World Neurosurg
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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.
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Early decompression craniectomy (within 48 hours of stroke onset) in acute and malignant middle cerebral artery (MCA) ischemic stroke (IS) reduces mortality and increases the proportion of patients with favorable functional outcome. Various cultural and social issues among Asians lead to some differences in clinical practice, especially when surgical interventions are involved. Accordingly, decompressive craniectomy in Asian patients with stroke is often delayed. ⋯ Early decompression craniectomy, especially in right MCA ischemic stroke, is associated with better favorable functional outcome.
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Comparative Study
Comparison of Single-Level and Multilevel Decompressive Laminectomy for Multilevel Lumbar Spinal Stenosis.
This study aimed to clarify whether multiple compressions of nerve roots resulted in poorer surgical outcome when patients were treated with single-level decompressive laminectomy or multilevel decompressive laminectomy. To reach this we compared preoperative and postoperative Oswestry Disability Index (ODI) scores, Visual Analogue Scale (VAS) scores, and walking duration of multilevel lumbar spinal stenosis (LSS) patients treated with single-level and multilevel decompressive laminectomy. ⋯ Recovery in terms of ODI scores, VAS scores, and walking duration was better in LSS patients undergoing single-level laminectomy than in those undergoing multilevel laminectomy. Also, the rates of operative complications and postoperative follow-up spondylolisthesis were higher in patients treated with multilevel laminectomy.
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The literature on multiple intracranial aneurysms (MIA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) focuses largely on risk factor analysis and consists essentially of retrospective cohort studies of limited sample size, or studies in populations outside Europe and North America. The purpose of this cohort study was to identify predictors for aneurysm multiplicity and to investigate the anatomic distribution of MIA in a representative Western cohort of patients with aSAH. ⋯ In patients with aSAH, the location of the ruptured index aneurysm is correlated with the probability of finding bystander aneurysms, and is predictive of the sites at which bystander aneurysms are most likely to be found.
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The persistence of synchondrosis in adulthood can confound diagnostic decisions made during patient management. ⋯ The localization and level of the remnant of the dentocentral synchondrosis are extremely important from the clinical viewpoint because of odontoid and C2 fractures. Neurosurgeons should thus be aware of the possible presence of a persistent (remnant) C2 dentocentral synchondrosis in adult subjects in order to avoid misdiagnosis with C2 fracture.