World Neurosurg
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The aim of this study was to evaluate the long-term clinical outcomes of Gamma Knife radiosurgery (GKRS) for residual and recurrent nonfunctioning pituitary adenomas (NFPAs) after surgery and the role of GKRS in the management of NFPAs. ⋯ GKRS provided high tumor control and a low complication rate in our long-term follow-up. We recommend that early GKRS should be considered the routine adjuvant treatment for residual NFPAs approximately 6 months after subtotal surgical resection.
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Secondary brain injuries, such as delayed cerebral infarction (DCI), are the leading causes of disability after subarachnoid hemorrhage (SAH). Detecting DCI may be challenging, especially for patients presenting an altered level of consciousness. ⋯ Multiple secondary complications (DCI, seizures, hydrocephalus) may occur after SAH but are clinically difficult to diagnose. A multimodal evaluation (transcranial Doppler, CT or magnetic resonance imaging, electroencephalography) is useful in order to detect and treat late complications.
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Chronic subdural hematoma (CSDH) is the most common disease encountered in neurosurgery. Diagnoses of CSDH are usually made on the basis of computed tomography (CT) images. In this report, we discuss the case of a patient with meningioma whose findings instead suggested CSDH. ⋯ In almost all cases, CSDH can be diagnosed using CT images only. However, our patient's true diagnosis was meningioma, rather than CSDH. We rouse attention not to take it for CSDH with a CT image easily.
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Nigeria has the largest population in Africa and has suboptimal access to neurooncology care. It has been estimated that there is approximately 1 neurosurgeon for every 2.4 million people in the country, with only few of these trained in the neurooncology subspecialty and no dedicated medical or radiation neurooncologists. There is a paucity of information on the field of neurooncology in Nigeria. This manuscript aims to provide an overview of the current state of neurooncology literature in Nigeria. ⋯ There is a small but growing amount of scholarly literature on neurooncology from Nigeria. However, there continues to be room for growth in neurooncology research output. With Nigeria's large patient population, there is potential to learn and add to the academic literature. Although there are logistical obstacles to both patient care and research in neurooncology in Nigeria, there is promise for favorable advancement.
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In thoracolumbar spinal instrumentation surgery, pedicle screw fixation is widely used, whereas screw loosening occurs only occasionally over time. It is common to evaluate screw loosening by the radiographic lucent zone around screws, which can neither evaluate loosening quantitatively nor detect slight screw loosening. In the present technical note, we describe a novel assessment technique of screw loosening by generating 3-dimensional screw images from computed tomography data and superposing them in time series. ⋯ This technique enables the quantitative evaluation of screw loosening and loosening between screws and rods. In conjunction with conventional methods of assessing radiographic lucent zone, we are able to obtain more accurate information regarding screw loosening after spinal instrumentation surgery.