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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Dorothy Russell's contributions to neuropathology are pivotal in the evolution of modern neurosurgery. In an era preferential to men in medicine, she entered the second medical school class to include women at the London Hospital Medical College in 1919. In the laboratory of Hubert Turnbull, she met Hugh Cairns, who would become her professional neurosurgeon-neuropathologist partner. ⋯ Her textbook, Pathology of the Tumours of the Nervous System, written with Lucien Rubinstein, is considered a landmark text in neurosurgery, neuropathology, and neurooncology. Honored by Penfield and Cone as their first neurosurgery research fellow, Russell was considered a favorite of the Montreal Neurological Institute. Dorothy Russell's extraordinary career elucidating the mysteries of neurosurgical pathology has made an enduring mark on neurosurgery.
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Journal of neurosurgery · May 2022
Long-term tumor control after endoscopic endonasal resection of craniopharyngiomas: comparison of gross-total resection versus subtotal resection with radiation therapy.
Surgical management of craniopharyngiomas (CPAs) is challenging. Controversy exists regarding the optimal goals of surgery. The purpose of this study was to compare the long-term outcomes of patients who underwent gross-total resection with the outcomes of those who underwent subtotal resection of their CPA via an endoscopic endonasal approach. ⋯ GTR, which is possible to achieve in smaller tumors, resulted in improved tumor control, better visual outcome, and better functional recovery but a higher rate of diabetes insipidus compared with STR, even when the latter was supplemented with postoperative radiation therapy. GTR should be the goal of craniopharyngioma surgery, when achievable with minimal morbidity.
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Journal of neurosurgery · May 2022
Stereotactic radiosurgery for prostate cancer cerebral metastases: an international multicenter study.
As novel therapies improve survival for men with prostate cancer, intracranial metastatic disease has become more common. The purpose of this multicenter study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of intracranial prostate cancer metastases. ⋯ SRS appears to be a safe, well-tolerated, and effective management option for patients with prostate cancer intracranial metastases.
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Journal of neurosurgery · May 2022
Targeting for stereotactic radiosurgical thalamotomy based on tremor treatment response.
Stereotactic radiosurgery (SRS) treats severe, medically refractory essential tremor and tremor-dominant Parkinson disease. However, the optimal target for SRS treatment within the thalamic ventral intermediate nucleus (VIM) is not clearly defined. This work evaluates the precision of the physician-selected VIM target, and determines the optimal SRS target within the VIM by correlation between early responders and nonresponders. ⋯ For tremor control in early responders, the Elements Basal Ganglia Atlas autocontour for the VIM provides the optimal SRS target location that is 0.7-0.9 mm lateral to the VIM center.