World Neurosurg
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Although distal dorsal scapular nerve (DSN) anatomy has been well characterized, a paucity of literature exists detailing its proximal origin. To our knowledge, this is the first study examining DSN origin and its anatomy relative to the C5 nerve root, which may help localize pathology and provide insight into timing of DSN or C5 nerve root clinical and electrophysiological recovery. ⋯ The C5 nerve root contributed to the DSN in all specimens that originated from the proximal, intraforaminal, C5 nerve root in the majority of specimens. As the first C5 nerve branch, surgeon knowledge of this proximal DSN pattern will help localize lesional pathology, as well as may help monitor clinical and electrophysiological recovery.
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Observational Study
Deployment of Neurosurgeons at the warfront against COVID-19.
The coronavirus disease 2019 (COVID-19) pandemic has taken the world by storm, especially the health care system. Medical practitioners of all specialties are being assigned to treat patients of COVID-19. In this article, two authors (T.V. and N.G.) from the Department of Neurosurgery who were deployed in the COVID-19 testing ward between April 25 and May 31, 2020 share their experience. ⋯ The authors share their experience and their institute's protocol in various facets during this war against COVID-19 pandemic. Preadmission and presurgical testing of patients is important in preventing the spread of the disease amongst health care workers.
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The use of nonsedated T2-weighted Half-Fourier Acquisition Single-shot Turbo spin Echo magnetic resonance imaging (MRI) sequences in screening for spinal cord syrinx in neonates with spinal dysraphism has not been reported in the literature. We sought to review our experience using T2-weighted Half-Fourier Acquisition Single-shot Turbo spin Echo imaging of the spine (i.e., rapid spine MRI) in nonsedated neonates for detecting spinal cord syrinx in neonates with spinal dysraphism. ⋯ Rapid spine MRI acquired without sedation or anesthesia may be used as a screening technique to detect spinal cord syrinx in neonates with spinal dysraphism.
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To evaluate the clinical manifestations of cystic vestibular schwannomas (VSs), investigate the immunohistochemical profiles of matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) expression in Antoni A and B areas, and speculate the pathogenesis of cystic formation and intratumoral hemorrhage. ⋯ MMP-14 and VEGF expression were significantly greater in the Antoni B area than in the Antoni A area. Upregulated MMP-14 may degrade loose collagen in the Antoni B area and contribute to cystic formation. MMP-14 can enhance VEGF activity, which may induce extravasation of a plasma ultrafiltrate, cystic expansion, and intratumoral hemorrhage. Therefore, MMP-14 inhibition may be a therapeutic strategy for treating cystic VSs.
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We assessed the prognostic value of the preoperative magnetization transfer ratio (MTR) and morphometrics of the spinal cord in patients with degenerative cervical myelopathy (DCM) in a longitudinal cohort study. ⋯ Preoperative MTR and eccentricity measurements of the spinal cord have prognostic value in assessing the response to surgery and recovery in patients with DCM. Advanced MRI and atlas-based postprocessing techniques can inform interventions and advance the healthcare received by patients with DCM.