World Neurosurg
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Multicenter Study
Adult Spinal Arteriovenous Malformations: Natural history and a multicenter study of short-term surgical outcomes.
Spinal arteriovenous malformations (SAVMs) are a very rare and complex spinal cord pathology that require high clinical acumen to diagnose and treat. Management includes both nonoperative and operative paradigms. A review of the literature yields a paucity of data regarding the surgical outcomes of SAVMs, with the majority of data limited to single-center outcomes and/or small sample sizes. The purpose of this study was to use a multi-institutional international database to study the natural history of SAVMs. ⋯ This study presents the largest analysis of patients undergoing surgery for SAVMs and 30-day postoperative outcomes. Operative time differed based on SAVM location. The three most frequent complications (deep vein thrombosis, wound infection, and UTI) occurred at rates of 3.6% or less.
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Review Case Reports
Network-basis of seizures induced by deep brain stimulation: Literature Review and Connectivity Analysis.
Whereas transient, self-limiting seizures are an infrequent but known complication of deep brain stimulation (DBS) implantation surgery, stimulation itself has occasionally been reported to result in seizure activity at delayed time points. The neural circuitry implicated in stimulation-induced seizures is unknown. ⋯ Nonmotor DBS targets, particularly in patients with epilepsy, may be more vulnerable to stimulation-induced seizures; as such, extra caution should be used when programming stimulation parameters at these DBS targets.
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Review Biography Historical Article
Edwin Boldrey and Wilder Penfield's homunculus: a life given by Mrs. Cantlie (in and out of realism).
For nearly 90 years, notions of the brain have been inextricably associated with a homunculus that has become embedded within medical education as the precise representation of rolandic cortical function. We sought to define the history, evolution, accuracy, and impact of this pictorial means of showing cortical representation. ⋯ Discrepancy between cortical perpendicular length attributed to a particular function on 1937 diagrams was greater than that attributed on the 1950 homunculus (motor: mean, 74%; range, 63%-96%; sensory: mean, 66%; range, 17%-92%) (P < 0.05). The homunculus, if truly drawn according to cortical mapping evidence, could never have been recognized as near humanoid, yet it has attained epic educational and practical longevity.
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Review Case Reports
Adult-onset mixed germ cell tumor composed mainly of yolk sac tumor around the pineal gland: a case report and review of the literature.
Mixed germ cell tumors (MGCTs) usually occur in children. In the present report, we discuss an extremely rare case of adult-onset MGCT composed mainly of yolk sac tumor (YST) around the pineal gland. ⋯ The present case highlights the need for clinicians to include YST in the differential diagnosis of acute progressive lesions around the pineal region, even in adult patients.
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Review Historical Article
Re-Resection And Intraoperative Radiotherapy For Malignant Gliomas Of The Brain: A History And Review Of Current Techniques.
The degree of primary resection of malignant brain gliomas (MBGs) has correlated positively with progression-free and overall survival. The indications for surgery and reoperation in MBG relapse remain controversial. ⋯ We reviewed the reported studies with respect to repeat resection and the various methods of intraoperative radiotherapy for MBGs from the initial experience with high-energy linear accelerators in Japan to modern, integrated brachytherapy solutions using solid and balloon applicators. Because of the findings from our review, we have begun to research into the use of intraoperative balloon brachytherapy for recurrent MBGs.