World Neurosurg
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Intraoperative neuromonitoring has been established as one of the methods by which modern neurosurgery can improve surgical results while reducing morbidity. Despite routine use of intraoperative facial nerve (FN) monitoring, FN injury still is a complication of major concern due to severe negative impact on patient's quality of life. ⋯ Although there is a general agreement on the satisfactory functional prediction of different electrophysiological criteria, the lack of standardization in electrode montage and stimulation parameters precludes a definite conclusion regarding the best method. Moreover, studies emphasizing comparison between criteria or even multimodal monitoring and its impact on FN anatomical and functional preservation are still lacking in the literature.
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Traumatic brain injury in contact sports has significant impact on short-term neurologic and neurosurgical function as well as longer-term cognitive disability. In this study, we aim to demonstrate that contact sport participants exhibit differences in diffusion tensor imaging (DTI) caused by repeated physical impacts on the brain. We also aim to determine that impact incurred by the contact sports athletes during the season may result in the differences between the pre- and postseason DTI scans. ⋯ There are significant DTI changes in the CC, the external capsule, the inferior fronto-occipital fasciculus, as well as regions such as the superior/posterior corona radiata the preseason contact versus the noncontact control athletes were compared and also when the postseason contact athletes with the control athletes were compared.
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Review
Current status of pipeline embolization device in the treatment of intracranial aneurysms: a review.
Pipeline embolization device (PED) implantation is a novel endovascular treatment option for the treatment of intracranial aneurysms. It is emerging as a useful alternative to coiling and to open surgery, and its use is increasing worldwide. We performed a literature review to examine its efficacy, technical challenges, and safety. ⋯ PED offers an alternative to endovascular coiling for aneurysms with complex morphology. The indication for its use has evolved from the limited scope of treatment of giant aneurysms with wide necks to the inclusion of smaller aneurysms. The procedural safety profile of PED is comparable with or possibly superior to balloon-remodeling or stent-assisted coil embolization in specific circumstances. However, questions remain regarding the incidence of post-procedural subarachnoid hemorrhage. Ongoing monitoring and meticulous documentation of PED postimplantation safety is strongly recommended.
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Case Reports
The transconjunctival transorbital approach: a keyhole approach to the midline anterior skull base.
To report an initial experience with a medial transorbital approach to the midline skull base performed via a transconjunctival incision. ⋯ The transconjunctival medial orbital craniectomy provides a minimally invasive keyhole approach to lesions located anteriorly along the anterior cranial fossa that are in the midline with lateral extension over the orbital roof. Based on our initial experience with this technique, the working space afforded limits complex surgical dissection; this approach is primarily well suited for less extensive pathology.