Journal of neurosurgery
-
Journal of neurosurgery · May 2024
The Device for Intraventricular Entry guide: a novel solution to a perpetual problem.
The authors designed a low-profile device for reliable ventricular access and prospectively studied its safety, efficacy, and accuracy at a large academic center. ⋯ This single-center prospective study investigated the safety and efficacy of DIVE-assisted ventricular access. In total, 100% of procedures had successful ventricular cannulation, with 92% achieving Kakarla grade 1, with an average of 1.06 passes without any clinical complications.
-
Journal of neurosurgery · May 2024
A novel high-precision fiber tractography for nuclear localization in transcranial magnetic resonance-guided focused ultrasound surgery: a pilot study.
In transcranial MR-guided focused ultrasound (TcMRgFUS), fiber tractography using diffusion tensor imaging (DTI) has been proposed as a direct method to identify the ventral intermediate nucleus (Vim), the ventral caudal nucleus (Vc), and the pyramidal tract (PT). However, the limitations of the DTI algorithm affect the accuracy of visualizing anatomical structures due to its low-quality fiber tractography, whereas the application of the generalized q-sampling imaging (GQI) algorithm enables the visualization of high-quality fiber tracts, offering detailed insights into the spatial distribution of motor cortex fibers. This retrospective study aimed to investigate the usefulness of high-precision fiber tractography using the GQI algorithm as a planning image in TcMRgFUS to achieve favorable clinical outcomes. ⋯ This pilot study suggests that incorporating the high-precision GQI algorithm for fiber tractography as a planning imaging technique for TcMRgFUS has the potential to enhance targeting precision and achieve favorable clinical outcomes.
-
Management of olfactory groove meningiomas (OGMs) has changed significantly with the advances in extended endoscopic endonasal approaches (EEAs), which is an excellent approach for patients with anosmia since it allows early devascularization and minimizes retraction on the frontal lobes. Craniotomy is best suited for preservation of olfaction. However, not infrequently, a tumor presents after extending outside the reach of an EEA and a solely transcranial approach would require manipulation and retraction of the frontal lobes. These OGMs may best be treated by a staged EEA-craniotomy approach. In this study the authors' goal was to present their case series of patients with OGMs treated with their surgical approach algorithm. ⋯ A staged approach for the management of large OGMs with associated anosmia and significant lateral extension is a safe and effective option for surgical management. Through utilization of the described algorithm, the authors achieved a high rate of GTR, and this strategy may be considered for large OGMs.
-
Journal of neurosurgery · May 2024
Flexible in-cavity MRI receiving coil for ultra-high-resolution imaging of the pituitary gland.
The objective of this study was the preclinical design and construction of a flexible intrasphenoid coil aiming for submillimeter resolution of the human pituitary gland. ⋯ A transnasal radiofrequency coil feasibly provides a 17-fold boost in the SNR at 3 T. The ability to safely improve the quality of pituitary imaging may be helpful in the identification and subsequent resection of small functional pituitary lesions.