Journal of neurosurgery
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Journal of neurosurgery · May 2022
Cutoff values for the best management strategy for magnetic resonance-guided focused ultrasound ablation for essential tremor.
The efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) ablation for essential tremor (ET) is well known; however, no prognostic factors have been established. The authors aimed to retrospectively investigate MRgFUS ablation outcomes and associated factors and to define the cutoff values for each prognostic factor. ⋯ ACPC = anterior commissure-posterior commissure; AP = anterior to posterior; CRST = Clinical Rating Scale for Tremor; ET = essential tremor; MRgFUS = magnetic resonance-guided focused ultrasound; PC = posterior commissure; PSA = posterior subthalamic area; RL = right to left; ROC = receiver operating characteristic; SDR = skull density ratio; SI = superior to inferior; T2WI = T2-weighted imaging; VIM = ventral intermediate nucleus.
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Journal of neurosurgery · May 2022
Supraorbital and mini-pterional keyhole craniotomies for brain tumors: a clinical and anatomical comparison of indications and outcomes in 204 cases.
The authors' objective was to compare the indications, outcomes, and anatomical limits of supraorbital (SO) and mini-pterional (MP) craniotomies in patients with intra- and extraaxial brain tumors, and to assess approach selection, utility of endoscopy, and surgical field overlap. ⋯ This clinical experience suggests the SO and MP craniotomies are versatile, safe, and complementary approaches for tumors located in the anterior and middle cranial fossae and perisylvian and parasellar regions. The SO route, used in 85% of cases, achieved greater overall reach than the MP route. Both approaches may benefit from expanded visualization with endoscopy.
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Journal of neurosurgery · May 2022
Follow-up imaging of clipped intracranial aneurysms with 3-T MRI: comparison between 3D time-of-flight MR angiography and pointwise encoding time reduction with radial acquisition subtraction-based MR angiography.
Metallic susceptibility artifact due to implanted clips is a major limitation of using 3D time-of-flight magnetic resonance angiography (TOF-MRA) for follow-up imaging of clipped aneurysms (CAs). The purpose of this study was to compare pointwise encoding time reduction with radial acquisition (PETRA) subtraction-based MRA with TOF-MRA in terms of imaging quality and visibility of clip-adjacent arteries for use in follow-up imaging of CAs. ⋯ This study demonstrated that PETRA-MRA is superior to TOF-MRA for visualizing adjacent vessels near clips and can be an advantageous alternative to TOF-MRA for follow-up imaging of CAs.
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Journal of neurosurgery · May 2022
The Woven EndoBridge (WEB) device: feasibility, techniques, and outcomes after FDA approval.
Wide-neck bifurcation cerebral aneurysms have historically required either clip ligation or stent- or balloon-assisted coil embolization. This predicament led to the development of the Woven EndoBridge (WEB) aneurysm embolization system, a self-expanding mesh device that achieves intrasaccular flow disruption and does not require antithrombotic medications. The authors report their operative experience and 6-month follow-up occlusion outcomes with the first 115 aneurysms they treated via WEB embolization. ⋯ The WEB device has been successfully used for the treatment of both unruptured and ruptured wide-neck bifurcation aneurysms by achieving intrasaccular flow diversion. Here, the authors have shared their experience with its unique technical considerations and device size selection, as well as critically reviewed complications and aneurysm occlusion rates.
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Journal of neurosurgery · May 2022
Triceps and cutaneous radial nerve branches investigated via an axillary anterior arm approach: new findings in a fresh-cadaver anatomical study.
The authors sought to describe the anatomy of the radial nerve and its branches when exposed through an axillary anterior arm approach. ⋯ The new understanding of radial nerve anatomy delineated in this study should aid surgeons during reconstructive surgery to treat upper-limb paralysis.