Journal of neurosurgery
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Journal of neurosurgery · Apr 2024
Longitudinal treatment outcomes of recurrent clival chordomas: a single-center retrospective study.
The objective of this study was to clarify the detailed clinical course of recurrent clival chordoma and the outcomes of each treatment modality. ⋯ Despite the aggressive nature of recurrent chordoma, 14 of 29 patients (48%) survived for more than 5 years after the initial recurrence using combined therapies. Multiple treatment options may contribute to the long-term survival of patients with this intractable tumor.
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Journal of neurosurgery · Apr 2024
Clinical outcomes after MRI connectivity-guided radiofrequency thalamotomy for tremor.
Radiofrequency thalamotomy (RF-T) is an established treatment for refractory tremor. It is unclear whether connectivity-guided targeting strategies could further augment outcomes. The aim of this study was to evaluate the efficacy and safety of MRI connectivity-guided RF-T in severe tremor. ⋯ RF-T guided by connectivity-derived segmentation is a safe and effective option for severe tremor in both PD and ET.
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Journal of neurosurgery · Apr 2024
Nonenhancing motor eloquent gliomas: navigated transcranial magnetic stimulation oncobiological signature.
Preoperative grading of nonenhancing motor eloquent gliomas is hampered by a lack of specific imaging surrogates. Tumor grading is crucial for the informed consent discussion before tumor resection. In this paper, the authors hypothesized that navigated transcranial magnetic stimulation (nTMS)-derived metrics could provide significant information to distinguish between high- and low-grade motor eloquent gliomas that present as nonenhancing tumors and therefore contribute to improving patient counseling, timing of treatment, preoperative planning, and intraoperative strategies. ⋯ Nonenhancing motor eloquent gliomas have a different impact on both anatomical and functional reorganization of motor areas according to their WHO grading.
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Journal of neurosurgery · Apr 2024
The 5-factor modified frailty index as a prognostic factor of stereotactic radiosurgery for metastatic disease to the brain.
Frailty, a state of increased vulnerability to adverse health outcomes, is associated with poor neurosurgical outcomes. The relationship between frailty and stereotactic radiosurgery (SRS) for brain metastases (BMs), however, has not been adequately described. In this study, the authors attempted to examine the connection between frailty and outcomes for patients receiving SRS for BMs. ⋯ Higher frailty scores at the time of SRS treatment were predictive of shorter OS and PFS intervals.
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Journal of neurosurgery · Apr 2024
Malignant primary tumors of scalp with cranial extension: multidisciplinary surgical strategies and outcomes.
Malignant cancers arising in the scalp may exhibit calvarial invasion, dural extension, and rarely cerebral involvement. Typically, such lesions require a multidisciplinary approach involving both neurosurgery and plastic surgery for optimal resection and reconstruction. The authors present a retrospective analysis of patients with scalp malignancies who underwent resection and reconstruction. ⋯ A multidisciplinary approach with aggressive neurosurgical resection is associated with good outcomes in patients with primary malignant scalp tumors, despite invasive disease on presentation. This analysis suggests that aggressive resection (level II and higher) is effective at reducing locoregional recurrence and is not associated with a higher risk of complications relative to resection without craniectomy. As most patients require scalp reconstruction to close the postresection defect, usually with vascularized free tissue transfer, involving a plastic surgeon in the surgical planning and execution is essential.