World Neurosurg
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Atypical teratoid rhabdoid tumors (ATRTs) are rare and aggressive tumors, usually affecting patients younger than 3 years of age, that are characterized by a poor prognosis. Nowadays multimodal management, including surgery, chemotherapy and radiation therapy (RT), is advocated depending on the patients' age and tumor stage, even if no consensus exists regarding the best treatment modality. Local RT seems to be the most effective treatment in prolonging progression-free and overall survival rates, although RT might not be used on younger children because of the risk of neurocognitive and endocrine sequelae. Stereotactic radiosurgery (SRS) is a valuable alternative therapeutic option to conventional RT because of the more conformal dose delivery. The aim of this study was to review the available literature on SRS in the management of ATRT. ⋯ SRS should be considered in the multimodal treatment of ATRT, and future studies should focus on a better definition of the role played by SRS in their management.
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Review Biography Historical Article
Joseph Buford Pennybacker CBE MD FRCS (1907-1983): Continuing Sir Hugh Cairns' Oxford Legacy and Pioneer of the Modern Management of Cerebral Abscesses.
The authors examine the life and contribution of Joseph Buford Pennybacker to British neurosurgery and the modern management of cerebral abscesses. Pennybacker's inspirational journey began with him aspiring to follow in the footsteps of the pioneering surgeon, Ephraim McDowell. It saw him cross the Atlantic, learn medicine at Edinburgh, train in neurology at Queen Square in London, and study neurosurgery under Sir Hugh Cairns in Oxford. ⋯ The pioneering Pennybacker system of managing cerebral abscesses stood the test of time and the ethos of preoperative imaging, intervention, and postoperative monitoring-clinically, biochemically, and with imaging results-remains today. Pennybacker contributed significantly to British neurosurgery and the training of both home-grown and international neurosurgeons and he was also a remarkably kind-hearted and calm individual. These qualities inspired many of his contemporaries and junior colleagues, and we hope will continue to do so for generations to come.
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Bibliometric analyses based on total citation count come with many limitations, which investigators in other fields have overcome using the average number of citations per year since publication. ⋯ These results suggest that ranking articles based on relevancy rather than historical popularity results in a list of more recently published articles and includes more studies addressing topics of surgical management and outcomes. The ability to appraise the literature in this fashion is worthwhile to those seeking a better understanding of the science underlying modern clinical practice and is thus a highly valuable tool for neurosurgical residents, program directors, and neuroscientists as they acquire an understanding of modern neurosurgery and its scientific foundation.
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Review Historical Article
Assessing the relevancy of "citation classics" in neurosurgery. Part II: Foundational papers in neurosurgery.
The second part of this study reanalyzes Ponce and Lozano's (2010) list of classics to create a new list of "foundational" articles in neurosurgery. Ponce and Lozano (2010) previously published a list of 106 neurosurgery classics, as defined by Garfield and his 400 citation criterion. ⋯ By assessing citation counts as a function of time, we are able to differentiate classic neurosurgical studies that are critical to modern-day practice from those that are primarily of historic interest. Given the exponential growth of literature in our field, analyses such as these will become increasingly important to both trainees and senior neurosurgeons who strive to educate themselves on the data that drive modern-day clinical decision making.
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Review
Metabolic in vivo Visualization of Pituitary Adenomas: a Systematic Review of Imaging Modalities.
Pituitary adenomas (PAs) are the most common intrasellar mass. Functional PAs constitute most of pituitary tumors and can produce symptoms related to hormonal overproduction. Timely and accurate detection is therefore of vital importance to prevent potentially irreversible sequelae. Magnetic resonance imaging is the gold standard for detecting PAs, but is limited by poor sensitivity for microadenomas and an inability to differentiate scar tissue from tumor residual or predict treatment response. Several new modalities that detect PAs have been proposed. ⋯ PET and MRS appear to have the strongest predictive value in detecting PAs. MRS has the advantage of low cost, but the literature is lacking in specific studies of the pituitary. Due to high recurrence rates of functional PAs and low sensitivity of existing diagnostic workups, further investigation of metabolic imaging is necessary.