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Prepontine Shunting for Pseudotumor Cerebri in Previously Failed Shunt Patients

Neurosurgery 88(2)2021: 306–312 Shunting procedures have a high failure rate when used to treat pseudotumor cerebri (PTC) patients who have failed medical therapy. This failure is believed to be attributable to the collapsibility of the ventricular systemwhenexposed to increased differential pressure gradients in the cerebral spinal fluid compartments caused by ventriculoperitoneal shunts…

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#Cisternal shunting #CSF shunting #idiopathic intracranial hypertension #Papilledema #Prepontine shunt #pseudotumor cerebri

The ipsilateral interhemispheric transprecuneal approach: microsurgical anatomy, indications, and neurosurgical applications

Neurosurgical Review (2021) 44:529–541 Surgical treatment of intraventricular lesions is challenging because of their deep location, vascularization, and their complex relationships with white matter fibers. The authors undertook this study to describe the microsurgical anatomy of the white matter fibers covering the lateral wall of the atrium and temporal horn and to demonstrate how the…

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#interhemispheric approach #intraventricular tumor #superior longitudinal fasciculus #Surgical management . Atrium

A Retrospective Analysis in 1347 Patients Undergoing Cement Augmentation for Osteoporotic Vertebral Compression Fracture: Is the Sandwich Vertebra at a Higher Risk of Further Fracture?

Neurosurgery 88(2) 2021: 342–348 Multiple percutaneous vertebral cement augmentation may create sandwich vertebrae. Whether the sandwich vertebra is at higher risk of further fracture remains unknown. OBJECTIVE: To compare the incidence of further fractures of sandwich vertebrae and adjacent vertebrae and to identify potential risk factors for sandwich vertebral fractures. METHODS: Patients who…

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#Compression fracture #Kyphoplasty #Osteoporosis #Sandwich vertebra #vertebroplasty

Stereotactic radiosurgery as the first-line treatment for intracanalicular vestibular schwannomas

J Neurosurg February 5, 2021: 1-7 This report evaluates the outcomes of stereotactic radiosurgery (SRS) as the first-line treatment of intracanalicular vestibular schwannomas (VSs). METHODS Between 1987 and 2017, the authors identified 209 patients who underwent SRS as the primary intervention for a unilateral intracanalicular VS. The median patient age was 54 years (range 22–85 years); 94…

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#Gamma Knife surgery #Gardner-Robertson grade #hearing preservation rate #Koos grade #Stereotactic radiosurgery #Tumor control rate #Vestibular schwannoma

Revision and complication rates in adult shunt surgery

Acta Neurochirurgica (2021) 163:447–454 CSF diversion with shunt placement is frequently associated with need for later revisions as well as surgical complications. We sought to review revision and complication rates following ventriculoperitoneal, ventriculoatrial and cystoperitoneal shunt placement in adult patients, and to identify potential risk factors for revision surgery and postoperative…

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#Shunt complications #shunt revisión #Shunt surgery #Ventriculoperitoneal shunt

Practical answers to frequently asked questions for shared decision-making in adult spinal deformity surgery

J Neurosurg Spine 34:218–227, 2021 The shared decision-making (SDM) process provides an opportunity to answer frequently asked questions (FAQs). The authors aimed to present a concise list of answers to FAQs to aid in SDM for adult spinal deformity (ASD) surgery. METHODS From a prospective, multicenter ASD database, patients enrolled between 2008 and 2016 who underwent fusions of 5 or more levels…

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Stereotactic Radiosurgery With Versus Without Embolization for Brain ArteriovenousMalformations

Neurosurgery 88(2) 2021: 313–321 Prior comparisons of brain arteriovenous malformations (AVMs) treated using stereotactic radiosurgery (SRS) with or without embolization were inherently flawed, due to differences in the pretreatment nidus volumes. OBJECTIVE: To compare the outcomes of embolization and SRS, vs SRS alone for AVMs using pre-embolization malformation features. METHODS: We…

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Risk factors for developing subdural hematoma: a registry-based study in 1457 patients with shunted idiopathic normal pressure hydrocephalus

J Neurosurg 134:668–677, 2021 Subdural hematomas and hygromas (SDHs) are common complications in idiopathic normal pressure hydrocephalus (iNPH) patients with shunts. In this registry-based study, patients with shunted iNPH were screened nationwide to identify perioperative variables that may increase the risk of SDH. METHODS The Swedish Hydrocephalus Quality Registry was reviewed for iNPH…

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#cerebrospinal shunt #chronic subdural hematoma #complications #hydrocephalus #hygroma #normal pressure

Mild and Severe Obesity Reduce the Effectiveness of Lumbar Fusions

Neurosurgery 88 (2) 2021: 285–294 Elevated body mass index (BMI) is a well-known risk factor for surgical complications in lumbar surgery. However, its effect on surgical effectiveness independent of surgical complications is unclear. OBJECTIVE: To determine increasing BMI’s effect on functional outcomes following lumbar fusion surgery, independent of surgical complications. METHODS:We…

