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World neurosurgery
Elsevier
World neurosurgery

Elsevier

1878-8750

World neurosurgery/Journal World neurosurgeryAHCISCIISTP
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    T7-T11 Posterior Decompression and Instrumented Fusion, T9 Partial Corpectomy, and Intradural Microsurgical Diskectomy: An Operative Video

    Hudson, Joseph S.Agarwal, PrateekZhang, XiaoranZinn, Pascal O....
    1页
      原文链接:
    • NSTL
    • Elsevier

    Spinal Subdural Hematoma: Rare Complication of Spinal Decompression Surgery

    Reidy, JosephMobbs, Ralph
    4页
    查看更多>>摘要：OBJECTIVE: Spinal subdural hematoma (SSH) is a rare and infrequently reported complication of hemilaminectomy, laminectomy, and other spinal decompression surgeries. In this review, we aim to analyze the available literature for reported cases of SSH to better identify risk factors and presenting symptoms, as well as highlight the importance in prompt investigation and management of SSH to prevent long-term morbidity and chronic neurologic deficit. -METHODS: A review of the medical literature was undertaken using search terms hemilaminectomy OR laminectomy AND spinal subdural haematoma. All identified reports were screened for language, adult population, and human studies. Report abstracts were screened for relevance to question, with SSH occurring postoperatively following hemilaminectomy or laminectomy included. Four reports were included in the review. -CONCLUSIONS: SSH is a rare, emergency condition with neurologic deficit that can present as recurrent back pain and acute cauda equina postoperatively following hemilaminectomy and laminectomy procedures. Vigilance, early investigation, and surgical evacuation is important in preventing short-and longterm morbidity. Further collation of data and analysis is required to better identify patients at high risk for developing SSH postoperatively.
      原文链接:
    • NSTL
    • Elsevier

    Cerebral Pressure Autoregulation in Brain Injury and Disorders - A Review on Monitoring, Management, and Future Directions

    Wettervik, Teodor SvedungFahlstrom, MarkusEnblad, PerLewen, Anders...
    14页
    查看更多>>摘要：The role of cerebral pressure autoregulation (CPA) in brain injury and disorders has gained increased interest. The CPA is often disturbed as a consequence of acute brain injury, which contributes to further brain damage and worse outcome. Specifically, in severe traumatic brain injury, CPA disturbances predict worse clinical outcome and targeting an autoregulatory-oriented optimal cerebral perfusion pressure threshold may improve brain energy metabolism and clinical outcome. In aneurysmal subarachnoid hemorrhage, cerebral vasospasm in combination with distal autoregulatory disturbances precipitate delayed cerebral ischemia. The role of optimal cerebral perfusion pressure targets is less clear in aneurysmal subarachnoid hemorrhage, but high cerebral perfusion pressure targets are generally favorable in the vasospasm phase. In acute ischemia, autoregulatory disturbances may occur and autoregulatory-oriented blood pressure (optimal mean arterial pressure) management reduces the risk of hemorrhagic transformation, brain edema, and unfavorable outcome. In chronic occlusive disease such as moyamoya, the gradual reduction of the cerebral circulation leads to compensatory distal vasodilation and the residual CPA capacity predicts the risk for cerebral ischemia. In spontaneous intracerebral hemorrhage, the role of autoregulatory disturbances is less clear, but CPA disturbances correlate with worse clinical outcome. Also, in communityacquired bacterial meningitis, CPA dysfunction is frequent and correlates with worse clinical outcome, but autoregulatory management is yet to be evaluated. In this review, we discuss the role of CPA in different types of brain injury and disease, the strengths and limitations of the monitoring methods, the potentials of autoregulatory management, and future directions in the field.
      原文链接:
    • NSTL
    • Elsevier

    Contiguous Meningioma and B-Cell Lymphoma: A Scoping Review and Case Illustration

