World Neurosurg
-
Enhanced Recovery After Surgery (ERAS) is a perioperative model of care aimed at optimizing postoperative rehabilitation and reducing hospital length of stay (LOS). Decreasing LOS avoids hospital-acquired complications, reduces cost of care, and improves patient satisfaction. Given the lack of ERAS protocols for endoscopic endonasal transsphenoidal surgery (EETS) resection of pituitary adenomas, a systematic review of EETS was performed to compile patient outcomes and analyze factors that may lead to increased LOS, reoperation, and readmission rates with the intention to contribute to the development of a successful ERAS protocol for EETS. ⋯ EETS may be an ideal candidate for the development of ERAS cranial protocols. While our data largely supports the safe implementation of shortened LOS protocols in EETS, our findings highlight the importance of transient DI and nonfunctional pituitary adenomas management when formulating ERAS protocols.
-
Review Biography Historical Article
Giuseppe Dagnini (1866-1928): Discoverer of the Trigemino-Cardiac Reflex and Practical Implications in Neurosurgery and other Medical Specialties.
The authors present the life and art of Giuseppe Dagnini, a renowned Italian physician who was born in Bologna in 1866. He was the chief of the Maggiore Hospital in Bologna and authored valuable scientific works on the trigemino-cardiac reflex which is still applied in modern clinical practice. ⋯ Dagnini firstly described the reflex in 1908 postulating that stimulation of one of the 3 branches of the trigeminal nerve triggers the afferent pathway in lowering heart rate. The authors also provide a modern outlook on the clinical implications of the TCR in neurosurgery, neuroanesthesia, and other medical specialties.
-
Meningiomas are the most common primary central nervous system tumors. The preferred treatment is maximum safe resection, and the heterogeneity of meningiomas results in a variable prognosis. Progression/recurrence (P/R) can occur at any grade of meningioma and is a common adverse outcome after surgical treatment and a major cause of postoperative rehospitalization, secondary surgery, and mortality. ⋯ In recent years, the development of advanced magnetic resonance imaging technology and machine learning has provided new insights into noninvasive preoperative prediction of meningioma P/R, which helps to achieve accurate prediction of meningioma P/R. This narrative review summarizes the current research on conventional magnetic resonance imaging, functional magnetic resonance imaging, and machine learning in predicting meningioma P/R. We further explore the significance of tumor microenvironment in meningioma P/R, linking imaging features with tumor microenvironment to comprehensively reveal tumor heterogeneity and provide new ideas for future research.
-
Stroke is a leading cause of death in the United States, with significant economic and human costs. Early diagnosis and rapid treatment are critical for preventing stroke-related morbidity and mortality. However, accessibility to neurointerventional medical centers remains a challenge for many Americans, highlighting the need for innovative solutions to improve stroke management. ⋯ RCA shows potential as a valuable tool in neuroendovascular interventions. Addressing the technical challenges and conducting further research will be crucial to fully realize the clinical benefits of this innovative technology and improve patient outcomes in stroke management.
-
Multicenter Study
CSF SHUNT REINFECTION AND MALFUNCTION IN ECUADORIAN CHILDREN WITH DIFFERENT RESHUNTING CRITERIA AFTER INFECTION. "IS JUST A SHUNT AFTER ANOTHER?
There is no firm evidence regarding cerebrospinal fluid (CSF) shunt reimplantation after infection in the pediatric population. The purpose of this study was to compare different criteria and analyze new shunt failure. ⋯ G2 reimplantation criteria were related to improved pleocytosis, CSF proteins, and blood neutrophils compared with G1. Mechanical and infectious dysfunction of the new shunt was 3 times more prevalent in G1 than in G2, considering the differences between the groups at diagnosis. Increased parameters of infection at diagnosis were associated with future malfunction more than parameters before reimplantation in both groups.