World Neurosurg
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To explore quantitatively and qualitatively how the number of gradient directions (NGD) and spatial resolution (SR) affect diffusion tensor imaging (DTI) tractography in patients planned for brain tumor surgery, using routine clinical magnetic resonance imaging protocols. ⋯ This study indicates that, under time constraints of clinical imaging, a higher number of diffusion gradients is more important than spatial resolution for superior DTI probabilistic tractography in patients undergoing brain tumor surgery.
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Case Reports
Was Cavum Septum Pellucidum the cause of intractable seizure in this 17 years old boy with Wilson's disease?
Cavum septum pellucidum (CSP), which is often found incidentally in a few populations, occasionally becomes symptomatic if enlarged significantly. Wilson disease (WD) is an uncommon autosomal recessive inborn defect in copper metabolism characterized by abnormal accumulation of copper in various tissues, particularly in the liver and the brain. Seizure disorder, although rare both in CSP and WD, may happen in a few patients with either of the conditions. ⋯ Symptomatic CSP is a rare disorder, but the coexistence of WD is even rarer. Endoscopic cyst fenestration is a novel procedure that can be successful in properly selected cases. To the best of our knowledge, CSP associated with WD has not been reported in any English literature. We present this case for its rarity along with a relevant literature review.
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Surgical treatment of spinal tumors regularly includes spinal instrumentation with pedicle screws. Most modern pedicle screws are made of titanium alloy, which is associated with artifacts on postoperative imaging such as computed tomography and/or magnetic resonance imaging. These artifacts hamper radiation treatment planning and execution and follow-up imaging. Recently, carbon fiber-reinforced polyetheretherketone (CFRP) implants became available for posterior instrumentation with the aim to reduce imaging artifacts by implants. ⋯ Carbon fiber-reinforced PEEK pedicle screws reduce image artifacts on computed tomography and magnetic resonance imaging. Thereby, they are a valuable and feasible option for spinal instrumentations in patients harboring spinal tumors where postoperative imaging and radiation therapy planning are necessary and might be crucial for long-term outcome and overall survival.
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The supracerebellar infratentorial (SCIT) paramedian approach in sitting position represents one of the most used surgical routes for dealing with pineal region lesions. The purpose of this study is to determine the cornerstones to perform this approach in a simple, safe, and effective way, so that it could be easily reproduced in other neurosurgical centers, particularly in those with modest resources. ⋯ A correct application of microsurgical principles may allow to safely and rapidly perform the SCIT approach, therefore offering an effective and relatively atraumatic route for dealing with pineal region lesions.
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Case Reports
Cervical burst fracture in a patient with contiguous two-level cervical stand-alone cages: A case report.
Cervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multilevel ACDF has remained controversial. This report discusses a burst fracture seen as a complication in multilevel cervical stand-alone cage use. ⋯ This case suggests that use of cervical stand-alone cages in contiguous levels may cause late complications despite good instrumentation and illustrates the need for more careful consideration of technique selection in multilevel ACDF.