World Neurosurg
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Global neurosurgery is the practice of neurosurgery with the primary purpose of delivering timely, safe, and affordable neurosurgical care to all who need it. The aim of this study is to identify the most frequently cited articles in global neurosurgery through a bibliographic review to characterize articles and trends around this growing topic. ⋯ There is currently a deficit in both the amount of literature surrounding the topic of global neurosurgery and how much that literature is cited. Developing innovative ways to increase academic productivity within, or in collaboration with, low-middle income countries is essential to contribute to global neurosurgery.
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Long-term outcomes after surgical treatment and intensive care have not been investigated in elderly patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to analyze 12-month outcomes and prognostic factors of patients with poor-grade aSAH who were at least age 70 years. ⋯ The absence of delayed cerebral ischemia and small fluctuations in the average absolute daily difference from the normal sodium levels were independently associated with good neurologic outcomes at 12 months in elderly patients. Intracerebral hemorrhage did not appear to affect long-term outcomes. These findings suggest that elderly patients with severe subarachnoid hemorrhage should not be excluded from receiving surgical treatment on the basis of their age alone.
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Little is known about the results of young vascular neurosurgeons who perform only microsurgical clip reconstruction in the era since the International Subarachnoid Aneurysm Trial (ISAT) or about the training and caseload required to equivocate the results of senior, more experienced colleagues. The aim of this study was to compare clinical outcomes of patients treated by young and senior vascular neurosurgeons at Erasmus MC University Medical Center Rotterdam, adjusting for case mix. ⋯ In a high-volume neurovascular center where both endovascular and microsurgical treatment options are available, young vascular neurosurgeons can be trained to achieve at least the same results as their senior colleagues despite increased complexity.
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Primary spinal cord glioblastoma is an extremely rare disease that shows dismal prognosis. Here we report the first case, to our knowledge, of multicentric primary spinal cord glioblastoma presenting with exophytic involvement mimicking teratoma. A 12-year-old girl presented to our hospital with a 6-month history of back pain and progressive paraplegia. ⋯ After surgery, the patient underwent further adjuvant therapy consisting of radiotherapy and temozolomide. However, 8 months after surgery, the follow-up magnetic resonance imaging scan revealed tumor recurrence with intracranial dissemination. The patient is still alive at the current stage (9 months after surgery).
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Although most meningiomas will be benign, a small proportion will have atypical or anaplastic histologic features and will exhibit more aggressive behavior. The treatment of these tumors has been controversial, especially for patients with recurrence after resection and radiotherapy. We have presented a large series of atypical and anaplastic meningiomas treated with stereotactic radiosurgery (SRS). ⋯ High-risk meningiomas are a heterogeneous group of tumors with a propensity for multiple failures. The most common pattern of relapse after SRS was distant. However, local control remains an issue. Further studies evaluating dose-escalation strategies are warranted.