    Hicks, William H.Pernik, Mark N.Adeyemo, EmmanuelMathews, John...
    7页
    查看更多>>摘要：BACKGROUND: The diagnosis of a contiguous, synchronous meningioma and central nervous system B-cell lymphoma is rare and associated with paradoxical treatment paradigms. We performed a scoping review of contiguous me ingioma and B-cell lymphoma and included an additional illustrative case. METHODS: The OVID Medline and PubMed databases were systematically searched using the Preferred Reporting Items of Systematic Reviews and Meta Analysis guidelines. Only human clinical reports of contiguous, synchronous meningioma and B-cell lymphoma were included. We concurrently detailed a representative case from our institution. RESULTS: Nine case reports met our criteria, including the present case. The average age at diagnosis was 67.4 years. Patients showed a female-to-male predominance of 7:2. The diagnosis of synchronous intracranial tumors was not suspected or discovered until after surgical resection in 100% of cases. All meningiomas were grade I on histopathologic diagnosis, while lymphomas were distributed between diffuse large B-cell lymphoma (56%), metastatic lymphoma (22%), Burkitt lymphoma (11%), and follicular lymphoma (11%). All patients underwent surgical resection. Patients (n = 5) treated with adjuvant chemotherapy had evidence of longer progression-free survival (median 12 months; range, 3-18 months) than patients without adjuvant chemotherapy (n = 2; median 2 months; range, 1-3 months). CONCLUSIONS: Contiguous, synchronous meningioma/B-cell lymphoma is a rare diagnosis that may appear as an inconspicuous solitary intracranial neoplasm on imaging. Based on the limited cases and current treatment of lymphoma, progression-free survival may be contingent on the prompt initiation of chemotherapy targeting the lymphoma rather than surgical resection of the meningeal mass. Providers should prioritize prompt medical management.
      原文链接:
    • NSTL
    • Elsevier

    Gender Equity of Promoting Practices in Academic Neurosurgery in the United States

    Kearns, Kathryn N.Rabinovich, Emily P.Shabo, LeahShaffrey, Mark E....
    9页
    查看更多>>摘要：BACKGROUND: Women have historically been underrepresented in academic medicine, particularly in surgical subspecialties. This study investigated potential associations between gender and promoting practices in academic neurosurgery. METHODS: Faculty data, including time from residency, professorship, specialty, and h-index, were obtained from websites of the institutions listed in the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Demographics, training, and appointments were compared between male and female neurosurgeons. Predictors of professorship, chair, directorship, and division leadership were identified using multivariable models. RESULTS: The study examined 1629 faculty members. Women were more likely to be assistant professors (P < 0.0001), while men were more likely to be full professors (P < 0.0001), hold chair positions (P = 0.007), lead subspecialty divisions (P = 0.008), and have a higher Scopus h index (P < 0.0001). In a multivariable analysis, years from training (P < 0.001), fellowship (P = 0.009), h-index (P < 0.001), and chair/program director/division leadership position (P < 0.001) were significant positive predictors of full professorship. Holding additional advanced degrees (P = 0.010), leading a subspecialty division (P = 0.005), and having a higher h-index (P = 0.002) positively predicted chair position. However, when accounting for all other factors, gender was not a significant predictor of full professorship, division leadership, chair, or program directorship. CONCLUSIONS: While significantly more men hold leadership positions in U.S. academic institutions, after controlling for contributing variables, there did not appear to be an association between gender and full professorship, division leadership, chair, or program directorship in academic neurosurgery. While the field still has significant work to do to achieve gender equity, these results may serve as encouragement to women who are looking to advance their careers in academic neurosurgery.
      原文链接:
    • NSTL
    • Elsevier

    Neuronavigation Applied to Piezosurgery: Toward Robotic Image-Aided Craniotomy? A Technical Note

