World Neurosurg
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Randomized Controlled Trial Multicenter Study
Stereotactic Radiosurgery for A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA)-Eligible Spetzler-Martin Grade I and II Arteriovenous Malformations: A Multicenter Study.
ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations) found better short-term outcomes after conservative management compared with intervention for unruptured arteriovenous malformations (AVMs). However, because Spetzler-Martin (SM) grade I-II AVMs have the lowest treatment morbidity, sufficient follow-up of these lesions may show a long-term benefit from intervention. The aim of this multicenter, retrospective cohort study is to assess the outcomes after stereotactic radiosurgery (SRS) for ARUBA-eligible SM grade I-II AVMs. ⋯ For ARUBA-eligible SM grade I-II AVMs, long-term SRS outcomes compare favorably with the natural history. SRS should be considered for adult patients harboring unruptured, previously untreated low-grade AVMs with a minimum life expectancy of a decade.
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Review Biography Historical Article
Usher Parsons (1788-1868) and his 19(th) Century Understanding and Surgical Treatment of Spinal Curvatures.
Usher Parsons was a prominent surgeon in the 19th century. However, his contributions to the understanding and treatment of spinal curvatures have been largely forgotten. ⋯ This glimpse into history offers insight into the thought processes and surgical strategies that were available in the early 19th century. It is pioneers in this field, such as Usher Parsons, on which our current understanding of spinal curvatures and its treatment is built.
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The medical literature still lacks information about the impact of surgery and adjuvant treatment on the life of patients with meningioma. The clinical outcome, timing of tumor recurrence, and causes of death are often overlooked. This study evaluates these data taking into account tumor localization and histologic grade. ⋯ Histologic grade is the most important factor for long-term survival. Complete resection has to be pursued in GII and GIII meningioma but must be carefully weighed against morbidities in GI meningioma.
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To evaluate the association of perioperative hemoglobin A1c (HbA1c) level in patients with diabetes with the incidence of infection after anterior cervical discectomy and fusion requiring operative intervention, in addition to determining if a threshold level of HbA1c above which the risk of infection increases significantly exists. ⋯ The risk of deep postoperative infection in patients with diabetes mellitus increases as the perioperative HbA1c level increases. ROC analysis determined that a perioperative HbA1c level higher than 7.5 mg/dL could serve as a threshold for a significantly increased risk of infection.
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The purpose of this study is to evaluate the role of venous phase timing when compared with technetium-99m Single Photon Emission Computed Tomography (SPECT) during angiographic balloon test occlusion of the internal carotid artery (ICA) and subsequent sacrifice of the ICA. ⋯ Our study demonstrated no correlation between venous phase timing and SPECT. Future studies comparing multiple tests with patients who have had vessel occlusion are necessary to determine the best adjunctive measures to predict delayed ischemia following carotid occlusion.