World Neurosurg
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Pyogenic spondylodiscitis is a rare disease, but its incidence is increasing. Over the last decade, spinal surgery has been modified to become minimally invasive. In degenerative spinal disorders, such minimally invasive surgery (MIS) reduces blood loss, muscular trauma, and the hospital stay. However, it is not known whether MIS also confers these benefits to patients with pyogenic spondylodiscitis. This retrospective cohort study compared the safety and efficacy of MIS and the conventional open surgical procedure in patients with pyogenic spondylodiscitis. ⋯ Our 9-year experience suggests that MIS is safe and effective for spontaneous pyogenic thoracic and lumbar spondylodiscitis.
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Multicenter Study
Associations of endothelin polymorphisms and aneurysm size at the time of rupture.
Aneurysm size is an important risk factor for aneurysm rupture. The pathophysiologic mechanisms underlying aneurysm growth remain poorly understood. Endothelin signaling is critical for cerebrovascular blood flow regulation. The influence of endothelin single nucleotide polymorphisms (SNPs) on aneurysm size at the time of rupture has not been previously investigated. ⋯ The EDNRA SNP rs5335 was independently associated with aneurysms ≥7 mm in size at the time of rupture. Patients with cerebral aneurysms also carrying the G allele of EDNRA SNP rs5335 may develop larger aneurysms before rupture.
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Multicenter Study
Management of War-related Ballistic Craniocerebral Injuries in a French Role 3 Hospital During the Afghan Campaign.
France deployed to Afghanistan from 2001 to 2014 within the International Security and Assistance Force. A French role 3 hospital was built in 2009 in the vicinity of Kabul International Airport (KaIA). The objectives of this study were to describe the epidemiology, management, and outcome of war-related craniocerebral injuries during the Afghan campaign in a French role 3 hospital. ⋯ War casualties with ballistic head injuries were predominantly multitraumatized patients with hemodynamic compromise requiring neurosurgical damage control management and multidisciplinary care. The neurosurgeon has thus an essential role to play.
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Cranial deformation, including deformational plagiocephaly, brachycephaly, and craniosynostosis, is a condition that affects a large number of infants. Despite its prevalence, there are no standards for the systematic evaluation of the cranial deformation. Usually, the deformation is measured manually by the use of calipers. Experts, however, do not agree on the suitability of these measurements to correctly represent the deformation. Other methodologies for evaluation include 3-dimensional (3D) photography and radiologic scanners. These techniques require either patient's sedation and ionizing radiation or high investment. The aim of this study is to develop a novel, low-cost, and minimally invasive methodology to correctly evaluate the cranial deformation using 3D imagery. ⋯ Smartphone-based photogrammetry is a low-cost, highly useful methodology to evaluate cranial deformation. This technique provides a much larger quantity of information than linear measurements with a similar accuracy as far as head marks exist. In addition, a new approach for the evaluation is pointed out: the comparison between the head 3D model and an ideal head, represented by a 3-axis ellipsoid.
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Mechanical endovascular embolectomy using stent retrievers has gained popularity for treatment of large vessel occlusion in acute ischemic stroke. Use of open embolectomy as a direct surgical treatment has been limited, likely owing to the technical difficulty, therapeutic time window, and time-consuming procedure. ⋯ Open embolectomy resulted in a high complete recanalization rate with an acceptable safety profile. Open embolectomy is a safe and durable method of cerebral recanalization in patients with embolic stroke and can be considered as a potential treatment if endovascular embolectomy cannot be performed. The details of the occluded arteries presented here will be useful for endovascular surgeons to prevent complications.