World Neurosurg
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Regardless of acceptable surgical results of middle cerebral artery aneurysms (MCAs), MCA territory infarction (MCATI) remains a major obstacle to achieving a good outcome. We investigated the MCATI in patients with surgically treated MCA aneurysms. ⋯ In the present study, compared with M1-2 aneurysms, MCATIs were observed more frequently in EFCB aneurysms, and the presence of MCATI and a larger size ratio were related to 12-month neurologic worsening in patients with surgically treated MCA aneurysms.
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The volume of activated tissue (VTA) model attempts to represent in 3 dimensions the diffusion of the current provided by the deep brain stimulation lead on brain structures. The objective of the present study was to assess the correlations among the VTA, activation of the corticospinal tract, and the intraoperative side effect (ISE) threshold. ⋯ The present study is the first to show a relationship between the intensity threshold as determined by the use of the VTA and the ISE threshold. The correlation between the clinical features and the VTA appears to be stronger in the model based on a combination of high-resolution anatomic data and interpretable DTI data.
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Comparative Study
Comparison of Dural Peeling versus Duraplasty for Surgical Treatment of Chiari Type I Malformation: Results and Complications in a Monocentric Patients' Cohort.
Chiari malformation type I is typified by the downward herniation of the cerebellar tonsils through the foramen magnum, which can impede cerebrospinal fluid circulation and may lead to syringomyelia. The usual symptoms of this condition are neck pain and posterior headaches on Valsalva maneuver. Different surgical procedures have been described for cranio-cervical decompression (CCD), without a consensus being reached about the best suited technique. The primary end point of this study was to compare efficacy and complications rate of CCD using dural peeling (DPe) versus duraplasty (DP). The secondary end point was to find predictive factors of success of DPe. ⋯ CCD with DPe was less risky than with DP but had a lower responsive rate (66.7% vs. 100). Larger studies are therefore warranted to assess predictive factors of success of CCD with DPe.
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To investigate the effects of atorvastatin on the surgical treatment of patients with chronic subdural hematoma (CSDH). ⋯ Our findings demonstrate that the administration of atorvastatin perioperatively is associated with a lower risk of CSDH recurrence rate. The use of atorvastatin perioperatively was not associated with higher rates of morbidity or mortality.
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Gastroparesis following resection of a fourth ventricle tumor has never been reported in the literature. We report a unique case of gastroparesis following resection of a fourth-ventricle ependymoma in a child. ⋯ We report, to our knowledge, the first case of gastroparesis following resection of a fourth-ventricle ependymoma in a child. Gastroparesis can recover spontaneously, which we suspect may be due to reversible injury of the dorsal motor nucleus of the vagus.