Journal of neurosurgery
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Journal of neurosurgery · Jan 2015
In vivo measurement of the frame-based application accuracy of the Neuromate neurosurgical robot.
The application accuracy of the Neuromate neurosurgical robot has been validated in vitro but has not been evaluated in vivo for deep brain stimulation (DBS) electrode implantations. The authors conducted a study to evaluate this application accuracy in routine frame-based DBS procedures, with an independent system of measurement. ⋯ The in vivo application accuracy of the Neuromate neurosurgical robot, measured with a system independent from the robot, in frame-based DBS procedures was better than 1 mm. This accuracy is at least similar to the accuracy of stereotactic frame arms and is compatible with the accuracy required in DBS procedures.
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Journal of neurosurgery · Jan 2015
Review Meta AnalysisMeningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review.
Evolving interest in meningioma, the most common primary brain tumor, has refined contemporary management of these tumors. Problematic, however, is the paucity of prospective clinical trials that provide an evidence-based algorithm for managing meningioma. This review summarizes the published literature regarding the treatment of newly diagnosed and recurrent meningioma, with an emphasis on outcomes stratified by WHO tumor grade. ⋯ However, at present, there are no completed prospective, randomized trials assessing the role of either surgery or radiation therapy. Successful completion of future studies will require a multidisciplinary effort, dissemination of the current knowledge base, improved implementation of WHO grading criteria, standardization of response criteria and other outcome end points, and concerted efforts to address weaknesses in present treatment paradigms, particularly for patients with progressive or recurrent low-grade meningioma or with high-grade meningioma. In parallel efforts, Response Assessment in Neuro-Oncology (RANO) subcommittees are developing a paper on systemic therapies for meningioma and a separate article proposing standardized end point and response criteria for meningioma.
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Journal of neurosurgery · Jan 2015
Improved preservation of function during acoustic neuroma surgery.
Restoration of cranial nerve functions during acoustic neuroma (AN) surgery is crucial for good outcome. The effects of minimizing the injury period and maximizing the recuperation period were investigated in 89 patients who consecutively underwent retrosigmoid unilateral AN surgery. ⋯ Preservation of function was significantly better for patients who received extended recuperation treatment.
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Journal of neurosurgery · Jan 2015
Nerve transfers for elbow and finger extension reconstruction in midcervical spinal cord injuries.
The objective of this study was to report the results of elbow, thumb, and finger extension reconstruction via nerve transfer in midcervical spinal cord injuries. ⋯ Nerve transfers are effective at restoring elbow, thumb, and finger extension in patients with a midcervical spinal cord injury, which occurs in the majority of patients with a peripheral type of palsy with muscle denervation in their upper limbs. Efforts should be made to perform operations in these patients within 12 months of injury.