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Clinical implications and radiographic characteristics of the relation between giant intracranial aneurysms of the posterior circulation and the brainstem

Acta Neurochirurgica (2019) 161:1747–1753

Giant intracranial aneurysms of the posterior circulation (GPCirA) are rare entities compressing the brainstem and adjacent structures. Previous evidence has shown that the amount of brainstem shift away from the cranial base is not associated with neurological deficits. This raises the question whether other factors may be associated with neurological…

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Postoperative Rigid Cervical Collar Leads to Less Axial Neck Pain in the Early Stage After Open-Door Laminoplasty—A Single-Blinded Randomized Controlled Trial

Neurosurgery, Volume 85, Issue 3, September 2019, Pages 325–334

Cervical collars are used after laminoplasty to protect the hinge opening, reduce risks of hinge fractures, and avoid spring-back phenomena. However, their usemay lead to reduced range of motion and worse neck pain.

OBJECTIVE: To investigate the clinical, radiological, and functional outcomes of patients undergoing single-door…

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#Cervical myelopathy #Neck collar #Open-door laminoplasty #Plates #Randomized Controlled Trial

Posterior Reversible Encephalopathy Syndrome as a Complication of Induced Hypertension in Subarachnoid Hemorrhage: A Case-Control Study

Neurosurgery, Volume 85, Issue 2, August 2019, Pages 223–230

Induced hypertension (IH) remains the mainstay of medicalmanagement for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). However, raising blood pressure above normal levels may be associated with systemic and neurological complications, of which posterior reversible encephalopathy syndrome (PRES) has been…

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#Delayed cerebral ischemia #Induced hypertension #Posterior reversible encephalopathy syndrome #Subarachnoid hemorrhage #Vasopressor complication

Machine learning—aided personalized DTI tractographic planning for deep brain stimulation of the superolateral medial forebrain bundle using HAMLET

Acta Neurochirurgica (2019) 161:1559–1569

Growing interest exists for superolateral medial forebrain bundle (slMFB) deep brain stimulation (DBS) in psychiatric disorders. The surgical approach warrants tractographic rendition. Commercial stereotactic planning systems use deterministic tractography which suffers from inherent limitations, is dependent on manual interaction (ROI definition), and…

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#Brain #Deep Brain Stimulation #depression #Machine learning #Medial forebrain bundle #Obsessive compulsive disorder #stereotaxy

The Impact of Early Corticosteroid Pretreatment Before Initiation of Chemotherapy in Patients With Primary Central Nervous System Lymphoma

Neurosurgery, Volume 85, Issue 2, August 2019, Pages 264–272

The optimal timing of corticosteroid (CS) treatment in patients with primary central nervous system (CNS) lymphoma (PCNSL) remains controversial. While poor clinical presentation may justify early treatment with CS, this may ultimately result in reduced concentrations of chemotherapeutic agents via perturbations in the permeability of…

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#Complete response #corticosteroids #Primary CNS lymphoma #survival #Systemic therapy #Treatment response

Ultra-Early ( Neurosurgery, Volume 85, Issue 2, August 2019, Pages 199–203 Cervical spinal cord injury (SCI) is a devastating condition with very few treatment options.

#Cervical #Outcome #spinal cord injury #spinal decompression #Surgical timing

Early postsurgical diffusivity metrics for prognostication of long-term pain relief after Gamma Knife radiosurgery for trigeminal neuralgia

J Neurosurg 131:539–548, 2019

Gamma Knife radiosurgery (GKRS) is an important treatment modality for trigeminal neuralgia (TN). Current longitudinal assessment after GKRS relies primarily on clinical diagnostic measures, which are highly limited in the prediction of long-term clinical benefit. An objective, noninvasive, predictive tool would be of great utility to advance the clinical management…

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#diffusion tensor imaging #Gamma knife radiosurgery #neurosurgical prognostication #Pain #Stereotactic radiosurgery #tractograph #Trigeminal neuralgia

Outcome of unilateral versus standard open midline approach for bilateral decompression in lumbar spinal stenosis: is “over the top” really better?

J Neurosurg Spine 31:236–245, 2019

In this retrospective analysis of a prospective multicenter cohort study, the authors assessed which surgical approach, 1) the unilateral laminotomy with bilateral spinal canal decompression (ULBD; also called “over the top”) or 2) the standard open bilateral decompression (SOBD), achieves better clinical outcomes in the long-term follow-up. The optimal…

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#Decompression #Degenerative Lumbar spinal Stenosis #fusion #Laminectomy #laminotomy #Lumbar fusion #multicenter #Multilevel #Surgery

Dorsal anterior cingulate cortex (ACC) deep brain stimulation (DBS): a promising surgical option for the treatment of refractory thalamic pain syndrome (TPS)

Acta Neurochirurgica (2019) 161:1579–1588

Neuroimaging evidences and previous successful case series of cingulotomy for cancer pain have disclosed the key- role of the dorsal anterior cingulate cortex (ACC) in the generation of the empathic and affective dimension of pain. The aim of this study is to assess the effectiveness and safety of ACC neuromodulation for the treatment of the…

