Journal of neurosurgery
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Journal of neurosurgery · Jan 2025
Noninvasive evaluation of the glymphatic system in diffuse gliomas using diffusion tensor image analysis along the perivascular space.
The aim of this study was to noninvasively explore the glymphatic system (GS) in glioma and its association with glioma characteristics and prognosis by using diffusion tensor image analysis along the perivascular space (ALPS). ⋯ GS function was impaired in glioma and correlated with tumor characteristics, and worse contralateral GS function was associated with a shorter survival time.
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In 1783, Alexander Monro secundus maintained that because the brain is enclosed in a case of bone and its substance is nearly incompressible, the quantity of blood within the head must be the same, or very nearly the same, at all times. Years later, this hypothesis was experimentally supported by George Kellie, and became known as the Monro-Kellie doctrine. ⋯ Yet, almost nothing has been published about some of the physiological, pathophysiological, and therapeutic ideas prevailing at that time that may have influenced Monro's hypothesis. Lastly, and perhaps most importantly, it is not clear why Monro, who knew the ventricular system in detail, did not include it as a potential compensatory compartment for changes in the intracranial blood volume.
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Journal of neurosurgery · Dec 2024
Incidence, presentation, and outcomes of intracranial hemorrhage in left ventricular assist device patients.
The objective was to evaluate the etiology, natural history, and impact of surgical intervention on outcomes of left ventricular assist device (LVAD) patients presenting with intracranial hemorrhage (ICH). ⋯ ICH as a complication of LVAD placement is increasing in frequency. GCS score on presentation best predicted mortality at 90 days. Neurosurgical intervention did not impact outcomes in the authors' study, which warrants further investigation in prospective cohorts.
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Journal of neurosurgery · Dec 2024
A spinal perimedullary arteriovenous fistula treated by Walter Dandy and illustrated by Dorcas Hager Padget in 1934.
Dorcas Hager Padget was a renowned neurosurgical illustrator and neuroembryologist. She collaborated closely with Walter E. ⋯ The illustration portrays the patient's myelopathic symptoms and pmAVF treatment by ligation and resection of a venous pouch located at the fistula site, indicating Dandy's early understanding of the lesion's architecture. Whether the illustration was created for a publication that fell to the wayside or exclusively for Dandy's patient history records remains unknown.
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Journal of neurosurgery · Dec 2024
Cognitive impacts of unilateral MR-guided focused ultrasound thalamotomy: a meta-analysis and a call for systematic neuropsychological assessment.
Pharmacoresistant tremors, often seen in Parkinson disease and essential tremor, significantly impair patient quality of life. Although deep brain stimulation has been effective, its invasive nature limits its applicability. MR-guided focused ultrasound (MRgFUS) thalamotomy offers a noninvasive alternative, but its cognitive impacts are not fully understood. This meta-analysis aimed to evaluate the cognitive and emotional effects of unilateral MRgFUS thalamotomy in patients with pharmacoresistant tremors. ⋯ Unilateral MRgFUS thalamotomy appears to be a safe procedure with respect to cognitive and emotional outcomes in patients with pharmacoresistant tremors. However, the small number of studies and the short-term nature of assessments necessitate caution. Further research, especially on long-term cognitive effects and in the context of bilateral procedures, is essential for a comprehensive understanding of MRgFUS thalamotomy's neuropsychological impact. Systematic review registration no.: CRD42023491757 (www.crd.york.ac.uk/prospero).