World Neurosurg
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Although many studies have investigated functional localization by electrical stimulation, the threshold to identify each area remains controversial. The present study aimed to elucidate the threshold of a cortical stimulation for functional mapping. ⋯ Positive and sensory effects are induced by lower intensities than negative and motor responses, respectively. The present results provide not only a practical guide for functional mapping, but also a hierarchal concept of processing in the brain.
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Older patients are increasingly presenting for surgery with intracranial meningioma because of progress with diagnostic imaging and longer life expectancy. However, older patients have many problems, such as comorbidities and reduced physiological capacity reflected in the frailty index. This study examines the factors affecting clinical deterioration after surgery in older patients, particularly factors associated with frailty. ⋯ Skull base tumor location and serum albumin correlated with deterioration of clinical status after surgery.
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Multicenter Study
Traumatic Posterior Fossa Subdural Hemorrhage: A Multicenter, Retrospective Cohort Study.
Traumatic posterior fossa subdural hemorrhage (SDH) is a rare subtype of subdural hemorrhage in head injuries. Existing data on its pathophysiology and outcome are currently limited; therefore, the condition is not yet fully understood. The present study aimed to determine the incidence, outcome, and prognostic factors for traumatic posterior fossa SDH. ⋯ Traumatic posterior fossa SDH was extremely rare in our data set. Mortality correlated with the size of the SDH, GCS score on admission, and the presence of a skull fracture.
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The incidental dural tear is a common complication in lumbar spine surgery. It has been reported that the incidence of dural tears is much greater in endoscopic procedures. Primary closure via suturing remains challenging in endoscopic procedures. The objective of this study was to conduct a literature review on the surgical technique for dural closure and repair in endoscopic spine surgery. ⋯ An autologous muscle or fat graft in combination with fibrin glue or a fibrin-sealed collagen sponge seems to be a good and safe method for the management of dural tear in lumbar endoscopic spine surgery.
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Case Reports
Minor trauma in ankylosing spondylitis causing combined cervical spine fracture and oesophageal injury.
We illustrate the case of an unstable fracture of the cervical spine in ankylosing spondylitis with associated esophageal injury after minor trauma. ⋯ This case demonstrates the severity of injury after minor trauma in the context of ankylosing spondylitis, the capacity for full recovery in esophageal perforations in spinal trauma, and that clinical suspicion of such injuries allows early diagnosis, treatment, and reduced complications.