World Neurosurg
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Chronic shunt-dependent hydrocephalus is a well-known complication of subarachnoid hemorrhage. Although the risk factors have been extensively investigated, most fail to predict permanent shunt dependency. It is unknown whether the volume of cerebrospinal fluid (CSF) from external ventricular drainage and the daily volume of drainage during the acute hydrocephalus phase (first 72 hours) can predict shunt dependency. We aimed to determine whether CSF output during the acute hydrocephalus phase is a risk factor for shunt dependency. ⋯ Overall CSF output, especially during the acute hydrocephalus phase (first 72 hours), predicts the development of chronic hydrocephalus.
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To report clinical outcomes of temozolomide (TMZ)-based radio-chemotherapy and adjuvant chemotherapy in patients with aggressive/high-risk low-grade glioma (LGG). ⋯ Upfront TMZ-based concurrent radio-chemotherapy and adjuvant TMZ chemotherapy provides acceptable survival outcomes in aggressive/high-risk LGG with modest toxicity.
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Pituitary macroadenomas occasionally disrupt the sellae diaphragma and extend directly to the third ventricle causing hydrocephalus. We present the results of a single-stage extended endoscopic approach for managing giant pituitary adenomas (GPAs) occupying the entire third ventricle. ⋯ The extended endonasal endoscopic approach can be safely and efficiently used for single-stage excision of GPAs that disrupt the diaphragm and occupy the third ventricle. Preoperative cerebrospinal fluid diversion may be used to manage associated acute hydrocephalus in these cases.
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This study was conducted to elucidate the clinical significance of postoperative segmental height decrease (SHD) in anterior cervical discectomy and fusion (ACDF) using allografts. ⋯ Significant SHD was associated with decreased segmental lordosis, global cervical lordosis, and foraminal height. However, significant SHD did not result in worsening of clinical symptoms. Larger allograft size was associated with risk of significant SHD. This study demonstrates provisional results that suggest allograft resorption or fracture may be a factor that adversely affects fusion or SHD.
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After the official announcement of the coronavirus disease-19 pandemic on March 11, 2020, the disease impacted most aspects of health care delivery, especially postgraduate education and training. ⋯ Our study showed that educational activities significantly decreased and shifted toward virtual teaching methods. Operative volume showed a substantial reduction for both junior and senior residents. Academic and clinical teaching was the main concern for PDs, and they faced challenges interviewing newly matched residents.