World Neurosurg
-
Observational Study
Anatomical Feasibility of Right Oblique Approach for L5-S1 Oblique Lumbar Interbody Fusion.
We compared left and right vascular anatomy at the L5-S1 disc space and validated the anatomical feasibility of the right oblique approach for L5-S1 oblique lumbar interbody fusion. ⋯ The vessels on the right side of the L5-S1 disc were located more laterally, and most vessels on the right side were arteries accompanying PVAT, which might minimize vessel manipulation. These results indicate that the right side of the L5-S1 disc could provide feasible access for oblique lumbar interbody fusion at L5-S1.
-
Treatment of cystic craniopharyngiomas can be challenging and recurrences are frequent, even after total resection. In selected cases, less-aggressive surgery with the sole drainage of the cyst reliefs symptoms caused by mass effect and represents a valid alternative option, notably in pediatric population. We herein analyze a series of adult cystic craniopharyngiomas, managed with Ommaya Reservoir implant, focusing on local tumor control and eventual complications. ⋯ In selected patients, tailored procedures are required to achieve long-term tumor control and as well limit surgery-related morbidity. ORS could represent a safe and effective treatment option for cystic craniopharyngiomas, providing also reduced surgical-related morbidity, especially in recurrent lesions and in patients not suitable for radical surgery.
-
Vestibular schwannomas (VSs) can either be solid or contain variable amounts of cystic components. It has been established that gamma knife radiosurgery (GKRS) is an effective treatment modality for solid VSs. However, in the case of cystic VS, given the somewhat unpredictable growth of the cystic portion of these tumors, microsurgery has often been preferred to GKRS in the management of cystic VS. However, to date, a relative paucity of data evaluating the outcomes after GKRS for cystic VS has been available. In the present study, we reviewed our experience treating cystic VSs with GKRS and evaluated the results. ⋯ The results from the present study have demonstrated that GKRS is an effective treatment modality for cystic VSs.
-
To evaluate the clinical results and factors related to the resolution of preoperative cranial neuropathy after internal carotid artery ligation with high-flow bypass in patients with symptomatic large or giant cavernous carotid aneurysms. ⋯ Early treatment is recommended when treating large or giant cavernous carotid aneurysms with cranial neuropathy. Complete resolution is possible in younger patients with partial neuropathy.
-
Computed tomography images of patients with chronic subdural hematoma (CSDH) sometimes show obliteration of the basal cistern with high density in an obliterated Sylvian cistern, termed pseudo-subarachnoid hemorrhage (SAH). The present study aimed to clarify the characteristics and outcomes of these conditions. ⋯ Although the outcomes of patients with basal cistern effacement and pseudo-SAH were similar to outcomes of other patients with CSDH, problematic postsurgical complications and cerebrospinal fluid leaks were more likely to arise in such patients.