Journal of neurosurgery
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Journal of neurosurgery · Dec 2024
Cognitive impacts of unilateral MR-guided focused ultrasound thalamotomy: a meta-analysis and a call for systematic neuropsychological assessment.
Pharmacoresistant tremors, often seen in Parkinson disease and essential tremor, significantly impair patient quality of life. Although deep brain stimulation has been effective, its invasive nature limits its applicability. MR-guided focused ultrasound (MRgFUS) thalamotomy offers a noninvasive alternative, but its cognitive impacts are not fully understood. This meta-analysis aimed to evaluate the cognitive and emotional effects of unilateral MRgFUS thalamotomy in patients with pharmacoresistant tremors. ⋯ Unilateral MRgFUS thalamotomy appears to be a safe procedure with respect to cognitive and emotional outcomes in patients with pharmacoresistant tremors. However, the small number of studies and the short-term nature of assessments necessitate caution. Further research, especially on long-term cognitive effects and in the context of bilateral procedures, is essential for a comprehensive understanding of MRgFUS thalamotomy's neuropsychological impact. Systematic review registration no.: CRD42023491757 (www.crd.york.ac.uk/prospero).
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Journal of neurosurgery · Dec 2024
Comparative analysis of intraoperative MRI and early postoperative MRI findings in glioma surgery patients.
The extent of resection (EOR) is an important prognostic factor for both low- and high-grade gliomas. Intraoperative MRI (iMRI) has been used to increase the EOR in glioma surgery. While a recent study reported differences between iMRI and early postoperative MRI (epMRI), their specific relationship to postoperative clinical symptoms remains unclear. This study aims to compare the differences between iMRI and epMRI in glioma surgery. ⋯ Overall, iMRI demonstrated more accurate EOR and less SICE compared with epMRI. Although the positive rate of DWI abnormality was lower on iMRI than on epMRI, the late-developing group showed no postoperative neurological deficits. Therefore, iMRI is more useful in assessing accurate EOR and detecting postoperative neurological deficits than epMRI.
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Journal of neurosurgery · Dec 2024
Early radiological reduction of periventricular anastomosis after direct bypass surgery for adult moyamoya disease.
Periventricular anastomosis (PA), a recently recognized cause of hemorrhage in moyamoya disease, is reducible after bypass surgery. The timing of the reduction, however, remains poorly understood. The objectives of the present study were to demonstrate radiological reduction of PA occurring within 48 hours after surgery and to identify factors associated with reduction. ⋯ PA could be reduced within 48 hours after direct bypass surgery, suggesting an early preventive effect against hemorrhage. Early reduction, a potential predictor for late-phase reduction, might be promoted by targeted bypass surgery.
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Journal of neurosurgery · Dec 2024
Impact of smoking on the detection of brain aneurysms in general population screening: a systematic review and meta-analysis.
While the relationship between smoking and subarachnoid hemorrhage is well established, data regarding the probability of detecting unruptured intracranial aneurysms (UIAs) in smokers remain sparse. The aim of this systematic review and meta-analysis is to provide a comprehensive understanding of the relationship between smoking and the likelihood of identifying UIAs in healthy asymptomatic patients who underwent brain imaging for indications unrelated to UIAs. ⋯ This study suggests a potentially higher risk of UIAs in patients who smoked than in those who never smoked. However, the results of this meta-analysis revealed that smoking was not statistically associated with higher UIA detection. This result could be explained by the limited number of studies published on this topic. If these findings reach statistical significance in future larger studies, it could justify revising guidelines to include cigarette smokers in intracranial aneurysm screening.
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Journal of neurosurgery · Dec 2024
A spinal perimedullary arteriovenous fistula treated by Walter Dandy and illustrated by Dorcas Hager Padget in 1934.
Dorcas Hager Padget was a renowned neurosurgical illustrator and neuroembryologist. She collaborated closely with Walter E. ⋯ The illustration portrays the patient's myelopathic symptoms and pmAVF treatment by ligation and resection of a venous pouch located at the fistula site, indicating Dandy's early understanding of the lesion's architecture. Whether the illustration was created for a publication that fell to the wayside or exclusively for Dandy's patient history records remains unknown.