World Neurosurg
-
Tumors presenting with drug-resistant seizures are termed as long-term epilepsy-associated tumors (LEATs). LEATs are more common in the temporal lobe, occur predominantly in pediatric age, and focal neurological deficits are rare. In this article, we aim to highlight our surgical experience in terms of seizure outcome among LEATs and discuss the factors affecting outcome. ⋯ A shorter duration of symptoms, younger age of the patient, partial/focal seizures, and gross total excision were predictors of a good seizure outcome. Histopathology of the tumor does not affect the outcome when one compares glioneuronal tumors with non-glioneuronal tumors.
-
Case Reports
Effect of cycling thalamo-subthalamic stimulation on tremor habituation and rebound in Parkinson's disease.
Deep brain stimulation is an effective treatment for severe tremor in essential tremor and Parkinson disease (PD). However, progressive loss of the beneficial effects of deep brain stimulation may occur due to several factors. ⋯ Certain temporal patterns of cycling (10 seconds on/1 second off or 30 seconds on/5 seconds off, soft start off) were useful for treating tremor habituation and rebound and showed long-term tremor suppression. Cycling stimulation may prevent tremor habituation in PD patients with severe tremor rebound.
-
Observational Study
Factors of Adjacent Segment Disease Onset After Microsurgical decompression for Lumbar Spinal Canal Stenosis.
Few studies have examined the underlying cause of adjacent segment disease (ASD) after decompression surgery for lumbar spinal stenosis. The goal of this study is to investigate factors related to the onset of ASD after decompression surgery based on the imaging results. ⋯ Biomechanical changes at the operated level and adjacent segments contribute to the onset of ASD after lumbar decompression. Preoperative high sagittal rotation angle of adjacent segments and negative postoperative slip progression at the operated level are risk factors of ASD.
-
Direct carotid-cavernous fistulas (DCCF) develop due to breach in the integrity of the wall of the internal carotid artery, and its localization can sometimes be difficult due to rapid high flow shunts. We hypothesized that 3D rotational angiography could locate the fistula site accurately, where an interrupted rim of the carotid wall would be silhouetted against opacified vascular structures. This finding was described as a broken-rim sign, and in this study, we assessed the utility of this sign in the localization of the shunt point of DCCF. ⋯ Our study highlights the role of 3D rotational angiogram and analysis of the carotid wall in the localization of the shunt site in DCCF. The broken-rim sign accurately points to the location of the fistula.
-
To evaluate the surgical technique and accuracy of S2 alar-iliac (SAI) screw placement using intraoperative O-arm-based 3-dimensional navigation (O-arm). ⋯ SAI screw placement can be safely performed using the intraoperative O-arm system and our surgical technique.