Jiwei Wang, Jianhua Xiong, Xinlong Dong, Mengchen Yang, Yixin Liu, Jun Shen, Guangen Wang, Aiguo Song, Jianning Zhang
OBJECTIVE: The purpose of this study was to evaluate the efficacy of surgical revascularization versus conservative treatment and different surgical modalities, in order to provide evidence for the patient with MMD to choose the appropriate treatment. METHODS: We comprehensively searched PubMed, Embase, Web of Science and the Cochrane Library for the articles published regarding MMD treatment. If the I2 value, which evaluated the heterogeneity, was less than 50%, a fixed effect model was used; if not, a random effect model was applied...
April 14, 2019: World Neurosurgery
Joshua Loewenstern, William Shuman, John W Rutland, Remi A Kessler, Karan M Kohli, Melissa Umphlett, Margaret Pain, Joshua Bederson, Mary Fowkes, Raj K Shrivastava
OBJECTIVE: Atypical (WHO grade II) meningiomas (AM) are associated with a substantial risk for recurrence even following a complete, gross total resection (GTR). The present study aimed to evaluate clinical and AM tumor histopathological features that may predict risk of recurrence and survival within this patient population. METHODS: 72 consecutive patients and corresponding tumor specimens who received a primary GTR for an AM from 2007-2016 at a single institution were reviewed...
April 14, 2019: World Neurosurgery
Yuanlong Zhang, Jinsheng Huang, Chunlin Zhang, Changzhen Jiang, Chenyu Ding, Yuanxiang Lin, Xiyue Wu, Chenyang Wang, Dezhi Kang, Zhangya Lin
BACKGROUND: Chondrosarcoma is a malignant tumor that originates from mesenchymal cells that have differentiated into chondrocytes, often growing laterally, rarely seen in the cranium, and seldom seen in the saddle area. We believe that only a few cases have been reported in the literature. We report a case of pituitary fossa chondrosarcoma, which was completely resected by an extended endoscopic endonasal approach, and a literature review. CASE DESCRIPTION: A 20-year-old man was admitted to hospital with bilateral temporal headache and blurred vision, without any history of sexual dysfunction or diabetes insipidus...
April 14, 2019: World Neurosurgery
Shogo Kikuta, Joe Iwanaga, Jingo Kusukawa, R Shane Tubbs
The carotid sinus nerve branches off the glossopharyngeal nerve just after its appearance from the jugular foramen, descends along the internal carotid artery, and enters the carotid sinus. There have been many studies of the pathway and the course of the carotid sinus nerve and its communications with surrounding nerves. The intercommunication is exceedingly complicated. Acknowledgment of its anatomical diversity can be important in specific operations dealing with this area. Herein we review the anatomy, variations, pathology, and clinical applications of the carotid sinus nerve...
April 14, 2019: World Neurosurgery
Dingding Zhang, Zong Zhuang, Yongxiang Wei, Xiangyu Liu, Wei Li, Yongyue Gao, Jinsong Li, Chunhua Hang
BACKGROUND: and Purpose Serum hyperglycemia and hypophosphatemia were reported to be common in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study was aimed to explore whether admission serum glucose-phosphate ratio was associated with the severity and prognosis of aSAH. METHODS: We retrospectively analyzed 198 patients with aSAH who were admitted within 24 hours of hemorrhage occurrence to a single academic hospital from June 2016 to September 2017...
April 14, 2019: World Neurosurgery
Ramon Torné, Sergio García, Luís Sanroman, Ana Rodríguez-Hernández, Luís Reyes, Javier Tercero, Joaquim Enseñat
OBJECTIVE: To describe the technique and initial experience using a rotational 3D fluoroscopy system (O-arm, Medtronic) as intraoperative angiography (IA) in the surgery of cerebral aneurysms. METHODS: The 3D IA with O-arm (IAWOA) was performed in a consecutive cohort of patients with unruptured intracranial aneurysms. Conventional microsurgical clipping was performed with the assistance of indocyanine green videoangiography (ICGVA). Then the O-arm chasis was brought in, ipsilateral internal carotid artery was catheterized and contrasted images acquired...
