Journal of neurosurgery
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Journal of neurosurgery · Jan 2019
Distal peroneal nerve decompression after sciatic nerve injury secondary to total hip arthroplasty.
OBJECTIVE The sciatic nerve, particularly its peroneal division, is at risk for injury during total hip arthroplasty (THA), especially when a posterior approach is used. The majority of the morbidity results from the loss of peroneal nerve-innervated muscle function. Approximately one-third of patients recover spontaneously. ⋯ Dorsiflexion recovered to MRC ≥ 4- for 15 (41%) patients. In multivariate logistic regression analysis, motor unit potentials in the tibialis anterior (OR 19.84, 95% CI 2.44-364.05; p = 0.004) and in the peroneus longus (OR 8.68, 95% CI 1.05-135.53; p = 0.04) on preoperative electromyography were significant predictors of a good surgical outcome. CONCLUSIONS After performing peroneal nerve decompression at the fibular tunnel, 65% of the patients in this study recovered dorsiflexion strength of MRC ≥ 3 at latest follow-up, potentially representing a significant improvement over the natural history.
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Journal of neurosurgery · Jan 2019
Outcomes of chronic subdural hematoma in patients with liver cirrhosis.
Burr hole craniostomy is an effective and simple procedure for treating chronic subdural hematoma (CSDH). However, the surgical outcomes and recurrence of CSDH in patients with liver cirrhosis (LC) remain unknown. ⋯ Even for simple procedures following minor head trauma, LC remains a serious comorbidity with a poor prognosis.
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Journal of neurosurgery · Jan 2019
Quality of life following surgical treatment of lesions within the pineal region.
OBJECTIVEPineal region tumors are a rare and heterogeneous group of lesions. The optimal therapeutic approach is currently a topic of controversy, particularly in light of the potential operative risks and complications. The potential beneficial effects of surgery have already been described, but information about neurological outcome and, in particular, health-related quality of life (HRQOL) is still lacking in the literature. ⋯ Furthermore, significant improvements in HRQOL scores occurred in global health status, in all functional scales, and in pain, nausea and vomiting, fatigue, and insomnia (p < 0.0001). Moreover, a significant reduction in the necessity for permanent shunt procedures was observed after gross-total tumor resection compared with subtotal resection (p = 0.035) of pineal cysts. CONCLUSIONSDespite potential risks, (radical) surgery is a highly effective and safe treatment option for pineal region lesions and should be considered for the majority of patients.
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Journal of neurosurgery · Jan 2019
Impactful publishing: the Journal of Neurosurgery and its diamond anniversary (1944-2019).
With this landmark issue of the Journal of Neurosurgery (JNS), we celebrate the 75th anniversary of continuous publication of articles in neurosurgery. It is likely not a coincidence that the diamond anniversary of the JNS coincides precisely with the 150th anniversary of the birth of Harvey Cushing. It is possible that some events in life are inextricably and cosmically tied together, such as the birth of the founding father of our specialty, the society named after him that ultimately became the American Association of Neurological Surgeons (AANS), and the journal of this organization-the JNS.