Journal of neurosurgery
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Journal of neurosurgery · Sep 2022
Predictive factors for recovery from adult growth hormone deficiency after transsphenoidal surgery for nonfunctioning pituitary adenoma.
Recovery from adult growth hormone deficiency (AGHD) after transsphenoidal surgery (TSS) has not been well discussed because of the lack of examinations including pituitary provocation tests (PPTs) before and after the procedure. This study aimed to evaluate the growth hormone (GH) axis function of patients with nonfunctioning pituitary adenoma (NFPA) via pre- and postoperative PPTs. Moreover, the predictive factors for recovery from AGHD after TSS were validated to facilitate surgery for AGHD in patients with NFPA. ⋯ AGHD caused by NFPA can improve after initial TSS among young patients with certain peak GH levels assessed by preoperative PPT. Whether TSS for NFPA can promote recovery from AGHD is worth considering in some patients.
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Journal of neurosurgery · Sep 2022
Prognostic factors for long-term outcomes of microvascular decompression in the treatment of glossopharyngeal neuralgia: a retrospective analysis of 97 patients.
The authors aimed to investigate predictors of postoperative outcomes of microvascular decompression (MVD) for the treatment of glossopharyngeal neuralgia (GPN). ⋯ Venous compression of the glossopharyngeal nerve root entry zone and lower degree of neurovascular conflict were significantly correlated with shorter pain-free survival in patients who underwent MVD for GPN. Microvascular decompression is a safe, feasible, and durable approach with a low complication rate for the treatment of GPN.
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The authors investigated the microvascular anatomy of the hippocampus and its implications for medial temporal tumor surgery. They aimed to reveal the anatomical variability of the arterial supply and venous drainage of the hippocampus, emphasizing its clinical implications for the removal of associated tumors. ⋯ An understanding of the vascular variability and network of the hippocampus is essential for medial temporal tumor surgery via anterior temporal lobectomy with amygdalohippocampectomy and transsylvian selective amygdalohippocampectomy. Stereotactic procedures in this region should also consider the anatomy of the vascular arcade at the hippocampal sulcus.
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Journal of neurosurgery · Sep 2022
Do social determinants of health impact access to neurosurgical care in the United States? A workforce perspective.
This study attempts to use neurosurgical workforce distribution to uncover the social determinants of health that are associated with disparate access to neurosurgical care. ⋯ Multiple factors demonstrate a significant correlation with neurosurgical workforce distribution in the US, most notably with Hispanic and Native American populations being associated with greater distances to care. Additionally, higher proportions of Hispanic residents correlated with fewer neurosurgeons per capita. These findings highlight the interwoven associations among socioeconomics, race, ethnicity, and access to neurosurgical care nationwide.