World Neurosurg
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The standard treatment for craniopharyngiomas (CPs) involves either initial gross total resection or subtotal resection with adjuvant radiotherapy. However, there is no consensus regarding the management of recurrent cases. We reviewed a series of patients with CP to evaluate the characteristics of patients with recurrent/progressing CP. ⋯ The management of recurrent CP is too complicated to fit into a standard treatment algorithm. Therefore, surgical treatment for these patients should be individualized and planned according to patient symptoms and radiologic findings, which is presumably a more versatile, efficient, and safe approach for recurrent CPs.
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In the United States, chronic wounds affect more than 6.5 million people annually-a mean cost of $23,755 among neurosurgery patients. Current wound management solutions have disadvantages, including rejection, disease transmission from mammalian sources, and cultural issues prohibiting some products. Here, we describe preliminary use of xenograft tissue derived from axolotl (Ambystoma mexicanum) dermis for use in wound management after neurosurgical procedures. ⋯ Axolotl dermis patches support mammalian wound management, demonstrating favorable potential in improving neurosurgical wound closure and healing and overall outcomes.
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Hypopituitarism, one or more pituitary hormones inefficiently produced by the anterior pituitary or released from the posterior pituitary to adapt to the needs of the organism. Existing epidemiological data show that immune-mediated diffuse infiltration of the anterior pituitary is important in the development of hypopituitarism. However, the precise connection between immune cells and hypopituitarism remains unclear. This study aimed to elucidate the potential causal links between the 731 immune cell types and hypopituitarism risk. ⋯ Our investigation shed light on the intricate potential relationship between immune cells and hypopituitarism via genetic methods, underscoring the immune-mediated pathway in hypopituitarism pathogenesis, thereby offering valuable insights for future clinical investigations.
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A quarter of spine surgery patients take antidepressants. Basic science research has suggested serotonergic antidepressants impair platelet function. This has been supported by only a small number of works in the setting of spine surgery. The purpose of this study is to investigate the impact of antidepressants on intraoperative bleeding risk during lumbar fusion. ⋯ Antidepressant use was not associated with increased intraoperative blood loss or increased postoperative transfusion requirement, regardless of subanalysis by fusion type or antidepressant class. The current findings do not support discontinuing antidepressants prior to lumbar fusion.
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Cryptococcoma in central nervous system is a special form of cryptococcal infection that presents as occupying lesions in human brains. Usually, it happens in cerebral or cerebellar lobes. Brainstem cryptococcoma is extremely rare, as only a few cases were reported until now. ⋯ Here, we showed images of a 37-year-old male suffering from brainstem occupying lesion, which was finally diagnosed as brainstem cryptococcoma. Details of treatment strategy as well as pathologic exam were also presented. Our work highlights the varied imaging features of brainstem cryptococcoma and provides valuable information for differential diagnosis of brainstem occupying lesions.