Neurosurgery
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Identifying which factors influence treatment costs of transsphenoidal surgery for removal of sellar lesions can be complex. ⋯ Most patients undergoing transsphenoidal surgery for sellar tumors experience stable or improved postoperative quality of life, even shortly after surgery. Factors associated with increased costs of surgery included larger tumor size and in-hospital complications. Using these data, further study can be directed at determining which interventions may improve the value of transsphenoidal surgery.
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Multicenter Study
Cervical Alignment Changes in Patients Developing Proximal Junctional Kyphosis Following Surgical Correction of Adult Spinal Deformity.
Proximal junctional kyphosis (PJK) following adult spinal deformity (ASD) surgery is a well-documented complication, but associations between radiographic PJK and cervical malalignment onset remain unexplored. ⋯ Patients who develop PJK following surgical correction of ASD have a 15% incidence of development of new-onset CD. Patients developing PJK following surgical correction of ASD tend to have an increased preoperative T1 slope. Increased progression of C2-T3 Cobb angle and C2-T3 SVA are associated with development of PJK following surgical correction of thoracolumbar deformity.
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Interictal epileptiform discharges are an important biomarker for localization of focal epilepsy, especially in patients who undergo chronic intracranial monitoring. Manual detection of these pathophysiological events is cumbersome, but is still superior to current rule-based approaches in most automated algorithms. ⋯ Unsupervised learning offers a powerful approach towards automated identification of recurrent pathological neurophysiological signals, which may have important implications for precise, quantitative, and individualized evaluation of focal epilepsy.
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Navigated transcranial magnetic stimulation (nTMS) enables preoperative mapping of the motor cortex (M1). The combination of nTMS with diffusion tensor imaging fiber tracking (DTI-FT) of the corticospinal tract (CST) has been described; however, its impact on surgery of motor-eloquent lesions has not been addressed. ⋯ nTMS-based mapping enables a tailored surgical approach for motor-eloquent lesions. It may improve the risk/benefit analysis, EOR and outcome, particularly when nTMS-based DTI-FT is performed.
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Case Reports
Endovascular Treatment of Posterior Cerebral Artery Aneurysms With Flow Diversion: Case Series and Systematic Review.
Flow diversion of posterior cerebral artery (PCA) aneurysms has not been widely reported, possibly owing to concerns regarding parent vessel size and branch vessel coverage. ⋯ The safety and effectiveness profile of flow diverter treatment of PCA aneurysms may be acceptable in select cases.