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Surgical anatomy and nuances of the extended endoscopic endonasal transtuberculum sellae approach: pearls and pitfalls for complications avoidance

Acta Neurochirurgica (2021) 163:399–405 Using the expanded endoscopic transtuberculum approach (EETA), the nuances of this technique have rendered a safe, direct, and feasible ventral corridor for the treatment of extending suprasellar pathologies. This study illustrates surgical landmarks and strategies of paramount importance for complications avoidance. Methods This study presents the surgical…

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#cranial base #Endonasal #Endoscopic #parasellar #Suprasellar #Transplanum #Transtuberculum

Is the Goutallier grade of multifidus fat infiltration associated with adjacent-segment degeneration after lumbar spinal fusion?

J Neurosurg Spine 34:190–195, 2021 The aim of this study was to investigate whether fat infiltration of the lumbar multifidus (LM) muscle affects revision surgery rates for adjacent-segment degeneration (ASD) after L4–5 transforaminal lumbar interbody fusion (TLIF) for degenerative spondylolisthesis. METHODS A total of 178 patients undergoing single-level L4–5 TLIF for spondylolisthesis (2006 to…

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#Adjacent-segment degeneration #degenerative #fat infiltration #Goutallier classification #lumbar multifidus #Spondylolisthesis #TLIF #transforaminal lumbar interbody fusion

Survival, Dependency, and Health-Related Quality of Life in Patients With Ruptured Intracranial Aneurysm

Neurosurgery 88:252–260, 2021 Previous analyses of the International Subarachnoid Aneurysm Trial (ISAT) cohort have reported on clinical outcomes after treatment of a ruptured intracranial aneurysm with either neurosurgical clipping or endovascular coiling. OBJECTIVE: To evaluate the long-term quality-adjusted life years (QALYs) gained of endovascular coiling compare to neurosurgical clipping in…

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#Endovascular coiling #Quality of life #Randomized controlled trail #Subarachnoid hemorrhage

How I do it: mini invasive transforaminal lumbar interbody fusion

Acta Neurochirurgica (2021) 163:289–293 Minimally invasive approaches for lumbar fusion are aimed at reducing soft tissue injury in order to minimize surgical morbidity and facilitate recovery. Method Applied to lumbar fusion, such an approach is described as a mini-open transforaminal lumbar interbody fusion (TLIF). Important anatomical landmarks are reviewed. Indications, advantages, and…

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#Mini invasive #mini-open #TLIF #Transforaminal interbody fusion

Corpus callosotomy performed with laser interstitial thermal therapy

J Neurosurg 134:314–322, 2021 Corpus callosotomy is a palliative procedure that is effective at reducing seizure burden in patients with medically refractory epilepsy. The procedure is traditionally performed via open craniotomy with interhemispheric microdissection to divide the corpus callosum. Concerns for morbidity associated with craniotomy can be a deterrent to patients, families, and…

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#corpus callosotomy #Epilepsy #laser interstitial thermal therapy #MR-guided LITT

Small intracranial aneurysms in the Barrow Ruptured Aneurysm Trial (BRAT)

Acta Neurochirurgica (2021) 163:123–129 Treatment of small ruptured aneurysms (SRAs) remains controversial, with literature reporting difficulty with endovascular versus microsurgical approaches. This paper analyzes outcomes after endovascular coiling and microsurgical clipping among patients with SRAs prospectively enrolled in the Barrow Ruptured Aneurysm Trial (BRAT). Method All BRAT patients…

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#Endovascular coiling #Microsurgical clipping #Ruptured aneurysm #Small aneurysm

Intraoperative surveillance of the vertebral artery using indocyanine green angiography and Doppler sonography in craniovertebral junction surgeries

Neurosurg Focus 50 (1):E5, 2021 The authors sought to evaluate the usefulness of indocyanine green (ICG) angiography and Doppler sonography for monitoring the vertebral artery (VA) during craniovertebral junction (CVJ) surgery and compare the incidence of VA injury (VAI) between the groups with and without the monitoring of VA using ICG angiography and Doppler sonography. METHODS In total, 344…

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#complication #craniovertebral junction #Doppler sonography #indocyanine green angiography #Monitoring #vertebral artery injury

Histological and intraoperative evaluations of the arachnoid in patients with Chiari I malformation

Acta Neurochirurgica (2021) 163:219–225 Arachnoid dissection for decompression of Chiari I malformation is controversial. Whether arachnoid changes have an impact on the clinical course is not established. This paper documents the histological spectrum of arachnoid changes and evaluates correlations with preoperative, intraoperative, and postoperative data. Method Arachnoid samples of 162…

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#Arachnoid #Chiari I malformation #Syringomyelia

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