World Neurosurg
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To compare facial pain outcomes from different surgical techniques for patients with idiopathic trigeminal neuralgia (TN) who continue to have persistent or recurrent TN despite multiple operations. ⋯ Although no procedure is best for all patients, PFE gives the operating surgeon the option of performing either a nondestructive (microvascular decompression) or destructive (partial sensory rhizotomy) procedure and is associated with better facial pain outcomes for this difficult patient group.
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Anterior instrumentation has been used for surgical treatment of spinal tuberculosis, but there are different regimens of antituberculous chemotherapy used in combination with surgical intervention. The objective of this prospective study was to determine the efficacy of an antituberculous chemotherapy regimen by following a series of patients with spinal tuberculosis, for a minimum of 3 years, who underwent single-stage anterior radical debridement, autogenous bone grafting, and instrumentation. ⋯ In conclusion, postoperative chemotherapy with the 9-month three-drug regimen of isoniazid, rifampicin, and ethambutol is effective when combined with surgical treatment of spinal tuberculosis using single-stage anterior autogenous bone grafting and instrumentation.
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Molecular imaging is a field born out of the happy marriage of molecular biology and radiology. The first installment of this two-part series on molecular imaging demonstrated basic principles for practitioners in the field of the neurosciences. ⋯ The fields of functional neurosurgery including the treatment of neuropsychiatric disorders, novel treatments and imaging of tumors, neuroregenerative medicine, and nanotechnology in vascular disorders are covered. Finally, we give some parting thoughts on the future of molecular imaging, including advances in the imaging of neurodegenerative disorders.
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Case Reports
Awake craniotomy, electrophysiologic mapping, and tumor resection with high-field intraoperative MRI.
Awake craniotomy and electrophysiologic mapping (EPM) is an established technique to facilitate the resection of near eloquent cortex. Intraoperative magnetic resonance imaging (iMRI) is increasingly used to aid in the resection of intracranial lesions. Standard draping protocols in high-field iMRI units make awake craniotomies challenging, and only two groups have previously reported combined EPM and high-field iMRI. ⋯ Standard protocols for positioning and draping in high-field iMRI units make awake craniotomies problematic. This straightforward technique for combined awake EPM and iMRI may facilitate safe removal of large lesions in eloquent cortex.
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Early detection of vasospasm is essential for the treatment of delayed ischemic neurological deficits in subarachnoid hemorrhage (SAH). We evaluated cerebral blood oxygenation (CBO) changes after SAH employing quantitative time-resolved near-infrared spectroscopy (TR-NIRS) for this purpose. ⋯ TR-NIRS detected vasospasm by evaluating the CBO in the cortex and may be more sensitive than TCD, which assesses the blood flow velocity in the M1 portion. The cerebral oxygen metabolism in SAH might be reduced by brain damage due to aneurysmal rupture.