Journal of neurosurgery
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Journal of neurosurgery · Mar 2020
Recurrent and persistent carpal tunnel syndrome: predicting clinical outcome of revision surgery.
The aim of this study was to evaluate the self-reported outcome of revision surgery in patients with recurrent and persistent carpal tunnel syndrome (CTS) and to identify predictors of clinical outcome of revision surgery. ⋯ This study identified total duration of symptoms, BCTQ total score at intake, and diagnosis of CRPS along with CTS as predictors of clinical outcome and confirmed that revision surgery significantly improves self-reported symptoms and function in patients with recurrent and persistent CTS. Patients with more severe CTS symptoms have greater improvement in symptoms at 6 months postoperatively than patients with less severe CTS, but 80% of patients still had residual symptoms 6 months postoperatively. These results can be used to inform both patient and surgeon to manage expectations on improvement of symptoms.
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Journal of neurosurgery · Mar 2020
Blood-brain barrier disruption in humans using an implantable ultrasound device: quantification with MR images and correlation with local acoustic pressure.
One of the goals in this study was to set up a semiautomatic method to estimate blood-brain barrier disruption obtained in patients with glioblastoma by using an implantable, unfocused, ultrasound device. Another goal was to correlate the probability of significant ultrasound-induced signal enhancement (SUISE) with local acoustic pressure in the brain. ⋯ An algorithm for evaluating blood-brain barrier disruption was validated and can be used for future clinical trials to further understand and quantify this technique in humans.Clinical trial registration no.: NCT02253212 (clinicaltrials.gov).
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Journal of neurosurgery · Mar 2020
Survival benefit of lobectomy over gross-total resection without lobectomy in cases of glioblastoma in the noneloquent area: a retrospective study.
Following resection of glioblastoma (GBM), microscopic remnants of the GBM tumor remaining in nearby tissue cause tumor recurrence more often than for other types of tumors, even after gross-total resection (GTR). Although surgical oncologists traditionally resect some of the surrounding normal tissue, whether further removal of nearby tissue may improve survival in GBM patients is unknown. In this single-center retrospective study, the authors assessed whether lobectomy confers a survival benefit over GTR without lobectomy when treating GBMs in the noneloquent area. ⋯ In cases of completely resectable, noneloquent-area GBMs, SupTR provides superior PFS and OS without negatively impacting patient performance.
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Journal of neurosurgery · Mar 2020
Case ReportsGanglion cyst of the temporomandibular joint with intradural extension: case report.
Intracranial extension of temporomandibular joint (TMJ) ganglion cysts is very rare. Two previously reported cases presented clinically due to effects on cranial nerves and had obvious association with the TMJ on imaging. To the authors' knowledge, intracranial extension of a TMJ ganglion cyst presenting with seizures and mimicking a primary brain tumor has not been previously reported. ⋯ This case highlights an unusual presentation of this rare lesion, as well as its potential for recurrence. TMJ ganglion cysts should be included in the differential diagnosis of cystic tumors involving the anterior temporal lobe, presenting with or without seizures. Focused imaging evaluation of the TMJ can be helpful to rule out the possible role of associated TMJ lesions.
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Journal of neurosurgery · Mar 2020
Successful application of stereotactic radiosurgery for multiply recurrent Rathke's cleft cysts.
Rathke's cleft cysts (RCCs) are benign lesions of the sella turcica that usually come to neurosurgical attention due to compression of the optic apparatus (OA) and headaches. Treatment options for these lesions include observation, aspiration of cyst contents, or open resection of the cyst with the cyst wall. All of these options involve the potential for cyst recurrence or enlargement. In this study the authors report on a potential new therapeutic option for RCCs, i.e., stereotactic radiosurgery (SRS). ⋯ RCCs can be a challenging clinical entity to treat, especially when they are multiply recurrent. In patients with an average of 2 previous surgeries for resection, a single SRS session prevented recurrence universally, with an average follow-up of almost 3 years. These results indicate that further investigation of the treatment of RCCs with SRS is indicated.