World Neurosurg
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The standard of care for glioblastoma is surgical resection followed by combination temozolomide and radiation. Magnetic resonance imaging (MRI) is used preoperatively for tumor resection planning. In some instances, MRI is also obtained postoperatively to assess for any complications and to determine extent of resection. There is some question whether early routine postoperative imaging of patients after tumor resection is beneficial to long-term outcomes, especially with the increased scrutiny of increasing health care costs. ⋯ Although early postoperative MRI may not significantly affect patient overall survival from a statistical standpoint or therapeutic regimens, this type of imaging may be important to hone resident and attending skill. We encourage other institutions to perform similar analyses to determine the overall survival benefit of early postoperative imaging after glioma resection for patients with glioblastoma.
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To describe the incidence of and characterize risk factors for cerebrospinal fluid leak and symptomatic pseudomeningocele (CSFL/SP) after intradural spine surgery. ⋯ We present the largest series of intradural spine surgeries focusing specifically on the risk factors for and management of CSFL/SP. Although craniocervical junction surgery and use of external cerebrospinal fluid drain were associated with CSFL/SP, type of closure and type/number of dural substitutes were not.
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The pathophysiology of normal-pressure hydrocephalus and the correlation with its symptomatology is not well understood. ⋯ Expansion of the lateral ventricles maintained similar proportions over time, accompanied by a synchronous third ventricular expansion with less proportion and a nonsignificant fourth enlargement. Lateral ventricles enlarged most in those animals that were to develop late locomotor deterioration. Further research using this animal model combined with different radiologic imaging techniques, such as diffusion tensor imaging and perfusion studies, is recommended.