Neurosurgery
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Review
Central Nervous System Plasticity Influences Language and Cognitive Recovery in Adult Glioma.
Gliomas exist within the framework of complex neuronal circuitry in which network dynamics influence both tumor biology and cognition. The generalized impairment of cognition or loss of language function is a common occurrence for glioma patients. ⋯ Although the propensity of gliomas to infiltrate cortical and subcortical structures and disrupt key anatomic language pathways is well documented, there is new evidence offering insight into the network and cellular mechanisms underpinning glioma-related aphasia and aphasia recovery. In this review, we will outline the current understanding of the mechanisms of cognitive dysfunction and recovery, using aphasia as an illustrative model.
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Randomized Controlled Trial
A Crowdsourced Consensus on Supratotal Resection Versus Gross Total Resection for Anatomically Distinct Primary Glioblastoma.
Gross total resection (GTR) of contrast-enhancing tumor is associated with increased survival in primary glioblastoma. Recently, there has been increasing interest in performing supratotal resections (SpTRs) for glioblastoma. ⋯ We established a consensus definition for SpTR of glioblastoma and identified anatomically distinct locations deemed most amenable to SpTR. These results may be used to plan prospective trials investigating the potential clinical utility of SpTR for glioblastoma.
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Multicenter Study
Microvascular Decompression for Trigeminal Neuralgia: A Prospective, Multicenter Study.
Microvascular decompression (MVD) is the most effective procedure for the long-term management of trigeminal neuralgia (TGN). However, retrospective and single-center studies are inherently biased, and there are currently no prospective, multicenter studies. ⋯ In the hands of experienced neurosurgeons, MVD for TGN can achieve high long-term curative effects. In addition, complications are uncommon and usually transient. Our results indicate that MVD is an effective and safe treatment for patients with TGN, including elderly patients.
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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.