World Neurosurg
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Review Meta Analysis
Symptomatic and Radiographic Improvement Following Surgery for Posterior Fossa Arachnoid Cysts: Meta-Analysis and Literature Review.
Arachnoid cysts are benign, intradural collections of cerebrospinal fluid that are often asymptomatic but, in rare instances, will grow and may cause symptoms. When these are in the posterior fossa, the symptomatology greatly ranges, and the indications for surgery are not well defined. The objective of this study is to examine radiographic and symptomatic outcomes following surgery for posterior fossa arachnoid cysts (PFAC). ⋯ Although there is a high rate of radiographic improvement for PFAC surgery, there is a wide variety of presenting symptoms with differing postoperative improvement rates. This study reinforces the importance of preoperative counseling regarding symptomatic outcomes for PFAC surgery, with supporting statistical analysis but limited by the sample sizes available.
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Review
Beyond Surgery: Navigating Postoperative Care for Cauda Equina Syndrome Through a Scoping Review.
Cauda equina syndrome (CES) is a serious neurological injury that can result in permanent disability. Our objective was to review the evidence for rehabilitation strategies for CES in a scoping review. ⋯ Despite the risk of devastating injury and a recent Getting It Right First Time pathway recommending rehabilitation post CES surgery, there is very limited literature on rehabilitation for CES. Future high-quality rehabilitation trials following CES surgery are needed to guide treatment decisions and optimize postsurgical outcomes.
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Review Case Reports
Cervical Intradural Fungal Infection Masquerading as a Meningioma in an Immunocompetent Patient: A Case report and Systematic Review.
Intradural spinal fungal infection is a rare phenomenon that can carry a significant increase in morbidity and mortality. This systematic review and case report provides a presentation of a 75-year-old male patient with an intradural cervical mass that was diagnosed as a fungal infection intraoperatively. We analyze and report on intradural spinal fungal infections in immunocompetent patients. ⋯ Intradural fungal infections are rare, with only 10 total cases reported in the past 25 years. Nonetheless, they can be associated with significant mortality and morbidity. Thus, the timeline from presentation to intervention should be evaluated and determined carefully.
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Review Historical Article
Historical roots of modern neurosurgical cadaveric research practices: dissection, preservation, and vascular injection techniques.
Because of the complexity of the brain and its structures, anatomical knowledge is fundamental in neurosurgery. Anatomical dissection, body preservation, and vascular injection remain essential for training, teaching, and refining surgical techniques. This article explores the historical development of these practices and provides the contextual background of modern neurosurgical cadaveric brain models. ⋯ In 1868, August Hofmann synthesized formaldehyde, markedly improving tissue preservation. Later, William Kruse introduced latex in 1939, and Sidney Sobin introduced silicone in 1965 for vascular studies. These advancements laid the foundation for modern neurosurgical cadaveric studies, many remaining relevant today.
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Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in older adults and has a poor prognosis and limited response to treatment. The growing impact of palliative care on older people undergoing neurosurgery is becoming increasingly important. Palliative care aims to improve the quality of life for people and their families by addressing their physical, psychosocial, and spiritual needs. ⋯ Nonetheless, there are similarities between the needs of people with GBM and those with other, more common cancer diagnoses and nonmalignant chronic neurologic illnesses. The integration of palliative care into the management of older people with GBM during neurosurgery is crucial for addressing their unique needs and improving their quality of life. In this review, we aimed to comprehensively evaluate the impact of palliative care on people with GBM and its importance.