Journal of neurosurgery
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Journal of neurosurgery · Oct 2020
Detailed analysis of 5-aminolevulinic acid induced fluorescence in different brain metastases at two specialized neurosurgical centers: experience in 157 cases.
Incomplete neurosurgical resection of brain metastases (BM) due to insufficient intraoperative visualization of tumor tissue is a major clinical challenge and might result in local recurrence. Recently, visible 5-aminolevulinic acid (5-ALA) induced fluorescence was first reported in patients with BM. The aim of this study was thus to investigate, for the first time systematically, the value of 5-ALA fluorescence for intraoperative visualization of BM in a large patient cohort. ⋯ In this largest series to date, visible 5-ALA fluorescence was detected in two-thirds of BM. However, the characteristic heterogeneous fluorescence pattern and frequent lack of strong fluorescence limits the use of 5-ALA in BM and thus this technique needs further improvements.
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In 1950, Dwight Parkinson was the first qualified neurosurgeon to arrive in Winnipeg, Manitoba. He played a monumental role in developing one of the earliest neurosurgical training programs in Western Canada. Parkinson was a pioneering neurosurgeon who served as the first president of the Canadian Neurosurgical Society in 1965. ⋯ Parkinson's dedication to clinical excellence and education laid a cornerstone for the development of neurosurgery and the neurosciences in Manitoba, making him a key figure in Canadian neurosurgery. Using published materials, online resources, hospital archives, and personal interviews, the authors conducted a systematic review of Parkinson's formative years, his development of the Section of Neurosurgery at the University of Manitoba, his achievements, and his legacy. This updated biography captures the exploits of this remarkable, and at times strictly disciplinarian, neurosurgeon-anatomist.
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Journal of neurosurgery · Oct 2020
The impact of preradiosurgery embolization on intracranial arteriovenous malformations: a matched cohort analysis based on de novo lesion volume.
The benefits and risks of pre-stereotactic radiosurgery (SRS) embolization have been reported in different studies. The goal of this study was to compare the long-term outcome of arteriovenous malformations (AVMs) treated with and without pre-SRS embolization. ⋯ Both embolization plus SRS and SRS alone were effective therapies for moderately large (8-39 ml) AVMs. Even with a significantly higher prescription dose at the time of initial SRS, the embolized group still required more procedures to reach final obliteration. The presence of collateral flow and neovascularization could be risk factors for a failure to obliterate following treatment.