April 14, 2019: World Neurosurgery
Kanako Sato, Hidenori Endo, Miki Fujimura, Toshiki Endo, Hiroaki Shimizu, Teiji Tominaga
BACKGROUND: In clipping surgery, it is advantageous to dissect an adhered artery from the aneurysmal dome to achieve complete clipping. Bypass surgery is useful to reconstruct an adhered artery when dissection of the artery is technically difficult or risky. Here, we report the effectiveness of tailor-made intracranial (IC)-IC bypass to reconstruct an adhered artery in clipping surgery for middle cerebral artery (MCA) aneurysms. PATIENTS AND METHODS: A retrospective review of 384 consecutive patients presenting with MCA aneurysms between 2008 and 2016 identified four patients who underwent an IC-IC bypass during clipping surgery for reconstruction of an adhered artery...
April 14, 2019: World Neurosurgery
Georgios A Maragkos, Abdulrahman Y Alturki, Patricia E Greenstein, Alejandro Enriquez-Marulanda, Kimberly J Kicielinski, Justin M Moore, Christopher S Ogilvy, Ajith J Thomas
This is the case of an 84-year old woman, found to have a symptomatic transverse sinus dural arteriovenous fistula. The transverse sinus was isolated from all venous circulation and its arterial feeders stemmed from the occipital artery, precluding both arterial and venous access for effective obliteration of the fistula. Therefore, the patient underwent a combined open surgical/endovascular approach, where the sinus was percutaneously cannulated through a single burr hole, allowing access for effective coiling of the fistula...
April 14, 2019: World Neurosurgery
Lastikka Markus, Oksanen Hanna, Helenius Linda, Pajulo Olli, Helenius Ilkka
OBJECTIVE: Pedicle screw instrumentation is widely used for spinal deformity correction and fusion in adolescents for idiopathic scoliosis. The goal is to achieve and sustain good alignment in all three plains. We compared two different cobalt-chromium (CoCr) rod designs with different stiffness, in regard to the coronal and sagittal balance restoration in adolescents operated for idiopathic scoliosis. MATERIAL AND METHODS: A prospective comparative study of 90 consecutive children (mean age (SD) 15...
April 14, 2019: World Neurosurgery
Zhi-Peng Xiao, Jian-Lan Zhao, Wei-Lin Rong, Jin-Wen Jiang, Mei-Hua Li
BACKGROUND: Dysfunction of endothelial cells (ECs) constitutes a critical factor in formatting intracranial aneurysms (IAs). However, little is known about the response of ECs to hemodynamic insults and its contribution to IA formation. METHODS AND MATERIAL: IAs models were constructed in both adult female New Zealand white rabbits and male Sprague-Dawley rats. Morphological changes of vessel wall were detected by HE staining. Molecular and cellular changes, including P120ctn and VE-Cadherin, in the median sagittal section of the artery bifurcation were analyzed by fluorescent staining...
April 14, 2019: World Neurosurgery
Hai Qian, Xiang'en Shi, Long Wang
Anterior inferior cerebellar artery (AICA) aneurysm is a rare cerebral entity and its presentation in association with a hyper-vascularized tumor is even more exceptional. In this study, we presented a patient with rare coexistent pathologies in combination of a cerebellar hypervascularized tumor with an outflow related AICA aneurysm. A one-stage procedure to remove both lesions was carried out following meticulous discussion with patient. Postoperative imaging demonstrated no residual of aneurysm and total resection of tumor which was pathologically diagnosed as hemangioblastoma (HB)...
April 12, 2019: World Neurosurgery
Hao Chen, Rudong Chen, Hongkuan Yang, Hua Li, Junhong Wang, Jiasheng Yu
BACKGROUND: The optimal approach of blood blister-like aneurysms (BBAs) is debated. Wrapping has been reported to be an effective strategy, but artificial materials were often used. In addition, perforator protection was difficult using this technique. In this case, we report a ruptured BBA of the left internal carotid artery (ICA) treated with a clip-reinforced wrapping technique using a Y-shaped autologous temporalis fascia to protect the posterior communicating artery (PComA). The outcome was favorable...
April 12, 2019: World Neurosurgery
Hamid Reza Niknejad, Luc Stockx, Jan Wuyts
No abstract text is available yet for this article.
April 12, 2019: World Neurosurgery
Cheat Wei Gan, Cheng-Shiu Chang, Jung-Dung Liu, Se-Yi Chen
BACKGROUND: Spontaneous spinal subdural hematoma is rare but lead to severe nerve compression. According to symptom, surgery decompression and conservative treatment are justified option. We present a spontaneous spinal SDH case treated by decompression surgery for the lumbar region, and conservative observation for the thoracic region. Series of image of the disease course are available. CASEDESCRIPTION: A 55 year-old woman, without malignancy nor coagulopathy history, presented progressive low back pain since 2 weeks ago...
April 12, 2019: World Neurosurgery
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