World Neurosurg
-
The transciliary keyhole approach has been actively employed for unruptured intracranial aneurysms in many institutions, although applying this technique to ruptured aneurysms remains controversial. We investigated risk factors related to poor surgical outcomes in ruptured aneurysms and attempted to clarify the differences between conventional craniotomy and keyhole surgery. ⋯ Because incidence of poor surgical outcome of keyhole surgery is not different from known conventional craniotomy, this approach is an acceptable treatment option in a good-grade ruptured anterior circulation aneurysm.
-
Glioblastoma, also known as glioblastoma multiforme, is the most common primary malignant cerebral tumor in adults. Although glioblastoma multiforme is one of the most aggressive tumors in the brain, propagation through the dura mater is rare. ⋯ Although the mechanism of tumor spread is unknown, we hypothesized that originally there may have been spontaneous dural defects or thinning, such as a meningoencephalocele in the middle fossa, and the tumor coincidentally occurred there.
-
The impact of obesity on spine surgery has been studied extensively, but only a few investigations have been focused on minimally invasive spinal fusion techniques and complication rates in normal-weight, preobese, or obese patients. Obesity was found to be a risk factor for intraoperative complications. Published data tend to favor minimal access surgery techniques (MAST) for obese patients. In a prospective study, we assessed the perioperative and postoperative complications of MAST in a large population of 187 patients. ⋯ We conclude that preobese and obese patients are good candidates for MAST because BMI did not affect complication rates or duration of surgery.
-
To determine prevalence of cerebrovascular abnormalities in diagnostic subgroups of spontaneous subarachnoid hemorrhage (SAH) in a regional neurosurgical center in the modern era. ⋯ Frequency of vascular abnormalities in spontaneous SAH is lower than the traditionally quoted figure, which has diagnostic and prognostic implications for patient management.
-
Gross total resection (GTR) in patients with glioblastoma (GB) and anaplastic astrocytoma (AA) is associated with improved survival. We examined how tumor location, tumor grade, and age affected this benefit. ⋯ Our results demonstrate complex interaction between tumor grade, frontal lobe location, and age in their various contributions to survival benefit gained from GTR. The greatest survival benefit of GTR relative to STR was observed in patients ≤50 years old with frontal AAs.