Neurosurgery
-
The natural history of surgically treated intracranial meningiomas can be quite variable. Recurrence and patient outcome cannot currently be predicted with accuracy. ⋯ HIF, VEGF, and MIB-1 are significantly correlated with tumor recurrence. With further study, these molecular markers may be used to predict outcome for patients with intracranial meningiomas.
-
Conus medullaris arteriovenous malformations (AVMs) are rare, challenging spinal vascular lesions that cause progressive debilitating myeloradiculopathy. Only sporadic reports of conus AVMs have been published. ⋯ Although conus AVMs are challenging to treat, excellent long-term outcomes are possible with a multimodality approach. Recurrence is associated with long-term neurological decline and calls for close follow-up.
-
Giant invasive spinal schwannoma (GISS) is defined as a lesion that extends over > 2 vertebral levels, erodes vertebral bodies, and extends posteriorly and laterally into the myofascial planes. Because of its rarity, few reports have been issued. ⋯ Total resection is the treatment of choice for patients with GISS and provides functional improvements, low permanent morbidity, and a low rate of recurrence. Total resection of the intraspinal portion and regular follow-up with consideration of the Ki-67 index is recommended when total resection is not achieved.
-
Kuntz et al recently introduced a new system for classifying spinal deformities. This classification of spinal deformity was developed from age-dependent deviations from the neutral upright spinal alignment. ⋯ The new Kuntz et al deformity classification system is comparable to the Lenke et al system in terms of reliability. However, the Kuntz et al classification system provides no recommendations for surgical interventions. It is more complex and time-consuming and therefore may be of limited value in daily clinical practice.
-
The Rotterdam computed tomography (CT) score was developed for prognostic purposes in traumatic brain injury (TBI). ⋯ For head-injured patients undergoing DC, the Rotterdam CT score provides great prognostic discrimination and is an independent predictor of unfavorable outcomes. We suggest that the Rotterdam CT score be included as a prognosticator in the overall assessment of clinical condition of TBI patients before DC.