World Neurosurg
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Patients with brain metastases (BrMs) from esophageal cancer have poor prognosis, the incidence of which is expected to rise due to improved survival from the primary tumor and increased neuroimaging. We aimed to identify patient and esophageal cancer characteristics associated with longer survival in patients with BrMs and, secondly, to compare the prognosis of patients with HER2 overexpression. ⋯ The median survival from esophageal-to-brain metastasis was 8.4 months. Patients with a single lesion, KPS score >70, and treatment with surgical resection was correlated with improved survival. Further, HER2+ patients had distinct patient and BrM characteristics.
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A male in his 70s presented with progressive vision loss in his right eye for 2 months. The conjunctival vessels in both eyes appeared dark red, excessively dilated, and tortuous. Macular Optical coherence tomography (OCT) revealed macular edema in the right eye. ⋯ The patient was diagnosed with macular edema and tortuous conjunctival vessels secondary to a carotid cavernous fistula (CCF). Subsequently, the patient underwent endovascular interventional embolization of the fistula, resulting in complete occlusion of the fistula. At the one-month follow-up, the patient reported that the redness in his eyes had disappeared and his vision had improved.
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Pain is a complex sensory and emotional experience that significantly impacts individuals' well-being. Lumbar radicular pain (LRP) is a prevalent neuropathic pain affecting 9.9% to 25% of the population annually. Accurate identification of pain patterns in LRP is essential for diagnosis and management. Artificial intelligence has potential in health care but faces challenges in reliability and accuracy. This study aimed to investigate the accuracy and consistency of LRP patterns demonstrated by ChatGPT-4o. ⋯ ChatGPT currently lacks the capacity to accurately and consistently represent LRP patterns. AI tools in health care require further refinement, validation, and regulation to ensure reliability and safety. Future research should involve multiple AI platforms and broader medical conditions to enhance generalizability.
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Suprasellar hypothalamic-opticochiasmatic glioma (HOCG) and craniopharyngioma (CP) have similar appearances on conventional magnetic resonance imaging (MRI) and are difficult to distinguish. Moreover, these tumors are situated near vital structures like the optic chiasm and hypothalamus, rendering conventional surgery susceptible to significant complications. We mainly discussed the surgical application value and diagnostic value of diffusion tensor imaging (DTI) in HOCG and CP. ⋯ DTI enhances the accuracy of HOCG and CP differentiation. Furthermore, patterns of tractography described in this study assist neurosurgeons in delineating the surgical pathway and tumor resection range without damaging important fiber bundles, thereby avoiding permanent neurological deficits and improving survival quality for patients.
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Intraventricular cavernous malformations (IVCs) are rare vascular lesions of the central nervous system. Surgical resection remains a challenging endeavor, with conventional microsurgical techniques associated with morbidity due to direct brain tissue manipulation. Neuroendoscopic approaches offer a minimally invasive alternative, though their efficacy and safety in treating IVCs remain underexplored. ⋯ Neuroendoscopic surgery offers several advantages in treating IVCs, including minimally invasive access, precise visualization, and reduced brain tissue manipulation. Our findings support the efficacy and safety of ETVA, underscoring its potential as a valuable therapeutic strategy for selected IVCs.