World Neurosurg
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Currently, there is a unanimous opinion that the first line of the treatment of insular gliomas is microsurgical removal.1-3 At the same time, surgery of insular glial tumors remains a challenge because of the complex anatomy of the insular region. Among the most crucial anatomical structures are branches of the middle cerebral artery (MCA), lenticulostriate arteries (LSAs), and corticospinal tract.4 Surgery of the insular glioma becomes much more complicated in cases when the tumor extends to the anterior perforated substance, which, according to our data, occurs in 29,1% of cases.5 We present a 33-year-old woman with a history of generalized seizures (Video1). ⋯ The video demonstrates the technique of a Sylvian fissure dissection, manipulations with MCA branches and LSA, removal of the tumor from the region of the anterior perforated substance, and a discussion of surgical nuances and safety aspects. The most challenging part of the operation was to identify and protect the LSAs.6 Advanced microsurgical techniques, and the correct patient selection for surgical treatment, are cornerstones for a successful outcome and provide an acceptable frequency of postoperative neurologic deficits in patients who undergo surgery of insular gliomas through the transsylvian approach.
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To investigate the effect of age and sex on odontoid parameters and their relationships with cervical sagittal alignment in children. ⋯ Age emerged as a critical determinant of OI, which increased with age among pediatric populations. Clinicians should carefully consider the disparity in OI during the assessment and restoration of cervical sagittal balance in children.
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The aim was to conduct a comprehensive bibliometric analysis of meningioma research, focusing on publication trends, top authors, universities, countries, and thematic analysis of keywords. ⋯ Our findings may provide insights into the evolution of meningioma research and its scholarly impact. The analysis underscores the pivotal contributions of top authors and institutions, outlines thematic research trends, and highlights areas of significant interest and growth in the field. Our study may contribute to understanding the landscape of meningioma research, guiding future research directions and collaborations.
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To elucidate the effect of global spinal alignment on cervical degeneration in patients with degenerative lumbar scoliosis (DLS). ⋯ Patients with DLS may be at greater risk of cervical spine degeneration, especially patients with a PI-LL or sagittal vertical axis modifier grade of ++. A surgical strategy for patients with DLS should be carefully selected considering the restoration of LL.
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Advances in endoscopic endonasal transsphenoidal surgery have led to improved postoperative outcomes after pituitary adenoma resection, including reduced length of stay, complications and readmission rates, without compromising safety and satisfaction. ⋯ Implementing an interdisciplinary, perioperative protocol for transsphenoidal endoscopic pituitary surgery improves length of stay while minimizing readmissions and surgery-related complications.