World Neurosurg
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Review Case Reports
Successful surgery of an exophytic brainstem glioma mimicking a cerebellar- pontine angle tumor.
Nontectal plate exophytic brainstem gliomas with pilocytic histology are rare and occur mainly in children. Because of their eloquent location, therapy usually consists of bioptic histologic verification and radiotherapy in case of progression. ⋯ Exophytic brainstem gliomas may occur in the CPA and mimic vestibular schwannoma. Complete resection even with preserved hearing without neurologic deterioration may be feasible.
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Archaeological evidence of trepanation during the European Bronze Age is numerous and testifies a wide application of neurosurgical practices during prehistory. In some particular cases, trepanation may be associated with other peculiar evidence concerning funerary practices. The aim of this paper is to present the case of a woman from the Recent Bronze Age site of Castello del Tartaro (Verona, Italy), who was buried in a prone position and whose skeletal remains presented evidence of probable frontal trepanation. The association between a deviant burial and trepanation could be of interest in better understanding the history and perception of neurosurgical practices during prehistory.
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Ventricular shunting is one of the primary modalities for addressing hydrocephalus in both children and adults. Despite advances in shunt technology and surgical practices, shunt failure is a persistent challenge for neurosurgeons, and shunt revisions account for a substantial proportion of all shunt-related procedures. There are a wealth of studies elucidating failure patterns and patient demographics in pediatric cohorts; however, data in adults are less uniform. We sought to determine the rates of all-cause and shunt failure readmission in adults who underwent the insertion of a ventricular shunt. ⋯ Most shunt revisions occurred during the first 2 months. Readmissions occurred frequently. We identified patient factors that were associated with all-cause and shunt failure readmissions.
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Virtual reality (VR) and augmented reality (AR) represent novel adjuncts for neurosurgical planning in neuro-oncology. In addition to established use in surgical and medical training, VR/AR are gaining traction for clinical use preoperatively and intraoperatively. To understand the utility of VR/AR in the clinical setting, we conducted a literature search in Ovid MEDLINE and EMBASE with various search terms designed to capture the use of VR/AR in neurosurgical procedures for resection of cranial tumors. ⋯ When these technologies were compared with existing neuronavigation systems, quantitative clinical benefits were also reported. The capacity to visualize three-dimensional images superimposed on patient anatomy is a potentially valuable tool in complex neurosurgical environments. Surgical limitations may be addressed through future advances in image registration and tracking as well as intraoperatively acquired imaging with the ability to yield real-time virtual models.
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The National Cancer Database (NCDB) and the SEER (Surveillance Epidemiology and End Results) program are the 2 largest cancer registries in the United States. However, considerable differences exist between them regarding the sampling frame as well as the participating facility characteristics. In this study, NCDB and SEER are compared for primary central nervous system (CNS) tumors with the aims of discussing the implications for researchers and evaluating the generalizability of both databases. ⋯ Analysis of 623,361 patients with primary CNS tumors, which are identified using both the NCDB and SEER databases, showed significant differences in age, histopathologic classification of tumors, tumor behavior, and treatment of tumors between 2 databases. Overall, the differences observed between 2 databases provide helpful points for the researchers who would like to use NCDB or SEER. These observations should be taken into account when researchers design studies using these databases and discuss the generalizability of their findings.