Journal of neurosurgery
-
Journal of neurosurgery · Sep 2020
Identification of tumor stem-like cells in admanatimomatous craniopharyngioma and determination of these cells' pathological significance.
Nuclear β-catenin, a hallmark of active canonical Wnt signaling, can be histologically detected in a subset of cells and cell clusters in up to 94% of adamantinomatous craniopharyngioma (ACP) samples. However, it is unclear whether nuclear β-catenin-containing cells within human ACPs possess the characteristics of tumor stem cells, and it is unknown what role these cells have in ACP. ⋯ These results indicate that CSLCs play an important role in ACP development, calcification, and cystic degeneration.
-
Journal of neurosurgery · Sep 2020
Resection of tumors within the primary motor cortex using high-frequency stimulation: oncological and functional efficiency of this versatile approach based on clinical conditions.
Brain mapping techniques allow one to effectively approach tumors involving the primary motor cortex (M1). Tumor resectability and maintenance of patient integrity depend on the ability to successfully identify motor tracts during resection by choosing the most appropriate neurophysiological paradigm for motor mapping. Mapping with a high-frequency (HF) stimulation technique has emerged as the most efficient tool to identify motor tracts because of its versatility in different clinical settings. At present, few data are available on the use of HF for removal of tumors predominantly involving M1. ⋯ Resection of M1 tumors is feasible and safe. By adapting the stimulation paradigm and probe appropriately to the clinical context, the best resection and functional results can be achieved.
-
Journal of neurosurgery · Sep 2020
Presence of Propionibacterium acnes in patients with aseptic bone graft resorption after cranioplasty: preliminary evidence for low-grade infection.
Autologous bone graft reimplantation remains the standard treatment after decompressive hemicraniectomy. Unfortunately, some patients present with signs of bone resorption without any visible signs of infection; the reasons remain unknown. Contamination with Propionibacterium acnes has been discussed as a potential source of the osteolytic process. The aim of this study was to investigate the microbial spectrum detected in samples of grafts from patients with aseptic bone resorption and compare them to septic bone graft infections in order to identify P. acnes as the specific pathogen of aseptic bone resorption. ⋯ Aseptic bone resorption may be caused by low-grade infections with P. acnes. However, further analysis needs to be conducted in order to understand its clinical relevance and treatment perspective.
-
Journal of neurosurgery · Sep 2020
Costs and predictors of 30-day readmissions after craniotomy for traumatic brain injury: a nationwide analysis.
There is increasing interest in the use of 30-day readmission (30dRA) as a quality metric to represent hospital and provider performance. Data regarding the incidence and risk factors for 30dRA after traumatic brain injury (TBI) are sparse. The authors sought to characterize these variables using a national database. ⋯ The incidence of 30dRA after craniotomy for TBI decreased slightly from 2010 to 2014. This study identified several variables associated with 30dRA that require confirmation in a prospective study, which could direct attempts to prevent readmissions.
-
Journal of neurosurgery · Sep 2020
Assessment of tissue permeability by early CT perfusion as a surrogate parameter for early brain injury after subarachnoid hemorrhage.
The severity of early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) correlates with delayed cerebral ischemia (DCI) and outcome. A disruption of the blood-brain barrier is part of EBI pathophysiology. The aim of this study was to assess tissue permeability (PMB) by CT perfusion (CTP) in the acute phase after aSAH and its impact on DCI and outcome. ⋯ Changes in PMB can be detected by early CTP after aSAH, which correlates with DCI. Future studies are needed to evaluate the time course of PMB changes and their interaction with therapeutic measures.