World Neurosurg
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The optimal treatment of recurrent primary central nervous system lymphoma (PCNSL) has not yet been determined. We report a patient with recurrent PCNSL who has been successfully treated with stereotactic brachytherapy (SBT) with iodine-125 seeds plus temozolomide (TMZ). ⋯ To our knowledge, this is the first case of recurrent PCNSL successfully treated with SBT plus TMZ. Further randomized studies are needed to confirm the therapeutic impact of this new method.
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In India, men outnumber women in neurosurgery by a wide margin. At the graduation party of our woman colleague, we recalled the experiences of the past few years. It led to a transforming experience for the authors, who have hitherto only held the "mens' perspective." ⋯ Conversation itself is one of the greatest forces for changing the situation and how this conversation can be taken forward to transform a "culture of discrimination" to a "culture of acceptance."
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Classic trigeminal neuralgia (TN) involves sharp, shooting pain in any trigeminal nerve distribution, whereas atypical TN presents with constant aching, numbness, or burning that can appear with classic features, leading to a mixed presentation. Microvascular decompression (MVD) is an effective treatment for classic TN, but its utility in treating mixed TN has been less well studied. ⋯ Patients with mixed TN suffer from both classic and atypical TN symptoms. Following MVD, 91.8% of our patients with mixed TN reported partial or complete pain relief, including improvement of atypical pain, in the immediate postoperative stage, compared with 93% of those with classic TN. Recurrence eventually developed in 60.3% of the patients with mixed TN.
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Essential tremor (ET) is a common movement disorder. Resting-state functional magnetic resonance imaging is a noninvasive neuroimaging method acquired in absence of task. ⋯ Our results suggest that pretherapeutic resting-state seed-FC of left VLV predicts tremor arrest after SRS-T for ET. Visual areas are identified as the main regions in this correlation.
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Clinical Trial
Convection-Enhanced Delivery of Polymeric Nanoparticles Encapsulating Chemotherapy in Canines with Spontaneous Supratentorial Tumors.
Despite aggressive multimodal treatment, survival for patients with glioblastoma remains dismal. One obstacle to improving patient outcomes is the difficulty in delivering adequate therapeutic to the central nervous system due to the presence of the blood-brain barrier. Although direct drug infusion by convection-enhanced delivery (CED) can bypass the blood-brain barrier and facilitate delivery to intracranial tumors, determining the distribution of delivered therapeutic remains problematic. Image guidance is a strategy that can optimize the accuracy of therapeutic delivery. ⋯ These data suggest that CED of PMNPs carrying TMZ is safe in dogs with intracranial tumors and can lead to nanoparticle distribution in the region of the target. Image guidance is an important adjunct to CED, because distribution is unpredictable, with the potential for missed target delivery.