Neurosurgical review
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Neurosurgical review · Jan 2018
ReviewIs surgery for pineal cysts safe and effective? Short review.
In this short review, the authors performed a database search and summarize current knowledge of the management of patients with pineal cysts (PCs) and investigate the role of surgical treatment. The scientific literature on the surgical treatment of PCs is sparse and encompasses only case series with little over 200 operated patients combined. All included papers reported favorable results after pineal cyst surgery with improvement of symptoms in most patients. ⋯ Even patients with non-specific symptoms are reported to improve after surgery. However, evidence offered by this literature review is very limited and therefore our conclusions must be tempered by the restricted set of data. For ethical reasons, a randomized controlled trial is not an acceptable approach, and therefore patient registry could be a useful tool to identify a subset of symptomatic patients that might benefit from pineal cyst resection.
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Neurosurgical review · Jan 2018
Multicenter StudyThe patients' view: impact of the extent of resection, intraoperative imaging, and awake surgery on health-related quality of life in high-grade glioma patients-results of a multicenter cross-sectional study.
The objective of the present study is to assess the influence of extent of resection (EoR), use of intraoperative imaging, and awake surgery on health-related quality of life (HRQoL) in high-grade glioma (HGG) patients in a prospective multicenter study. We analyzed 170 surgeries of patients suffering from a HGG. During the first year after resection, HRQoL was evaluated using the European Organization of Research and Treatment of Cancer Core Questionnaire C30 and Brain Neoplasm 20 questionnaires. ⋯ In HGG patients, STR compared to biopsy was significantly associated with better HRQoL and fewer neurological symptoms in this series. An escalated use of intraoperative imaging increased EoR with stable or slightly better HRQoL and fewer neurological symptoms. Based on HRQoL, awake surgery was a well-tolerated and safe method in our series.
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Neurosurgical review · Jan 2018
Risk factors for neurological deficits after surgical treatment of brain arteriovenous malformations supplied by deep perforating arteries.
The treatment of brain arteriovenous malformations supplied by deep perforating arteries (PA) (P-BAVM) remains challenging. The aims of this study were to determine the outcomes after surgical treatment in patients with P-BAVMs and to identify the risk factors associated with postoperative neurological deficits. We retrospectively reviewed the medical charts and imaging records of 228 consecutive patients with BAVMs who underwent microsurgical resection of their BAVMs at Beijing Tiantan Hospital between September 2012 and March 2016. ⋯ The predominant supply of the PA (P = 0.008) was an independent risk factor for long-term neurological deficits. This study identified a high risk of surgical morbidity for P-BAVMs. The predominant supply of the PA and a shorter LFD are crucial risk factors for postoperative neurological deficits in patients with P-BAVMs.
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Neurosurgical review · Jan 2018
Sphenoorbital meningioma: surgical series and design of an intraoperative management algorithm.
Current surgical removal of sphenoorbital meningiomas (SOM) mainly aims at reduction of proptosis and restoration of visual function; some stages of the surgical technique are controversial. In this study, we aim to present a surgical decision-making algorithm for SOM. A retrospective study of 27 patients who underwent resection of SOM in our center (2005-2014) was conducted. ⋯ Preoperative visual deficit (P = 0.0001) and optic canal involvement (P = 0.04) appeared to predict postoperative improvement of visual function. Surgical complications were mainly transient cranial nerve deficits. Based on our results, we concluded that the proposed surgical algorithm leads to successful visual, cosmetic, and oncologic outcomes.