    Raccuia, GabriellaBroggi, MorganFerroli, PaoloIess, Guglielmo...
    4页
    查看更多>>摘要：BACKGROUND: Although simple in its concept, craniotomy can still cause serious consequences to the patient. A recent alternative to standard techniques (i.e., perforator and craniotome) is represented by piezosurgery (PS), which exploits a microvibration-emitting blade that cuts the bone directly from the outer surface of the skull. Although PS has been demonstrated to decrease complications, dural lacerations and neurovascular injuries are still possible from inadvertent penetration of the inner tabula. Modern neuronavigation systems can provide the surgeon with the possibility to track the instrument while carving the skull, thus potentially lowering the complication rates. METHODS: Two cases of miniretromastoid craniotomy for trigeminal neuralgia were performed using neuronavigated PS. Before surgery, the patients underwent volumetric brain magnetic resonance imaging and computed tomography. The piezosurgical cutter was registered on the S8 StealthStation neuronavigation system (Medtronic, Dublin, Ireland) using the step-by-step cranial standard instrument calibration protocol. RESULTS: The craniotomy was performed with the surgeon using the neuronavigation monitor to visualize both the position and the trajectory of the instrument's blade while penetrating the bone. No dural lacerations or neurovascular injuries were reported. At the end of the procedure, the bone flaps were perfectly repositioned within their craniotomy margins without the use of cranial fixation devices. CONCLUSIONS: Neuronavigated PS has the potential to decrease craniotomy-related complication rates. By allowing for real-time visualization of the blade's level of penetration, it provides the surgeon with the ability to halt progression when needed, avoiding dural lacerations and neurovascular injuries. The principles behind this technique could anticipate the advent of robotic-image aided craniotomy.
      原文链接:
    • NSTL
    • Elsevier

    Totally Endoscopic Resection of Recurrent Convexity Meningioma Following Multiple Surgeries: Oblique Trajectory to Avoid Manipulation of a Vascularized Free Flap: A Technical Note

    Hong, SukwooKimura, ToshikazuYano, TomoyukiHasegawa, Hirotaka...
    4页
    查看更多>>摘要：- BACKGROUND: Endoscopic surgery is widely used for intraventricular and skull base tumor resections; however, its utility is not limited to deep parts of the brain. - METHODS: A 73-year-old female presented with leftside hemiparesis and seizures due to a relapsed atypical meningioma of convexity. The tumor was located just under a synthetic bone substitute and was covered by a delicate myocutaneous free flap, preventing the usual skin incision route to approach the lesion. - RESULTS: The tumor was successfully removed using an endoscope without damaging the flap. - CONCLUSIONS: With the aid of an endoscope, a superficial meningioma could be removed with the affected dura through a small craniotomy.
      原文链接:
    • NSTL
    • Elsevier

    Surgical Resection of an Arteriovenous Malformation of the Orbital Surface of the Frontal Lobe with Olfactory Tract Preservation: 2-Dimensional Operative Video

    Budohoski, Karol P.Tajsic, TamaraBarone, Damiano G.Guilfoyle, Mathew...
    2页
      原文链接:
    • NSTL
    • Elsevier

    Ventriculoatrial Shunts: Review of Technical Aspects and Complications

    Bakhaidar, MohamadWilcox, Jared T.Sinclair, David S.Diaz, Roberto Jose...
    7页
    查看更多>>摘要：Diversion of cerebrospinal fluid is required in many neurosurgical conditions. When a standard ventriculoperitoneal shunt and endoscopic third ventriculostomy are not appropriate options, placement of a ventriculoatrial shunt is a safe, relatively familiar second-line shunting procedure. Herein we reviewed the technical aspects of ventriculoatrial shunt placement using an illustrative case. We focused on the different modalities for inserting and confirming the location of the distal catheter tip. We discussed how to overcome typical difficulties and significant concerns, such as cardiac arrhythmias and venous thrombosis. In addition, we reviewed the current literature for the different complications associated with ventriculoatrial shunt placement.
      原文链接:
    • NSTL
    • Elsevier

    Microsurgical Resection of a Giant Posterior Fossa Aneurysmal Malformation in a 21-Month-Old

    Rennert, Robert C.Kang, Keiko M.Santiago-Dieppa, David R.Steinberg, Jeffrey A....
    1页
      原文链接:
    • NSTL
    • Elsevier