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#Deep Brain Stimulation #Dejerine-Roussy syndrome #Neuropathic pain #Thalamic pain syndrome

Giant intracranial aneurysms of the posterior circulation and their relation to the brainstem: analysis of risk factors for neurological deficits

J Neurosurg 131:403–409, 2019

Giant posterior circulation aneurysms (GPCirAs) usually cause substantial mass effect on the brainstem, which may lead to neurological deficits. So far, there has been no systematic investigation of factors associated with such deficits in GPCirA. The authors aim to examine the risk factors for cranial nerve deficit (CND), motor deficit, and disability in…

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#Aneurysm volume #brainstem #cranial nerve deficit #Evans index #Giant intracranial aneurysms #giant posterior circulation aneurysms #McRae line #partially thrombosed aneurysm #vascular disorders

Withholding Perioperative Steroids in Patients Undergoing Transsphenoidal Resection for Pituitary Disease: Randomized Prospective Clinical Trial to Assess Safety

Neurosurgery, Volume 85, Issue 2, August 2019, Pages E226–E232

Perioperative steroid protocols for patients undergoing transsphenoidal surgery (TSS) for pituitary pathology vary by institution.

OBJECTIVE: To assess the safety of withholding glucocorticoids in patients undergoing TSS.

METHODS: Patients with an intact hypothalamic-pituitary-adrenal (HPA) axis undergoing TSS for a pituitary tumor…

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#adenoma #Cortisol #Glucocorticoids #Pituitary #Postoperative #Surgery #transsphenoidal

Results of Gamma Knife anterior capsulotomy for refractory obsessive-compulsive disorder

J Neurosurg 131:376–383, 2019

Obsessive-compulsive disorder (OCD) is a severe psychiatric condition. The authors present their experience with Gamma Knife radiosurgery (GKRS) in the treatment of patients with OCD resistant to any medical therapy.

METHODS Patients with severe OCD resistant to all pharmacological and psychiatric treatments who were treated with anterior GKRS capsulotomy…

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#Capsulotomy #functional neurosurgery #Gamma knife radiosurgery #Obsessive compulsive disorder

Assessment of costs in open surgery and stereotactic radiosurgery for vestibular schwannomas

J Neurosurg 131:561–568, 2019

Microsurgical resection and radiosurgery remain the most widely used interventions in the treatment of vestibular schwannomas. There is a growing demand for cost-effectiveness analyses to evaluate these two treatment modalities and delineate the factors that drive their total costs. Here, the authors evaluated specific cost drivers for mi- crosurgical and…

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#Cost-effectiveness #Middle cranial fossa #retrosigmoid #stereotactic radiosurgery; value-driven outcome #translabyrinthine #Vestibular schwannomas

A modern series of subdiaphragmatic craniopharyngiomas

J Neurosurg 131:526–531, 2019

The endoscopic endonasal approach has been proposed as a primary surgical strategy for select cranio- pharyngiomas. However, those tumors that arise from the sella have not been classified with the other craniopharyn- gioma subtypes in terms of surgical nuances, intraoperative findings, and postoperative outcomes. The authors describe their experience with a…

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Surgical management of camptocormia in Parkinson’s disease: systematic review and meta-analysis

J Neurosurg 131:368–375, 2019

Camptocormia is a potentially debilitating condition in the progression of Parkinson’s disease (PD). It is described as an abnormal forward flexion while standing that resolves when lying supine. Although the condition is relatively common, the underlying pathophysiology and optimal treatment strategy are unclear. In this study, the authors systematically…

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#camptocormia #Deep Brain Stimulation #functional neurosurgery #repetitive trans-spinal magnetic stimulation #sagittal bending #Spine surgery

Clinical Outcomes of Upfront Stereotactic Radiosurgery Alone for Patients With 5 to 15 Brain Metastases

Neurosurgery, Volume 85, Issue 2, August 2019, Pages 257–263

The role of primary stereotactic radiosurgery (SRS) for patients with >4 brain metastases (BM) remains controversial.

OBJECTIVE: To compare the outcomes of patients treated with upfront SRS alone for 1, 2 to 4, and 5 to 15 BM and assess for predictors of clinical outcomes in the 5 to 15 BM group.

METHODS: A total of 478 patients…

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#Brain neoplasms #Cranial irradiation #Neoplasm metastasis #radiosurgery

Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections

Neurosurg Focus 47 (2):E6, 2019

Various implanted materials are used in neurosurgery; however, there remains a lack of pooled data on infection rates (IRs) and infective bacteria over past decades. The goal of this study was to investigate implant infections in neurosurgical procedures in a longitudinal retrospective study and to evaluate the IRs of neurosurgically implanted materials and…

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#cerebral surgery #cranioplasty #infection rate #infective bacteria #Neurosurgery

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