World Neurosurg
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Cervical spondylotic myelopathy (CSM) is the most common progressive degenerative disease of the spine in the geriatric population. The aim of the current review is to provide an evidence-based stepwise surgical approach to CSM according to the recent literature. ⋯ This article provides a stepwise evidence-based surgical approach for the management and treatment of patients with CSM.
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To determine the role of intracranial pressure (ICP) monitoring in management of patients with severe traumatic brain injury (TBI) admitted to a large level I trauma center in Southern Iran. ⋯ Age, GCS score on admission, Rotterdam score, intracranial hypertension, and maximum recorded ICP are important determinants of outcome in patients with severe TBI. ICP monitoring assisted us in targeted therapy and management of patients with severe TBI.
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Stent-Assisted Coiling of 501 wide-necked Intracranial Aneurysms: A Single-Center 8-Year Experience.
Stent-assisted coiling has expanded the treatment of complex wide-necked intracranial aneurysms. We present our experience with stent-assisted coiling, with an emphasis on procedure-related neurologic complications and the incidence of angiographic recurrence. ⋯ Stent-assisted coiling appears to be a safe and effective option for treating complex wide-necked aneurysms. Higher complication rates are associated with coiling before stenting, use of multiple stents, and hypertension. Stent delivery before coil deployment reduces the risk of procedural complications. Larger aneurysm size and initial incomplete occlusion are associated with aneurysm recanalization.
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Knowledge of the course of the vertebral artery during instrumentation is of paramount importance. It has been shown that erosion of the C2 pedicle and body can occur due to pulsations of the adjacent vertebral artery. This often results in a "cave" for this segment of the artery. The descriptions of this anatomy are limited. The current study was performed with the hope that these data will be of use to spine surgeons during C2 instrumentation. ⋯ Additional osteologic data regarding the course of the vertebral artery while within C2 may decrease morbidity during surgery in this region.
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The study aim was to evaluate the utility of 2-fraction, dose-staged Gamma Knife radiosurgery (GKRS) in patients with large, high-risk brain metastases (BMs). ⋯ The new 2-fraction, dose-staged GKRS concept seems to be a well-tolerated and effective treatment option for large BMs. This method may be indicated in elderly patients or patients with surgical contraindications with large or high-risk brain metastases.