World Neurosurg
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Tracheostomy has proven benefits for patients requiring prolonged mechanical ventilation. However, whether early tracheostomy (ET; <10 days after injury) can also improve outcomes in patients with severe traumatic brain injury (TBI) (Glasgow Coma Scale score ≤8) remains controversial. The aim of this study was to clarify this question. ⋯ The available evidence suggests that ET may reduce the length of ICU and hospital stays, duration of mechanical ventilation, and incidence of pneumonia in patients with severe TBI. Well-designed randomized controlled trials are needed to confirm these findings.
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Liponeurocytoma is a very rare tumor classified as grade II (neuronal and mixed neuronal-glial tumors) according to 2016 World Health Organization classification of tumors of the central nervous system. The median age at detection is 50 years, and the most frequent location is the posterior cranial fossa, especially within the cerebellar hemispheres; liponeurocytomas arising in the cerebellopontine angle (CPA) are exceptional. ⋯ To the best of our knowledge, 59 cases of cerebellar liponeurocytomas have been reported to date, which include only 6 cases of CPA liponeurocytomas. Treatment relies on total removal whenever possible, with an excellent prognosis, but a high MIB-1 index (>10%) and/or incomplete tumor resection are the main adverse prognostic factors.
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To analyze the differences in tumor progression patterns and histopathologic characteristics between skull base meningiomas (SBMs) and non-skull base meningiomas (NSBMs). ⋯ There is a divergent tumor progression pattern for surgically treated SBMs vis-à-vis NSBMs. Differences in tumor biology and the proportion of Simpson grade I resections are likely attributable factors.
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Laser therapy has become an appealing treatment modality in neurosurgery. In this review, we report on the history, physics, surgical steps, indications and uses, and complications that have been reported to date. ⋯ With the advent of real-time monitoring and damage estimation, LITT has gained ground in the management of intracranial tumors. Larger scale trials must be performed to develop standard protocols to define specific indications for use. Further large clinical studies for LITT in non-oncologic cases are also of interest.
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To investigate the carotid atherosclerotic plaque features in patients with acute ischemic stroke. ⋯ Higher carotid atherosclerosis plaque volume, hypoechoic plaque volume, and luminal carotid stenosis may be symptoms of ulcerated plaque. Increased MMP-9 and hs-CRP levels could be used as adjunctive therapies of carotid stenosis at the molecular level.