World Neurosurg
-
The fence post technique, which involves insertion of catheters as fence posts around a tumor, has been widely used to demarcate the tumor border for maximal resection of intraparenchymal tumors, such as gliomas. However, a standard procedure for fence post insertion has not been established, and there are some limitations. To overcome this problem, a simple microscopic navigation-guided fence post technique was developed. The feasibility and efficacy of this novel technique during glioma surgery were assessed. ⋯ Clinical experience indicated that the microscopic navigation-guided fence post technique, in which fence posts can be placed without requiring the surgeon to take their eyes off the microscope, is safe and useful in glioma surgery.
-
Case Reports Observational Study
Evaluation of the effectiveness of lumbar punctures in aneurysmal subarachnoid hemorrhage patient with external ventricle drainage.
For aSAH patients with external ventricular drainage (EVD) because of hydrocephalus, the consensus on application of CSF drainage from the lumbar cistern is mixed owing to concerns about its safety and questionable effectiveness. This study evaluated the additional effectiveness of CSF drainage from the lumbar cistern in aSAH patients with EVD. ⋯ For aSAH patients with EVD, serial LPs can accelerate clearance of toxic products from the subarachnoid space.
-
The prevalence of obesity continues to rise in the United States at a disparaging rate. Although previous studies have attempted to identify the influence obesity has on short-term outcomes following elective spine surgery, few studies have assessed the impact on discharge disposition following anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM). The aim of this study was to determine whether obesity impacts the hospital management, cost, and discharge disposition after elective ACDF for adult CSM. ⋯ Our study demonstrates that obesity is an independent predictor for nonroutine discharge disposition following elective anterior cervical discectomy and fusion for cervical spondylotic myelopathy.
-
Meningiomas are the most frequent primary brain tumors. The long-term natural history of asymptomatic meningiomas remains unclear and difficult to predict accurately, however. The purpose of this study was to determine the subsequent course of asymptomatic meningiomas preceded by 5 years of no treatment. ⋯ The present study revealed the subsequent course of asymptomatic meningiomas after 5 years of no treatment and demonstrated that 5y-TdT is useful to detect patients who may require treatment.
-
Preoperative differentiation of lymphoma from other aggressive intracranial neoplasms is important as the surgical and adjuvant therapy may be fundamentally different between the 2 types of tumors. The purpose of this study was to assess the ability of the dynamic susceptibility contrast-derived metrics, percentage signal recovery (PSR) ratio, and relative cerebral blood volume (rCBV) to distinguish between primary central nervous system lymphoma (PCNSL) and high-grade glioma (HGG). ⋯ The findings of our study show that rCBV and PSR ratio are different in HGG and PCNSL at both the group level and subject level. Incorporation of perfusion in routine magnetic resonance imaging of contrast-enhancing lesions can have a significant impact on patient management.