World Neurosurg
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Case Reports
Awake Craniotomy and Excision of A Diffuse Low-Grade Glioma in a Multilingual Patient - Neuropsychology and Language.
Diffuse low-grade gliomas are a group of brain tumors that require an individualized and targeted therapeutic approach, such as awake craniotomy for surgical resection and intraoperative monitoring of speech and language functions. ⋯ Awake craniotomy with speech and language monitoring allows a customized approach to the treatment and management of diffuse low-grade gliomas. Neuropsychological assessment and intraoperative findings are discussed in the context of functional reorganization and cortical representations of language.
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Implant-related infections carry a high morbidity. Infectious rates for neuromodulation implants range from 1% to 9% for deep brain stimulation (DBS), 0% to 10% for spinal cord stimulation (SCS) systems, and 3% to 15% for intrathecal (IT) pump systems. Meanwhile, studies of care bundles report infection rate reduction to 1.0% for SCS and 0.3% for cardiac implants. Herein, we evaluate the effectiveness of an infection prevention bundle (IPB) in minimizing infections after surgeries for neuromodulation implants. ⋯ Implementation of a standardized IPB approach reduced the number of infections for all neuromodulation implants studied. This approach can be adopted within any specialty to potentially decrease the incidence of implant-related infections.
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To describe a novel bilaterally pedicled pericranial flap for anterior cranial base reconstruction after removal of complex frontobasal cancers extending to the frontal region, thus precluding the use of standard reconstructive techniques. ⋯ This novel pericranial flap seems to be easily obtained and effective for anterior cranial base reconstruction when the use of a traditional galea frontalis flap is precluded for oncologic reasons and there are concerns for the possible development of contaminations and cerebrospinal fluid leaks.
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Case Reports
Kinked perforator due to clipping of parent vessel aneurysm - technical note and lessons learned.
Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. ⋯ Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.
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To analyze the stability of lateral lumbar interbody fusion (LLIF) and compare various methods of supplemental fixation in adjacent-segment disease. ⋯ LLIF with and without supplemental fixation reduced motion significantly at the adjacent segment as compared with intact disc. There was a trend toward increasing rigidity with supplemental fixation (plate and pedicle screw constructs). Further biomechanical studies with larger sample sizes are needed to confirm these initial findings.