Neurosurgery
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Core Outcome Sets (COSs) are necessary to standardize reporting in research studies. This is urgently required in the field of chronic subdural hematoma (CSDH), one of the most common disease entities managed in neurosurgery and the topic of several recent trials. To complement the development of a COS, a standardized definition and baseline Data Elements (DEs) to be collected in CSDH patients, would further improve study quality and comparability in this heterogeneous population. ⋯ This Delphi survey should result in consensus on a COS and a standardized CSDH Definition and DEs to be used in future CSDH studies.
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The relationship between trans-stenotic blood flow velocity differences and the cerebral venous pressure gradient (CVPG) in transverse sinus (TS) stenosis (TSS) has not been studied. ⋯ The trans-stenotic blood flow velocity difference significantly correlates with the CVPG in TSS. As a noninvasive imaging modality, 4D flow MRI may be a suitable screening or complimentary tool to decide which TSS may benefit from invasive venous manometry.
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Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRgLITT) has been used successfully to treat epileptogenic cortical cerebral cavernous malformations (CCM). It is unclear whether MRgLITT would be as feasible or safe for deep CCMs. ⋯ MRgLITT is feasible in the treatment of symptomatic deep CCM but may carry a high risk of complications without the benefit of definitive resection. We recommend cautious patient selection, low laser power settings, and conservative temperature monitoring in surrounding brain parenchyma.
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Historical Article
Evandro Pinto da Luz de Oliveira, MD, PhD (November 8, 1945-February 11, 2021): A Giant of Microneurosurgery and Neuroanatomy.
Dr Evandro de Oliveira, one of the most acclaimed and recognized names in neurosurgery, anywhere in the world, tragically left us on February 11, 2021, at the age of 75. The Rhoton Society submits an account of Dr Evandro de Oliveira's life with highlights of his personal journey, and his special contributions to the fields of microneurosurgery and neuroanatomy.
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Stereotactic radiosurgery (SRS) is widely accepted as a minimally invasive alternative to surgery in the management of arteriovenous malformations (AVMs). Dilated AVM outflow veins or varices may be caused by high-flow or partial outflow obstruction, which may increase the risk of a hemorrhage before or after SRS. ⋯ The presence of AVM variceal venous drainage did not affect the obliteration rate and did not confer a higher risk of a subsequent hemorrhage both before and after SRS.