World Neurosurg
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Next-generation sequencing (NGS) is one of the most promising technologies that have truly revolutionized many aspects of clinical practice in recent years. It has been and is increasingly applied in many disciplines of medicine; however, it seems that pediatric neurosurgery despite its great potential has not truly embraced this new technology and is hesitant to use it in routine practice and guidelines. In this review, we summarize the developments that led to the establishment of NGS technology, review the applications and potentials of NGS in the disorders treated by pediatric neurosurgeons, and discuss the steps that we need to be taken to better harness NGS in pediatric neurosurgery.
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Randomized Controlled Trial
Development and internal validation of prediction model in predicting the risk of recurrent stroke for middle-aged and elderly stroke patients: a retrospective cohort study.
To develop and validate a model for predicting the risk of recurrent stroke among middle-aged and elderly stroke patients. ⋯ A logistic regression model for predicting the risk of recurrent stroke was developed among middle-aged and elderly stroke patients after 2 years, and the model showed good discrimination and accuracy via internal validation.
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Intramedullary spinal cord tumors (IMSCTs) are rare neoplasms and their management involves tumors resection in most cases. Regarding the surgical procedure, adequate identification of tumor boundaries is paramount to achieve an extensive tumor resection. Fluorescence image-guided surgery (FIGS) has become an increasing popular intraoperative technique used in spine neuro-oncology surgery. However, evidence is lacking of their usefulness and their safety in spinal tumors. Therefore, the aim of the present study is to give an update of the existing literature and systematically review all studies that focus on the most-used fluorophores (5 aminolevulinic acid [5-ALA], sodium fluorescein, and indocyanine green [ICG]) in IMSCTs. ⋯ In intramedullary tumor surgery, 5-ALA has shown its usefulness in identifying the tumor margins and in searching for residues because of its properties as a tumor-specific metabolic marker. Sodium fluorescein and ICG video angiography have shown promising application in ependymoma and hemangioblastomas surgery, respectively. However, the evolving role of fluorescent dyes in guiding surgical strategies in intramedullary spinal tumor has yet to be shown by randomized clinical trials.
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Review
Review of the prevention and treatment of hydrocephalus after aneurysmal subarachnoid hemorrhage.
Hydrocephalus following a ruptured aneurysm portends a poor prognosis. Patients have to face the risk of infection and shunt obstruction after shunt surgery, which may require a second procedure and greatly reduce the quality of life for survivors. It is crucial to minimize the incidence of hydrocephalus and reduce cerebrospinal fluid shunt dependency. This article reviews current interventions before and after hydrocephalus formation after aneurysmal subarachnoid hemorrhage, focusing on the relationships between treatment options and the incidence of postoperative hydrocephalus, management of cerebrospinal fluid drainage and shunt dependent hydrocephalus, and advocates for the combination of prevention and treatment to develop individualized treatment plans for patients.
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This article aims to introduce an endoscopic-exoscopic technique for the resection of epidermoid cysts. ⋯ Endoscopic-exoscopic technique is safe and efficient in the resection of intracranial epidermoid cysts with panoramic views and superior maneuverability. With further development and accumulation of practical experiences, the endoscopic-exoscopic technique can also be applied in the resection of other intracranial tumors.