Neurosurgery
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The aim of the present study was to characterize the relation between quality of life (QOL) and the four major complaints (hearing loss, tinnitus, vertigo, and unsteadiness) caused by unilateral vestibular schwannomas (VS) in a cohort of well-characterized untreated patients. ⋯ Vertigo is the symptom causing the most pronounced negative effect on QOL in patients with VS. The more frequent VS symptoms, unilateral hearing loss and tinnitus, seem to be less important in the patients' perception of QOL as evaluated by the questionnaires used in this study. If vertigo could be relieved by treatment, this symptom should be a primary focus when discussing treatment options in small- to medium-sized VS.
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After excision of an arteriovenous malformation (AVM), intracerebral hemorrhage or edema can develop, most probably resulting from hyperperfusion. Changes in the perinidal cerebral microvessels probably play a role in the development of this complication but have not been well studied so far. In this study, microvascular changes associated with resection of an AVM were observed and quantified intraoperatively using orthogonal polarization spectral imaging. ⋯ With intraoperative orthogonal polarization spectral imaging, microcirculatory hemodynamic changes in the human brain can be readily observed and quantified. In AVM surgery, a dramatic increase in microvascular flow was observed in the perinidal brain tissue, which seems consistent with current hypotheses regarding normal perfusion pressure breakthrough.