World Neurosurg
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Tumor-treating fields (TTFs) have become an important, evidence-based modality in the treatment of glioblastoma (GBM). In patients requiring cardiac pacemakers, TTF therapy is complicated by theoretical concerns regarding possible electrical interaction between the devices. ⋯ The first reported case of successful TTF administration in a GBM patient with a previously implanted cardiac pacemaker may allay the concerns of neuro-oncologists, cardiologists, radiation oncologists, and all certified TTF prescribers regarding the applicability of TTF in suitable candidates with preexisting cardiac pacemakers. This case indicates that TTF therapy may be efficacious in patients with indwelling magnetic resonance image-conditional cardiac pacemakers turned to the off position and that physical removal of the pacemaker is not necessary before starting TTF.
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To determine whether the facet joint violation (FJV) impacts clinical outcomes after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures. ⋯ Approximately 15.9% of patients were diagnosed with FJV by postoperative computed tomography scans. FJV had a negative influence on clinical outcomes after PKP in osteoporotic vertebral compression fractures, primarily at short-term follow-up. In addition, FJV was also a risk factor in the long-term surgical satisfaction.
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Spinal metastases pose significant morbidity. For many histologies, the spine is a frequent site for bone metastases. This predilection is not fully understood, and there are conflicting reports regarding the distribution within the vertebral body itself. Knowing this distribution will give clues as to the underlying biologic reason for this increased incidence in the spine and lead to a better understanding of tumor dispersion and growth. ⋯ Metastatic lesions of the thoracolumbar spine have a greater propensity to localize to the posterior aspect of the vertebral body. These data support the hypothesis that there may be differences within the vertebral body leading to differential tumor dispersion and growth.
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Acute subdural hematomas are frequently seen in brain trauma-injured patients. However, spontaneous subdural hematomas are uncommon, especially those localized in the posterior fossa, where fewer than 10 case reports have been described in the medical literature. ⋯ The patient had a great outcome, with no neurologic deficits at hospital discharge and the 1-year follow-up.
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Dural arteriovenous fistulas (DAVFs) at the petrous apex are rare but may cause subarachnoid hemorrhage (SAH) or severe brainstem edema. This study aimed to summarize their clinical features and discuss the classification. ⋯ Petrous apex DAVFs carried a high risk of embolization-related complications. Based on the vascular architecture, this classification may reflect their clinical features and provide some advice on the treatment of DAVFs at the petrous apex.