World Neurosurg
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Extended margin tumor resection beyond the abnormal area detected by magnetic resonance imaging, defined as supratotal resection, could improve the outcomes of patients with lower grade gliomas (LGGs). The aim of the present study was to assess the surgical outcomes of awake brain mapping to achieve supratotal resection with determination of the normal brain tissue boundaries beyond the tumor of frontal LGGs, in both dominant and nondominant hemispheres. ⋯ The results of the present study have provided evidence that awake mapping can enable the preservation of higher neurocognitive function, including working memory and spatial cognition in patients with nondominant right frontal tumors. Despite the small number of cases, our findings suggest the surgical benefit of awake surgery for supratotal resection of diffuse frontal LGGs.
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Rosette-forming glioneuronal tumor has recently been included in the World Health Organization classification as a low-grade tumor. It usually occurs in young adults, arising from the fourth ventricular region. ⋯ Surgical total resection was performed, and histopathologic examination made the diagnosis, showing a biphasic neurocytic and glial tumor with neurocytic rosettes. Six months after surgery, the patient had fully recovered.
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To identify risk factors that are predictive of nonhome discharge after elective posterior cervical fusion. ⋯ Early identification of patients who are at high risk for nonhome discharge is important to implement early comprehensive discharge planning protocols and minimize hospital-acquired conditions related to prolonged length of stay and associated health care costs.
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Traumatic brain injury (TBI) is a devastating neurologic injury and remains a major cause of death in the world. Secondary injury after TBI is associated with long-term disability in patients with TBI. This study evaluated adrenomedullin (AM) on secondary injury and neurologic functional outcome in rats after TBI. ⋯ AM can improve neurologic function and ameliorate brain injury in rats with TBI. AM exerts its neuroprotective effect via its anti-inflammatory and antiapoptotic effect.
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The mechanical alteration in the adolescent/pediatric cervical spine after spinal fusion remains unknown. The purpose of this study was to investigate morphologic changes in the cervical spine in adolescent/pediatric patients who underwent spinal fusion. ⋯ Cervical kyphosis correction using posterior instrumentation combined with endplate destruction by anterior bone grafting is a risk factor for atrophic morphologic changes in the vertebral body in adolescent/pediatric patients. Endplate destruction and instrumentation-induced stress shielding could alter bone remodeling.