World Neurosurg
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Primary fourth ventricle outlet obstruction (PFVOO) is a rare cause of hydrocephalus with an unclear etiopathogenesis, and thus, consensus regarding the recommended treatment protocol is lacking. This study aims to summarize current knowledge of this condition in the light of our own treatment experience. ⋯ Despite the fact that PFVOO can be defined as an obstructive hydrocephalus, there seems to be a higher risk of ETV failure in such cases. The alternative treatment modalities presented are still recommended. Confirmation of these findings requires a larger multicenter study.
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Multicenter Study Comparative Study Observational Study
Comparisons of characteristics and outcomes after mechanical thrombectomy for vertebrobasilar occlusion with cardioembolism or atherosclerotic brain infarction: Data from the Tokyo-tama-Registry of Acute Endovascular Thrombectomy (TREAT).
Some reports suggest the efficacy of mechanical thrombectomy (MT) for acute vertebrobasilar artery (VBA) occlusion. The major causes of VBA occlusion include cardioembolism (CE) and large-artery atherosclerosis (LAA). However, the clinical characteristics of each cause remain unclear, and they might be important for decision making related to the indications and strategy of MT. ⋯ Functional outcomes of VBA occlusion were not significantly different between CE and LAA. Based on the subgroup analysis, patients with CE might have poorer collateral status than do patients with LAA, and earlier recanalization might therefore be desired.
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Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumefactive lesion that can develop anywhere within the neuraxis. The incidence is likely underreported, given its nonspecific imaging features and because CAPNON has often been overwhelmed by the presence of comorbid disease. CAPNON is typically diagnosed by the histopathological examination findings. ⋯ The management of CAPNON is largely dependent on the symptoms, which are mainly related to the location and associated mass effects. Maximal surgical resection will result in excellent patient outcomes with rare recurrence, especially in patients presenting with epilepsy. The discovery of neurofilament light chain protein within CAPNON suggests that neurofilament might be implicated in the pathogenesis of CAPNON, serve as an immunohistochemical marker to improve the diagnostic accuracy of CAPNON, and hold therapeutic potential for the treatment of CAPNON.
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Review Biography Historical Article
Jacques Forestier: Forgotten Contributions of a Rheumatologist to Spine Surgery.
Jacques Forestier (1890-1978) was a well-known rheumatologist and radiologist whose innovations have revolutionized spinal neurosurgery and rheumatology. He was well known as "Doctor Lipiodol" for his accidental discovery of spinal myelography, which he later extrapolated for use in many body cavities and their pathologies. He was the first to describe "senile ankylosing hyperostosis of the spine," which was later renamed "diffuse idiopathic skeletal hyperostosis." Furthermore, he is credited with the first use of gold salts as a disease-modifying therapy for rheumatoid arthritis. We have presented a historical vignette to chronicle the life of Jacques Forestier and his contributions to the field of spinal neurosurgery.
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Various prognostic models are used to predict mortality and functional outcome in patients after traumatic brain injury with a trend to incorporate machine learning protocols. None of these models is focused exactly on the subgroup of patients indicated for decompressive craniectomy. Evidence regarding efficiency of this surgery is still incomplete, especially in patients undergoing primary decompressive craniectomy with evacuation of traumatic mass lesions. ⋯ Random forest algorithms show promising results in prediction of postoperative outcome and mortality in patients undergoing primary decompressive craniectomy. The best performance was achieved by Classification Random forest for 6-month outcome.