World Neurosurg
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Anaplastic astrocytoma (AA) is an uncommon primary brain tumor with highly variable clinical outcomes. Our study aimed to develop practical tools for clinical decision-making in a population-based cohort study. ⋯ We constructed two predictive nomograms and risk classification systems to effectively predict the OS and CSS rates in AA patients. These models were internally validated with considerable accuracy and reliability and might be helpful in future clinical practices.
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Decompressive craniectomy substantially reduces mortality and disability rates following a malignant stroke. This procedure remains a life-saving option, especially in contexts with little access to mechanical thrombectomy despite downward trends in the performance of decompressive craniectomy due to discussions on the acceptance of living with severe disabilities. However, the outcomes of the surgery in cases involving concomitant occlusion of anterior or posterior cerebral arteries have not been extensively studied. ⋯ Our data suggest that, for patients with malignant stroke undergoing decompressive craniectomy, the outcomes for patients with and without involvement of additional vascular territory are similar.
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Surgical management of lumbar spondylolisthesis requires neural decompression, stabilization, and alignment restoration. Minimally invasive spine approaches offer a wide variety of advantages for spondylolisthesis management. This intraoperative note describes the treatment of L4-L5 lumbar spondylolisthesis with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw fixation (PSF). ⋯ LLIF with percutaneous PSF can be an effective technique for treating lumbar L4-L5 spondylolisthesis.
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Hemispherotomy is a surgical procedure aimed at the treatment of hemispheric epilepsy. Hemispherotomy disconnects the commissural fibers, projecting fibers, and limbic system while preserving most of the brain parenchyma, unlike conventional hemispherectomy.1 Hemispherotomy is one of most complicated operations currently used in epilepsy surgery and requires a high-level understanding of the intrinsic neuroanatomy. Generally, 2 main techniques are applied in hemispherotomy: lateral hemispherotomy and vertical hemispherotomy.2,3 Vertical hemispherotomy was developed after the lateral technique. ⋯ To ease the surgery and minimize the operation time, we apply "partial superior frontal gyrus removal." This procedure is useful to widen a shallower surgical field while skipping the need for interhemispheric dissection. Total callosotomy is then performed via the lateral ventricle. To disconnect limbic system, we used the technique following the falx and tentorial edge as a landmark.5 Here, we present our surgical steps for parasagittal hemispherotomy in a 5-month-old girl diagnosed as hemimegalencephaly (Figures 1-8).
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Retrospective Cohort Study. ⋯ The SFI provides a more precise assessment of muscle and fat distribution in the posterior cervical region than body mass index and is generally higher in patients with spinal cervical spondylosis who experience neck pain. These findings suggest the importance of early functional exercises postsurgery for potentially improving surgical outcomes in this patient population.