World Neurosurg
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To assess outcomes and complications of stereotactic radiosurgery treatment for trigeminal schwannoma (TS). ⋯ GKRS provides effective control for most TS. Increased margin doses are associated with tumor expansion, which was a poor prognostic event associated with progression and clinical decline. Based on these results, combined with analysis of available data from other series of TS treated with GKRS, we believe that margin dose between 13 and 14 Gy offers a high probability of tumor control, yet minimizing risk of adverse radiation effects.
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Indirect revascularization is simple and safe, but it is not commonly used in adult moyamoya disease owing to its unreliable effect. This prospective study aimed to evaluate the effectiveness of indirect revascularization in treating adult moyamoya disease after refinement of the surgical technique and perioperative care. ⋯ With refinements of surgical techniques and perioperative care, indirect revascularization is more reliable and can be a viable alternative treatment for adult moyamoya disease. In our cohort, outcomes were satisfactory, with mean 38.6-month follow-up.
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Innovative techniques have revolutionized minimally invasive surgeries, which has significant benefits for the patients. Despite the benefits, these advancements require a longer learning curve for an inexperienced surgeon. ⋯ How to stay out of trouble is explained with these surgeries. These techniques will help young surgeons to become proficient and achieve better outcome.
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Multicenter Study
Effect of Advanced Age on Stereotactic Radiosurgery Outcomes for Brain Arteriovenous Malformations: A Multicenter Matched Cohort Study.
The effect of age on adult brain arteriovenous malformation (AVM) outcomes after stereotactic radiosurgery (SRS) remains unclear. The aim of this study is to compare AVM outcomes between elderly (age ≥60 years) and nonelderly adult patients. ⋯ Advanced age does not seem to significantly affect obliteration or complication rates after SRS for AVMs. Although the decision to recommend intervention for AVMs in the elderly population is multifactorial, SRS may be a viable modality when treatment is deemed appropriate.
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Endoscopic endonasal transsphenoidal surgery (EETS) is a common treatment for patients with pituitary adenomas (PAs). A disadvantage of endoscopic surgery has been the lack of stereoscopic vision and depth perception. Recent developments offer high-definition 3-dimensional (3D-HD) visualization with a higher resolution and better image quality compared with 3D standard endoscopy (3D-SD). In this study, we compared treatment results of surgically treated patients with PAs using 3 different visualization systems: 2-dimensional (2D)-HD, 3D-SD, and 3D-HD. ⋯ Although the resection rate was higher in the 3D-HD group, and subjective advantages of the 3D-HD endoscopes were noted, there were no significant differences in terms of gross total resection or new hormonal deficits among the 3 groups.