World Neurosurg
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Viruses are critical for the regulation of cancer development and for therapy. Human adenovirus C (HadVC) has been detected in central nervous system and glioma tissue. The objective of the present study was the development of a robust prognostic model based on HadVC infection (HadVCi)-relevant genes. ⋯ The HadVCi score could be an effective tool for survival prediction and treatment guidance for patients with glioma.
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To investigate the relationship between muscle quality and 1) patient-reported outcomes and 2) surgical outcomes after lumbar microdiscectomy surgery. ⋯ Our analysis demonstrated that higher psoas muscle quality was associated with greater physical improvement postoperatively. Muscle quality did not affect surgical readmissions or reoperations. Additional studies are needed for further assessment of the implications of muscle quality on postoperative outcomes.
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With the advancement of endoscopic endonasal surgery in the treatment of anterior skull base (ASB) pathologies, extended, watertight reconstructions are needed to prevent cerebrospinal fluid (CSF) leakage. This often involves the use of multilayers closure, with free fascia lata (FL) graft frequently used as an in- and/or outlay. However, positioning the FL properly can be challenging and time-consuming, particularly on wider defects. In this technical note, we present an easier and faster way to position FL using a silicone sheet. ⋯ The "Gift wrap" technique offers an alternative approach for positioning the FL, which is less time-consuming compared to the traditional technique. Moreover, it enables improved placement of the FL, enhancing its efficacy.
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Patients who present with a large colloid cyst (CC) and nondilated ventricles represent a therapeutic challenge.1-3 Although transcallosal approaches provide reliable access to the lateral ventricle and foramen of Monro, direct visualization of the vascular attachment of the CC to the roof of the third ventricle is not always possible. This can be especially true with CCs located more posteriorly and superiorly.4 Opening of the choroidal fissure can improve access and visualization to the posterior third ventricle; however, this maneuver is associated with some element of risk.5 There is a paucity of operative video in the literature illustrating the technique of gentle, microblade elevation of the fornix to improve visualization into the third ventricle and, on occasion, avoid the need to open the choroidal fissure.6 We report the case of a 28-year-old woman who presented with headaches and progressive short-term memory dysfunction (Video 1). Magnetic resonance imaging demonstrated a 17-mm CC associated with distortion and thinning of the bilateral fornices without hydrocephalus. ⋯ The index operative video discusses the technical nuances associated with trans-callosal resection of CC with use of the microblade retractor. Special emphasis is placed on the intricate relationship of neighboring anatomic structures. The patient consented to the procedure and the publication of her image.
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Case Reports
Case report of indocyanine green endoscopy for intrasellar pituitary adenoma resection.
Indocyanine green (ICG) angiography has become an established technology in many surgical fields, as well as in neurosurgery with the first application of microscope-integrated indocyanine angiography, which dates to 2003.1 More recently we observed the integration of ICG into endoscopic visualization (e-ICG), which resulted in different applications during the endoscopic endonasal approach ranging from evaluation of intranasal flap perfusion to differentiation of pituitary neuroendocrine tumors from normal gland or even as a predictive factor of postoperative visual function after expanded approaches.2-8 A 49-year-old woman was admitted to our hospital after a 1-year history of amenorrhea and radiologic finding of an intrasellar lesion. The clinical picture was compatible with a nonfunctioning pituitary neuroendocrine tumor, and the mass was completely removed by means of an endoscopic endonasal approach with intraoperative use of e-ICG (Video 1). A 25 mg intravenous bolus of ICG was injected immediately after completion of the sphenoid phase of the approach. ⋯ Near-infrared excitation of fluorescence (780-820 nm) was obtained using a D-light P Cold Light Fountain. At follow-up, the patient experienced resolution of her symptoms, without residues or relapses on control magnetic resonance. This case sheds light on some possible applications and advantages of e-ICG, including visualization of internal carotid arteries before the sellar opening, individuation of the pituitary gland, its distinction from the adenomatous tissue, and the possible evaluation of its degree of compression.