World Neurosurg
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Detecting increased intracranial pressure early in pediatric patients is essential, as early initiation of therapy prevents morbidity and mortality. The objective of this study was to determine the diagnostic accuracy of the optic nerve sheath diameter (ONSD) measured via ultrasound for the prediction of increased intracranial pressure. ⋯ Optic nerve ultrasonography stands out as a precise and valuable diagnostic tool applicable across diverse patient populations and clinical scenarios. We recommend routine ocular ultrasound for optic nerve sheath diameter measurement in pediatric patients to increase the accuracy of diagnosing increased intracranial pressure.
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Endoscopic posterior approach can effectively decompress cervical root and cord secondary to posterior compression. We present our experience in 229 patients using tubular retractor, and the relevant literature is reviewed. ⋯ Endoscopic approach was effective and safe for root and cord decompression. This study was limited by its single-center, retrospective design, exclusion of some eligible patients, a short postoperative Nurick grade assessment period of 6 months, and absence of a comprehensive long-term postoperative biomechanical assessment. To validate these results, a prospective multicenter study addressing these limitations is needed.
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Review Historical Article
Contributions of Laurent Princeteau to trigeminal neuralgia and middle fossa anatomy: more than a mere tubercle.
The contributions of Laurent Princeteau (1858-1932) to anatomy and to the establishment of neurosurgery have largely gone unrecognized, perhaps because he was educated and practiced in a French city other than Paris at a time when Paris was one of the chief centers of medicine in Europe. After completing a thesis describing an iliac artery anomaly and obtaining the distinguished agrégé teaching degree, Princeteau began his surgical career at the University of Bordeaux. Within 10 years, he became chef de clinique and one of the busiest surgeons in Saint-André Hospital, as well as head of the anatomy institute and professor of anatomy at the dental school. ⋯ The surgical significance of the retrogasserian tubercle was quickly acknowledged in the European neurosurgical community and was noted in French textbooks of anatomy. Thierry de Martel, a founding member of the French neurosurgical School, named the tubercle after Princeteau. To the rest of the world, however, it remained almost unknown.
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Anterior column realignment via anterior, oblique, or lateral lumbar interbody fusion is increasingly recognized as a powerful mechanism for indirect decompression and sagittal realignment in flexible deformity. Single-position lateral surgery is a popular variation that places patients in the lateral decubitus position, allowing concomitant placement of lateral interbodies and posterior segmental instrumentation without the need for repositioning the patient. The addition of robotics to this technique can help to overcome ergonomic limitations of the placement of pedicle screws in the lateral decubitus position; however, its description in the literature is relatively lacking. In this review we aim to discuss the indications, advantages, and pitfalls of this approach.
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Brain metastases (BMs) are the most frequent tumors of the central nervous system. Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that provides insights into brain microstructural alterations and tensor metrics and generates tractography to visualize white matter fiber tracts based on diffusion directionality. This systematic review assessed evidence from DTI biomarker alterations in BMs and comparable tumors such as glioblastoma. ⋯ DTI metrics provide noninvasive biomarkers for distinguishing BMs from other tumors and predicting outcomes. Key metrics included peritumoral FA and mean diffusivity.