British journal of neurosurgery
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Tumours in the petroclival region have been a challenge to neurosurgeons. We present a cohort of 24 patients with petroclival meningioma (PCM) and trigeminal schwannoma (TS) in the petroclival region with extension to the middle fossa which were removed with the temporal base intradural transpetrosal (TBIT) approach. ⋯ Surgical strategy for PCM and TS in the petroclival region should be tailored to individual patients. The TBIT approach may improve the exposure of tumours in the petroclival region. A clear description of the 'safe area of intradural petrosectomy' appears to decrease the risk associated with petrosectomy procedure in the TBIT approach.
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We report two cases of cervical spondylotic myelopathy (CSM) with extensive T2-weighted intramedullary changes noted on preoperative imaging extending far beyond the level of compression. A delayed resolution 2 years after cervical oblique corpectomy was noted in both cases. This short report cautions against diagnosing this unusual magnetic resonance imaging (MRI) finding as an intramedullary tumour, demyelination or an inflammatory process.
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The complication of hardware infection related to deep brain stimulator implantation (or revision) varies between 0 and 15.2% in the literature. However, no national guidelines exist at present to define an average or acceptable rate of infection associated with, nor the preferred antibiotic prophylaxis required for, this procedure. The aim of this study was to examine the effect of changing the antibiotic prophylaxis regimen used in a single neurosurgical centre on the incidence and outcome of hardware infection. ⋯ The infection rate over 2 years in the prospective group for DBS surgery was 0 compared to 1 (5.6%) in the historical cohort (p = 0.11, χ(2)); the infection rate for IPG replacements was 1(3.6%) in the prospective cohort, versus 3 (17.6%) in the historical (p = 0.44, χ(2)). In this article, we have also systematically reviewed the literature to date and derived an average infection rate of 4.7% (PI 0.9-22%, Random Effects Meta-analysis, Stata) for 35 studies comprising 3550 patients. There is no significant difference in infection rates between DBS procedures that are primarily internalised (n = 9) compared to those in which there is a period of electrode externalisation (n = 23) (p = 0.9, Meta-regression analysis, Stata).
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To assess the diagnostic value of T2 star-weighted angiography (SWAN) sequence for diffuse axonal injury (DAI) by virtue of correlation analysis between the number, volume and regional distribution of haemorrhagic lesions determined with SWAN sequence and clinical variables. ⋯ More accurate and objective assessment of injury can be obtained in DAI patients via SWAN sequence.