World Neurosurg
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Stereotactic neuromodulation, such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), have emerged as some of the more promising means for managing drug-resistant epilepsy. This study serves as a comprehensive analysis of DBS of the anterior nucleus of the thalamus (ANT), centromedian nucleus of the thalamus, and hippocampus and RNS for seizure reduction in adult intractable epilepsy. ⋯ These results provide a vast amount of supporting data for these neurostimulation procedures while also indicating no significant difference between operations. Therefore, in this target population, operative decisions can be made based on surgeon preference and patient circumstance without affecting seizure reduction outcomes.
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Burr holes can lead to cranial defects that result in cosmetic and functional issues. Effective reconstruction of these burr holes is crucial for improving patient outcomes, yet there is no consensus on the optimal techniques and materials. This systematic review critically evaluates the efficacy and safety of various materials used in neurosurgical practice for burr hole reconstruction. ⋯ Burr hole reconstruction is essential for enhancing esthetic outcomes and patient satisfaction post-trephination. Autologous bone grafts, particularly cortical grafts, demonstrate superior integration, while synthetic materials offer viable alternatives with low complication rates. Future research should focus on long-term outcomes and the implementation of standardized, objective evaluation methods.
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This study explores the integration of chimeric antigen receptor T-cell (CAR-T) therapy with convection-enhanced delivery (CED) as a novel approach for treating diffuse intrinsic pontine glioma, a highly aggressive pediatric brain tumor with limited treatment options. Preliminary clinical results indicate that CED improves CAR-T cell distribution within the tumor microenvironment, leading to promising antitumor responses. ⋯ Ongoing research is essential to optimize these strategies and address ethical considerations surrounding patient safety and equitable access to innovative therapies. The aim is to assess the safety, efficacy, and distribution of CAR T cells delivered directly to the tumor site via CED, thereby enhancing therapeutic outcomes while minimizing systemic side effects.
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To summarize the clinical characteristics, pituitary function assessment, postoperative pathological features, and postoperative recurrence of surgically treated pituitary adenomas (PAs). ⋯ The management of patients with surgically treated PAs is limited by deficiencies in pathological classification, assessment of hypopituitarism, and detection of recurrence.
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Postoperative inflammatory parameters are important markers of surgical site infection. Some authors have reported that spine surgery with instrumentation elevates CRP levels more than that without instrumentation does. However, those studies compared early postoperative inflammatory markers with or without instrumentation in different patients, although CRP levels vary widely among patients. Therefore, we investigated the impact of early postoperative inflammatory reaction with or without instrumentation in the same patients. ⋯ Early postoperative trends were significantly higher after PLIF than after laminotomy for all three indices, with a significant interaction between time and N-level for CRP and NC.