World Neurosurg
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Suprasellar extension, cavernous sinus invasion, and involvement of intracranial vascular structures and cranial nerves are among the challenges faced by surgeons operating on giant pituitary macroadenomas. Intraoperative tissue shifts may render neuronavigation techniques inaccurate. Intraoperative magnetic resonance imaging can solve this problem, but it may be costly and time consuming. However, intraoperative ultrasonography (IOUS) allows for quick, real-time feedback and may be particularly useful when facing giant invasive adenomas. Here, we present the first study examining technique for IOUS-guided resection specifically focusing on giant pituitary adenomas. ⋯ We describe an operative technique in which side-firing IOUS may assist in maximizing extent of resection and protecting vital structures during surgery for giant pituitary adenomas. Use of this technology may be particularly valuable in settings in which intraoperative magnetic resonance imaging is not available.
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The frontal aslant tract (FAT) is a bilateral tract located within each frontal lobe. It connects the supplementary motor area in the superior frontal gyrus with the pars opercularis in the inferior frontal gyrus. There is a new and broader conceptualization of this tract called the extended FAT (eFAT). The eFAT tract role is believed to be related to several brain functions, including verbal fluency as one of its main domains. ⋯ The tract was successfully reconstructed, focusing on its morphology and anatomic characteristics.
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Pineal parenchymal tumors are exceedingly rare, and optimal disease management has yet to be defined. In this study, we aimed to identify prognostic factors and establish a predictive model for the prognosis of patients with pineal parenchymal tumors. ⋯ This nomogram is a convenient and precise tool for clinicians to evaluate prognosis of pineal parenchymal tumors.
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To evaluate the influence of symptom duration before anterior cervical discectomy and fusion (ACDF) on patient-reported outcomes (PROs) in workers' compensation patients. ⋯ Regardless of length of symptom duration before ACDF in workers' compensation patients, the patients demonstrated improvements in disability and arm pain. Patients with LD also demonstrated improvements in physical function and neck pain. Patients with LD demonstrated superior scores in physical function, pain, disability, and mental health and were more likely to achieve clinically significant improvement in physical function. Patients with PD were more likely to achieve clinically significant improvement in mental health.
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Anatomical studies of the tentorial sinuses (TS) are scant, and to our knowledge, histological studies of this structure have not been reported. Therefore, we aim to better elucidate this anatomy. ⋯ We identified novel findings for the TS which can be considered surgically and when diagnosing pathology involves these venous sinuses.