Surg Neurol
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Randomized Controlled Trial
Image-guided endoscopic evacuation of spontaneous intracerebral hemorrhage.
Spontaneous ICH is a devastating disease with high morbidity and mortality. Intracerebral hemorrhage lacks an effective medical or surgical treatment despite the acknowledged pathophysiologic benefits of achieved hemostasis and clot removal. Image-guided stereotactic endoscopic hematoma evacuation is a promising minimally invasive approach designed to limit operative injury and maximize hematoma removal. ⋯ Image-guided stereotactic endoscopic hematoma removal is a promising minimally invasive technique that is effective in immediate hematoma evacuation. This technique deserves further investigation to determine its role in ICH management.
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The purpose of the study was to evaluate the effects, frequency, and complications of repeated surgical resection for GBM relapse. ⋯ Despite inherent selection bias, this retrospective analysis suggests that repeated surgery for GBM relapse should only be considered in patients with severe symptoms and if additional salvage treatment can be administered postoperatively.
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Case Reports
Cystoperitoneal shunt as alternative treatment for a giant thoracic meningocele in a patient with neurofibromatosis.
Thoracic meningoceles are associated with neurofibromatosis 1 in 60% to 85% of all cases. Usually, these meningoceles remain asymptomatic, but back pain, headache, cough, and dyspnea are possible manifestations. Often, there is an associated kyphoscoliotic deformity of the thoracic spine. ⋯ Treatment of giant intrathoracic meningoceles in patients with progressive dyspnea can be challenging, and different options can be found in the literature. Treatment with a cystoperýtoneal shunt, as in our case, can be a less invasive alternative in patients with a high operative mortality risk. To our knowledge, this is the first report of a patient with neurofibromatosis 1 treated in this way.
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Bone morphogenic protein products enable lumber spine fusion. Few outcome studies have been performed to evaluate function and pain relief after posterior lumber decompression for degenerative disease, and few studies have provided detailed results of posterior lumbar fusion in elderly patients. This retrospective analysis presents a comprehensive examination of spinal fusion, functional outcomes, and pain relief in a growing elderly population in which a BMP was used. ⋯ The use of rhBMP-2 to augment fusion leads to satisfactory outcomes, specifically improved pain relief, function, and bone formation, in elderly patients without the use of instrumentation.