Journal of neurosurgery
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Journal of neurosurgery · Feb 2025
Comparative StudyThe impact of general anesthesia versus non-general anesthesia on thrombectomy outcomes by occlusion location: insights from the ETIS registry.
Identifying the optimal anesthetic technique for mechanical thrombectomy (MT) remains an unresolved issue. Prior research has not considered the influence of occlusion site when comparing general anesthesia (GA) with non-GA. This study evaluates the differential impacts of the anesthetic technique (GA vs non-GA) on outcomes according to the location of occlusion. ⋯ While GA and non-GA techniques did not differ significantly in functional outcomes, the influence of GA on angiographic and procedural safety outcomes was location dependent, underscoring the importance of a tailored anesthesia technique in MT procedures.
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Journal of neurosurgery · Feb 2025
A management algorithm for idiopathic intracranial hypertension in skull base meningoencephaloceles.
In this study, the authors assessed an algorithm for the diagnosis and management of idiopathic intracranial hypertension (IIH) in patients who had undergone surgical repair of skull base meningoencephaloceles presenting with spontaneous cerebrospinal fluid (sCSF) leakage. ⋯ Utilizing an algorithm of direct meningoencephalocele repair and selective shunting, acute and remote CSF leak recurrence rates were each 3.8%, and the VPS rate was 15.0%. These data provide further insight into CSF dynamics in this population and argue against the theoretical concern that CSF pressure will increase postrepair. Significant intraindividual variability suggests multiple LPs may be necessary before committing to invasive IIH treatment. Further work is necessary to determine the optimal IIH management strategy.
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Journal of neurosurgery · Feb 2025
Patient height and American Society of Anesthesiologists class as significant risk factors for posterior fossa surgery in the semisitting position.
To optimize surgical positioning for posterior fossa surgery (PFS) using the semisitting position (SSP) to avoid venous air embolism (VAE) and its possible life-threatening consequences, the authors evaluated their experiences with the SSP by analyzing a large cohort of PFS patients. ⋯ In summary, the data demonstrate that SSP can be used safely for PFS when taking special care to optimize positioning in tall and lower-grade ASA patients intraoperatively.
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Journal of neurosurgery · Feb 2025
Novel application of latent class analysis to outcome assessment in traumatic brain injury with multiple injury subtypes or poly-TBI.
The aim of this study was to stratify poly-traumatic brain injury (poly-TBI) patterns into discrete classes and to determine the association of these classes with mortality and withdrawal of life-sustaining treatment (WLST). ⋯ Distinct poly-TBI classes were associated with increased in-hospital mortality and WLST. Further research with larger datasets will allow for more comprehensive poly-TBI class definitions and outcomes analysis.
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Journal of neurosurgery · Feb 2025
Transsylvian transopercular peri-central core hemispherotomy for treating epilepsy: anatomy, surgical technique, and clinical outcome.
The objective of this study was to display the anatomical landmarks, surgical technique, and clinical outcome of transsylvian transopercular peri-central core hemispherotomy (TTPH) for treating refractory epilepsy. ⋯ TTPH offers anatomical landmarks as intraoperative guides and has achieved good seizure control and low complication rates.