World Neurosurg
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Meningiomas of the anterior clinoid process (ACP) present significant surgical challenges given their anatomic relation to critical neurovascular structures. Routine anterior clinoidectomy is often described as a critical step in the resection of these tumors to reduce recurrence and improve visual outcomes. Anterior clinoidectomy, however, is not without risk and its benefits have not been clearly delineated. We present the outcomes of our series of surgically managed ACP meningiomas in which an anterior clinoidectomy was not routinely employed. ⋯ Resection of ACP meningiomas without routine anterior clinoidectomy minimizes potential risk while achieving gross total resection, recurrence, and visual improvement rates comparable with those in previously reported series.
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Cage subsidence is a known complication of spinal fusion. Various aspects of cage design have been investigated for their influence on cage subsidence, whereas the potential contribution of graft material to load sharing is often overlooked. We aimed to determine whether graft in the aperture affects endplate pressure distribution. ⋯ Graft choice plays a role in reducing peak endplate pressures. This finding is relevant to implant subsidence, as well as graft loading and remodeling.
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To assess the cerebral hemodynamic data associated with transient cerebral hemodynamic disturbance (TCHD), including cerebral hyperperfusion syndrome (CHS) and watershed shift ischemia (WSI), by whole-brain (WB) computed tomography perfusion (CTP) before and after revascularization for ischemic moyamoya disease. ⋯ WB-CTP could be used to assess the cerebral hemodynamic characteristics before and after revascularization. DT >3 seconds and mismatch played important roles in evaluating distinct features of TCHD.
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Flow diverters are novel, contemporary tools in treating intracranial aneurysms. There is rapid publication turnover, with newer devices introduced and expanding indications. The bibliometric analysis measures the impact of particular articles and summarizes the chronologic trends overall. ⋯ This bibliometric analysis shows significant chronologic trends, with a shift from usefulness and outcome to short-term and long-term complications. Areas to improve in flow diverter research can be addressed after this analysis of the most impactful articles on this topic.
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Stroke is a potentially life-threatening condition that can lead to disability and prolonged hospital stay. Perioperative stroke is a rare complication of spine surgery, especially in elective procedures. The prevalence of this complication varies in the literature, and the physiopathology is uncertain in many cases. Our objective was to describe 5 cases of patients who underwent spine surgery complicated by perioperative stroke and to analyze their characteristics and clinical outcomes. ⋯ Despite the rarity of this complication, perioperative stroke in spine surgery can lead to considerable morbidity. Precocious diagnosis and treatment may improve patient outcomes.