World Neurosurg
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The intratumoral heterogeneity of high-grade gliomas (HGGs) is associated with isocitrate dehydrogenase (IDH) status and prognosis, which can be established by quantitative radioanalysis of spatial tumor habitats. Therefore, we designed a framework for tackling tumors based on spatial metabolism using the hemodynamic tissue signature (HTS), focusing on metabolic changes in tumor habitat to predict IDH status and assess prognosis in patients with HGG. ⋯ Spectral analysis based on hemodynamic habitat imaging can clearly distinguish IDH mutations and the prognosis assessment is more accurate, rendering it superior to traditional spectral analysis in tumor enhancement areas.
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Anterior clinoidectomy is an important procedure used in the treatment of a range of diseases of the frontotemporal region, both vascular and tumoral. Mastering this technique requires a high level of manual skills training. The objective of the study was to describe an easily accessible and economical alternative model of anterior clinoidectomy, with a principal focus on the significance of mastering technical skills and training tactile feedback. ⋯ A cadaveric sheep head model serves as a good model of anterior clinoidectomy regarding manual skills training and can serve as a good alternative to human cadaveric training.
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A narrow working space, small diameters, and the tendency to collapse with clamps make cerebral microvascular anastomosis challenging. A retraction suture (RS) is a novel technique to keep the recipient vessel lumen open during the bypass. ⋯ The RS allows continuous visualization of the vessel lumen, reduces the handling of intimal edges, and avoids incorporating the back wall in sutures, thus improving anastomosis patency.