World Neurosurg
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To evaluate results and feasibility of primary posterior reduction and fixation without fusion using C1-C2 screw-rod system for odontoid fractures. ⋯ Posterior reduction and fixation without fusion can be successfully performed for healing of odontoid fractures with acceptable results and minimal morbidity.
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The main target of stroke intervention is the revascularization of occluded vessels, usually achieved with thrombectomy or thrombus aspiration. Despite good results in limited series, intracranial primary stenting is controversial for increased hemorrhagic risk owing to the need for dual antiplatelet therapy. ⋯ Our experience with this patient demonstrates that primary intracranial stenting shoud be considered in selected cases when other revascularization techniques are difficult or impossible to perform owing to anatomic reasons. Extreme care should be taken in patient selection because of the risks associated with antiplatelet therapy. In particular, it may be recommended in patients with a small core on computed tomography perfusion or diffusion-weighted magnetic resonance imaging and in whom thrombectomy and thromboaspiration are impossible for anatomic reasons.
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To explore the superior frontal sulcus (SFS) morphology, trajectory of the applied surgical corridor, and white matter bundles that are traversed during the superior frontal transsulcal transventricular approach. ⋯ When feasible, the superior frontal transsulcal transventricular approach offers a safe and effective corridor to the anterior part of the lateral ventricle because it minimizes brain retraction and transgression and offers a wide and straightforward working corridor. Meticulous preoperative planning coupled with a sound microneurosurgical technique are prerequisites to perform the approach successfully.
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Case Reports
Sport-related structural brain injury: Three cases of subdural hemorrhage in American high school football.
The risk of sport-related concussion (SRC) has emerged as a major public health concern. In rare instances, sport-related head injuries can be even more severe, such as subdural hemorrhage, epidural hemorrhage, or malignant cerebral edema. Unlike SRCs, sport-related structural brain injury (SRSBI) is rare, may require neurosurgical intervention, and can lead to permanent neurologic deficit or death. Data characterizing SRSBI are limited, and many have recognized the need to better understand these catastrophic brain injuries. The goal of the current series is to describe, in detail, the presentation, management, and outcomes of examples of these rare injuries. ⋯ Acute subdural hemorrhage resultant from an in-game football collision is rare. The temporal proximity of the reported SRSBIs to recent SRCs emphasizes the importance of return-to-play protocols and raises questions regarding the possibility of second impact syndrome. Although epidemiologic conclusions cannot be drawn from this small sample, these cases provide a unique opportunity to demonstrate the presentation, management, and long-term outcomes of SRSBI in American high school football.
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The proper management of symptomatic patients with 2 or more brain metastases is not entirely clear, and the surgical outcomes of these patients undergoing multiple simultaneous craniotomies have not been well described. In this article, we describe patient outcomes after simultaneously resecting metastatic lesions through multiple keyhole craniotomies. ⋯ We present patient outcomes after simultaneously resecting metastatic brain tumors through multiple keyhole craniotomies in symptomatic patients. Our results suggest comparable outcomes and similar surgical risk compared with those undergoing resection of a single brain metastasis. Resection of multiple brain metastases may improve Karnofsky Performance Scale scores in the early postoperative period and allow patients to be weaned from steroids.