World Neurosurg
-
Arteriovenous malformations (AVMs) are congenital errors of vascular morphogenesis that occur during development of the cardiovascular system. Multiple treatment options exist, including coil embolization, Onyx embolization, n-butyl-2 cyanoacrylate, alcohol embolization or sclerotherapy, and open surgical treatments. When the AVM involves superficial regions of the face, head, and neck, it is important to consider cosmetic side effects, such as surgical scarring and skin discoloration. ⋯ This technique for treatment of superficial AVMs avoids the use of materials that may be seen through or discolor the skin and other soft tissue.
-
Atypical teratoid/rhabdoid tumor (ATRT) is a rare malignant neoplasm in the pediatric population. ATRT is characterized by rhabdoid cells combined with the loss of either the INI1 (integrase interactor 1) or BRG1 (Brahma-related gene-1) protein. ⋯ ATRT of the central nervous system in pediatric populations is a rare neoplasm associated with a poor prognosis in most patients. Future studies should be directed to find a standardized treatment protocol.
-
Review
Primary intraosseous cavernous hemangioma of the cranium: A systematic review of the literature.
Primary intraosseous cavernous hemangioma (PICH) is a rare, benign tumor of vascular origin, typically arising in the vertebral body. Its presence in the skull is exceedingly rare, with only a few cases being reported worldwide. We carried out the first systematic review of the literature, covering the epidemiology, clinical and imaging features, management, and prognosis of cranial PICH. ⋯ Preoperative embolization, aiming to minimize intraoperative blood loss, was performed in the case of large tumors. At a mean follow-up of 39 months, no patient experienced tumor recurrence, even after subtotal resection. Owing to the benign nature of the tumor, maximal safe resection is recommended as the treatment of choice for patients with cranial PICH.
-
Enhanced recovery after surgery (ERAS) for spinal surgery is new; specifically, an ERAS program for elderly patients is lacking. Geriatric patients have special characteristics that result in further harm by surgical stress. ERAS interventions are designed to improve recovery after surgery and can result in substantial benefits in clinical outcomes and cost-effectiveness. We aimed to determine whether ERAS significantly improved satisfaction and outcomes in elderly patients with long-level lumbar fusion. ⋯ The ERAS protocol used in elderly patients after long-level lumbar fusion surgery was safe and associated with incremental benefits regarding complications and LOS.
-
Homonymous hemianopia has been reported after brain tumor resection with a significant effect on quality of life. Nevertheless, no standardized methods exist for intraoperative optical radiation mapping. The purpose of this article is to describe a new intraoperative task for visual mapping and to review the existing literature. ⋯ The use of DES might be associated with a better outcome (level IV evidence). However, standardization of intraoperative tasks during DES could be improved. In this context, the Central and Peripheral Image task might be an adequate tool for the resection of tumors affecting the optic radiations.