World Neurosurg
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Recurrent symptomatic tethered cord (RTC) is a long-term complication of spinal cord lipomas, responsible for progressive motor deficits, urologic dysfunction, and aggravation of spinal deformities. We retrospectively analyzed all cases of recurrent tethering after spinal cord lipoma surgery, the clinical and radiologic features that led to the diagnosis, the surgical management, and the neuro-orthopedic outcome at the last follow-up. ⋯ When RTC is confirmed, the child should be referred to surgery as soon as possible, because we show that the postoperative clinical outcome improved and surgery did not worsen patients' condition. Follow-up should be as long as possible for these patients.
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In patients with traumatic cervical spinal cord injury (tCSCI), the potential role of intraoperative neuromonitoring as a prognostic tool has been insufficiently studied. This study aimed to determine if detectable signals during intraoperative neuromonitoring portend a greater likelihood of recovery for patients with tCSCI. ⋯ The presence of upper extremity SSEP signals in patients who present with complete tCSCI portends greater improvement in ASIA motor scores and likelihood of American Spinal Injury Association Impairment Scale grade conversion at final follow-up.
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Clinical paradigms and consensus recommend dopamine agonists (DAs) as the primary treatment for prolactinomas. However, medically treated patients also encounter challenges such as DA resistance, intolerable side effects, and recurrence of hyperprolactinemia after DA withdrawal. Technical advances in transsphenoidal resection, with an endoscopic endonasal approach, have led to improved visualization of tumor, decreased postoperative morbidity, and shortened length of stay. We examined the indications and outcomes in patients with prolactinomas who underwent surgical resection at our center. ⋯ Endoscopic endonasal resection is a viable option for management of patients with prolactinomas in the setting of a high-volume pituitary center, with minimal postoperative complications.
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The purpose of this study was to suggest appropriate indications and contraindications for full endoscopic surgery and to predict the prognosis for the incidence of complications by reviewing the literature on full endoscopic lumbar decompression for various spinal stenoses and systematically analyzing the contraindications and complications of endoscopic surgery. ⋯ Full endoscopic lumbar surgery, including transforaminal and interlaminar decompression, is a safe and effective surgical option for treating lumbar spinal stenosis; however, it is important to select the transforaminal or interlaminar approach according to the indication.
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An entrapped temporal horn (ETH) is one of the critical complications after tumor removal in the lateral ventricle trigone that sometimes becomes life threatening. ⋯ PIP might be beneficial to prevent ETH because constant osmotic pressure and constant cerebrospinal fluid pulse wave transmission are maintained between each compartment of the lateral ventricle.