World Neurosurg
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Complex skull base approaches are often used to treat lesions within the middle incisural space; yet the well-known retrosigmoid route may provide an effective avenue to this difficult-to-reach region. The purpose of this study was to quantify the exposure advantages on the middle incisural space provided by cutting of the tentorium cerebelli via a standard suboccipital retrosigmoid approach (i.e., via the cerebellopontine cistern route). Also, 2 illustrative cases are presented. ⋯ Tentorial incision may be useful to extend the rostral exposure of the middle incisural space via a simple retrosigmoid approach, avoiding the need for more complex skull base routes.
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Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the posterior tibial nerve in the tarsal tunnel. It is not known whether vascular or neuropathic factors are implicated in the cause of a cold sensation experienced by patients. Therefore, we studied the cold sensation in the pedal extremities of patients who did or did not undergo TTS surgery. ⋯ Our findings suggest that the cold sensation in the feet of our patients with TTS was associated with neuropathic rather than vascular factors.
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Visual loss can be encountered in the immediate, early, or even delayed postoperative period after resection of skull base meningiomas involving the optic apparatus. Various mechanisms for visual loss can include mechanical injury, vascular insult, optic nerve and chiasm edema, and vasospasm of the blood supply to the visual apparatus. ⋯ To our knowledge, this is the first report of successful reversal of postoperative unilateral visual loss related to vasospasm after resection of a skull base sphenoclinoidocavernous meningioma. This may be a useful strategy to diagnose and treat possible vasospasm-induced visual loss after resection of skull base meningiomas involving the optic apparatus.
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Recent decades have seen a rapid expansion of involvement of medical students in biomedical research during medical school training. Research within medical school has been shown to influence medical students with regard to medical knowledge, career development, and residency specialty choice. The objective of this study was to evaluate the impact of neurosurgery medical student research grants on neurosurgery residency choice and provide an insight on the demographics of grant awardees. ⋯ Neurosurgery grants for medical students are highly successful in producing future neurosurgeons with >50% of grant recipients matched into neurosurgery. Women are underrepresented in neurosurgery grants and neurosurgery residency programs. This situation can be improved by providing insight about the field early in medical school, perhaps through increased use of neurosurgery medical student grants.
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Cerebellar stroke causes major morbidity in the aging population. Guidelines from the American Stroke Association recommend emergent decompression in patients who have brainstem compression, hydrocephalus, or clinical deterioration. The objective of this study was to determine 30-day and 1-year mortality rates in patients >60 years old undergoing emergent posterior fossa decompression. ⋯ Increasing age and smaller craniectomy size were significantly associated with mortality in patients undergoing emergent posterior fossa decompression. Among patients ≥80 years old, one-quarter were dead within 1 month of the operation, and more than two-thirds were dead within 1 year.