World Neurosurg
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Pituitary apoplexy (PA) is a life-threatening syndrome. The usage of a dopamine agonist, such as bromocriptine or cabergoline, is considered a predisposing factor for PA, which commonly occurs 1.5 years within commencement. ⋯ PA related to dopamine agonist therapy can occur in cases of elevated bleeding tendency, even in long-term users, suggesting that attention should be paid in the administration of a dopamine agonist in the patient experiencing thrombocytopenia. Surgical intervention should be performed after the preoperative platelet number and adequate response to transfusion are confirmed, and the aggressive removal of prolactinoma in the cavernous sinus should be avoided to reduce the risk of hemorrhagic complications.
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To explore influence of reduction of slippage on radiologic parameters, clinical outcomes, and perioperative complications in treatment of grade II/III lumbar isthmic spondylolisthesis. ⋯ In patients with grade II/III lumbar isthmic spondylolisthesis, if postoperative slippage was grade I or less, pelvic tilt and sacral slope could be corrected more effectively, and better clinical outcomes would be obtained for cases with preoperative unbalanced pelvis. In cases with balanced pelvis, lumbar lordosis could be better corrected by the same degree of reduction, although clinical outcomes would not be influenced significantly. Perioperative complications would not be influenced by reduction of slippage.
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The prognosis for World Health Organization (WHO) grade II/III meningiomas is worse than for WHO grade I meningiomas. Histopathologic grade should ideally be identified during tumor resection, but current methods are time-consuming and have doubtful reliance. The aim of this study was to evaluate intraoperative flow cytometry (iFC) as a method for providing ultrarapid evaluation of meningioma malignancy. ⋯ Our method of calculating MI with iFC appears to be technically feasible and reliable for ultrarapid evaluation of meningioma malignancy. MI with iFC could potentially enable determination of an optimal treatment strategy during surgery, such as extent of resection of the tumor and management of invaded normal brain or nerves.
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Nearly 9.2% of vestibular schwannomas (VS) recur. We evaluate the association of cell proliferative markers like MIB with recurrence in VS. ⋯ MIB index ≥3.5% is associated with recurrence in VS. Maximal diameter of the tumor and extent of resection are perhaps not associated with recurrence of VS.
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Use of short-segment or long-segment fusion is controversial in treatment of adult lumbar degenerative scoliosis (ALDS). The aim of this study was to explore efficacy and feasibility of precision treatment of ALDS with selective nerve root block. ⋯ Precision treatment of ALDS with selective nerve root block can achieve favorable clinical outcomes and good fusion with less surgical injury and low complications. Deformity correction is limited, which requires further study.