Journal of neurosurgery
-
Journal of neurosurgery · Aug 2023
2-Hydroxyglutarate magnetic resonance spectroscopy in adult brainstem glioma.
Adult brainstem gliomas (BSGs) are rare tumors of the CNS that are poorly understood. Upregulation of the oncometabolite 2-hydroxyglutarate (2HG) in the tumor indicates the mutation of isocitrate dehydrogenase (IDH), which can be detected by magnetic resonance spectroscopy (MRS). Although histological examination is required for the definitive diagnosis of BSG, 2HG-optimized MRS (2HG-MRS) may be useful, considering the difficult nature of brainstem lesion biopsy. The aim of this study was to evaluate the utility of 2HG-MRS for diagnosing IDH-mutant adult BSG. ⋯ 2HG-MRS demonstrated high sensitivity and specificity for the prediction of IDH-mutant BSG. In addition, 2HG-MRS may be useful for predicting the prognosis of adult BSG patients.
-
Journal of neurosurgery · Aug 2023
Does a negative correlation of heme oxygenase-1 with hematoma thickness in chronic subdural hematomas affect neovascularization and microvascular leakage? A retrospective study with preliminary validation.
Chronic subdural hematoma (CSDH) is a common neurological disease among elderly adults. The progression of CSDH is an angiogenic process, involving inflammatory mediators that affect vascular permeability, microvascular leakage, and hematoma thickness. The authors aimed to identify biomarkers associated with angiogenesis and vascular permeability that might influence midline shift and hematoma thickness. ⋯ HO-1 is an independent risk factor in CSDH hematomas and is negatively correlated with CSDH thickness. HO-1 may play a role in the pathophysiology and development of CSDH, possibly by preventing neovascularization and reducing capillary fragility and hyperpermeability.
-
Journal of neurosurgery · Aug 2023
Inpatient healthcare burden and variables influencing hydrocephalus-related admissions across the lifespan.
The aims of this study were to quantify inpatient healthcare costs, describe patient demographics, and analyze variables influencing costs for pediatric and adult hydrocephalus shunt-related admissions in the US. ⋯ This is the first study to quantify the patient demographics and cost of hydrocephalus shunt-related admissions across the entire age spectrum. Shunt-related admissions cost the US more than $2.06 billion dollars per year and represent only a fraction of the total cost of hydrocephalus care.
-
Journal of neurosurgery · Aug 2023
Biography Historical ArticleThe temporary resection of the cranial vault by Wilhelm Wagner (1848-1900) instead of trepanation: the cornerstone of the modern craniotomy.
In this paper, the authors trace the history of cranial temporary resection, described by Wilhelm Wagner (1848-1900) in 1889, which changed the paradigm of the cranial opening from trephining to the craniotomy. The objective of the temporary resection was to obtain wide openings in the skull, keeping the cranial flap attached to the soft tissues to maintain bone vitality. ⋯ A literature review shows that the temporary cranial resection became a great success at that time because it allowed physicians to improve a number of constraints of the cranial opening using the crown trephine: bone vitality; a wide cranial window; easy, safe, and quick surgery; and economy of surgical instruments. The crude, primitive proposal of the temporary resection was ameliorated to quickly build the successful model of the modern craniotomy.
-
Journal of neurosurgery · Aug 2023
Randomized Controlled Trial Multicenter StudyA multicenter, randomized, placebo-controlled phase IIb trial of an autologous formalin-fixed tumor vaccine for newly diagnosed glioblastomas.
An autologous formalin-fixed tumor vaccine (AFTV) derived from resected glioblastoma (GBM) tissue can be used against unidentified tumor antigens. Thus, the authors conducted a multicenter double-blind phase IIb trial to investigate the efficacy of an AFTV. ⋯ The AFTV may have potential effects in certain patient subgroups. A phase III study for patients with total tumor removal remains warranted to confirm these findings. Clinical trial registration no.: UMIN000010602 (UMIN Clinical Trials Registry).