World Neurosurg
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The aim of the present study was to review the reported data for neurosurgical complication definitions, report the current scales used to classify these complications, and discuss their limitations. ⋯ No current standardized neurosurgical complication grade has been used throughout morbidity and mortality conferences. Although scales have been proposed in reported studies, each with their strengths and limitations, none of these has considered surgery complexity or patient frailty and comorbidities. We believe a comprehensive scale is required that includes a preoperative grading system that factors in baseline surgical complexity and patient frailty.
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Review Meta Analysis
Treatment of atlantoaxial tuberculosis with neurological impairment: A systematic review.
Tuberculosis (TB) in the atlantoaxial joint is a rare disease. However, the treatment of atlantoaxial TB with neurologic impairment is controversial. The aim of this review is to provide clinical outcomes of surgical and nonsurgical management of atlantoaxial TB. ⋯ Conservative and surgical treatments both significantly improved neurologic deficits in most patients. Compared with conservative treatment, surgical treatment reduced treatment failures without significantly increasing the rates of neurologic deficit improvement or mortality.
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Case Reports
3D Real-Time Image-Guided Navigation Spine Corpectomy with Ultrasonic Bone Cutter: Technical Note.
Surgical interventions for congenital scoliosis are challenging for spine surgeons. The coordination of 3-dimensional (3D), real-time, image-guided navigation with an ultrasonic bone cutter allows surgeons to localize the affected area of the spine accurately and remove the lesion without damaging soft tissue structures. The goal of this technical paper is to report a previously undescribed method of hemivertebrectomy that combines 3D, real-time, image-guided navigation and an ultrasonic bone cutter. We highlight the feasibility and safety of this method in spinal surgery. ⋯ We believe that the combination of 3D, real-time image navigation and an ultrasonic bone cutter improves hemivertebrectomy by increasing accuracy and avoiding dura laceration, major organ damage, or potential vessel damage.
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Review Case Reports
Ruptured Distal Superior Cerebellar Artery Aneurysm After Gamma Knife Radiosurgery for Trigeminal Neuralgia: A Case Report and Review of the Literature.
Intracranial aneurysm formation after Gamma Knife radiosurgery (GKRS) is a rare complication that has only recently been reported in the literature. We report the case of a fatal distal superior cerebellar artery (SCA) aneurysm rupture in a woman treated twice with GKRS for trigeminal neuralgia along with a review of the literature regarding radiation-induced aneurysms. ⋯ The pathophysiologic association of aneurysm formation after GKRS remains to be elucidated, but given the potentially fatal consequences of aneurysm rupture, we advocate for further research and propose serial vascular imaging during the postradiosurgery follow-up period for iatrogenic aneurysm formation surveillance.
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Meta Analysis
High leukocyte count and risk of poor outcome after subarachnoid haemorrhage - a metaanalysis.
Subarachnoid hemorrhage is (SAH) is a devastating neurologic emergency often associated with systemic inflammatory response. Many reports have demonstrated an association between elevated inflammatory markers and poor outcome. We performed an observational study and a meta-analysis of the impact of high leukocyte count on outcome after SAH. ⋯ Elevated white blood cells is a marker of poor outcome after SAH. Despite the fact that it is unlikely to be causative, it may be treated as a useful risk predictor.