World Neurosurg
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MicroRNAs (miRNAs) are a class of small noncoding RNAs that play important roles in tumor development and progression. miR-20a acts as an oncogene in many cancers; however, the underlying role of miR-20a in human glioma remains unknown. ⋯ Collectively, these results suggest a critical role for miR-20a in glioma cell apoptosis, proliferation, and invasion via the direct targeting of CELF2 and indicate its potential application in cancer therapy.
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To analyze treatment of microvascular decompression using the retrosigmoid approach (RA) in primary trigeminal neuralgia and hemifacial spasm using preoperative images combined with intraoperative microscopic navigation to avoid unnecessarily opening the mastoid air cells (MACs). ⋯ Image processing and intraoperative microscopic navigation can avoid unnecessarily opening MACs and might reduce postoperative cerebrospinal leakage and scalp infection after RA craniotomy.
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Case Reports
Intraoperative ultrasound guided posterior cervical laminectomy for degenerative cervical myelopathy.
We present our experience with routine intraoperative ultrasound (IOUS)-guided posterior cervical laminectomy (PCL) in patients with degenerative cervical myelopathy (DCM), describe the technique used, and describe relevant IOUS findings that may impact the surgical procedure. ⋯ IOUS is a poorly described yet easy-to-use and very effective tool for guidance and confirmation of adequate posterior decompression of the cervical spinal cord and nerve roots during PCL. Routinely using IOUS-guided decompression for PCL in patients with myelopathy will help avoid residual compression of neural elements and might be beneficial for functional outcome.
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The surgical repair of a cerebral aneurysm does not always lead to complete occlusion. A standardized repeatable method of reporting results of surgical clipping is desirable. Our purpose was to systematically review methods of classifying aneurysm remnants, provide a new scale with precise definitions of categories, and perform an agreement study to assess the variability in adjudicating remnants after aneurysm clipping. ⋯ Various classification schemes to evaluate angiographic results after surgical clipping exist in the literature, but they lack standardization. Adjudication using fewer, better defined categories may yield more reliable agreement.
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Voice alteration as a presenting symptom in cases with Chiari formation is analyzed, as well as outcome after atlantoaxial fixation. ⋯ Such critical symptoms of voice disturbance and inadequate breathing and the possibility of rapid postoperative recovery have not been recorded earlier in the literature.