World Neurosurg
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Review Case Reports
Giant Malignant Peripheral Nerve Sheath Tumor of the Scalp: Case Report and Review of the Literature.
Malignant peripheral nerve sheath tumors (MPNSTs) are rare nervous system tumors that rarely appear on the scalp. About half of the scalp MPNSTs described in the literature have reached giant dimensions at the time of diagnosis. The surgical treatment is the gold standard for this type of tumor. Some authors suggest adjuvant radiotherapy for local tumor control, although there is uncertainty about its advantages and its use is not without risks. ⋯ Giant MPNSTs of the scalp are highly aggressive lesions that should primarily be treated in a surgical fashion. Although adjuvant radiotherapy has been used routinely for local tumor control, there is uncertainty about its advantages.
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Comparative Study
Cerebral Spinal Fluid collected by Lumbar Puncture has a higher diagnostic accuracy than collected by Ventriculostomy.
Patients harboring an external ventricular drain (EVD) who develop signs of infection require screening for infection in the central nervous system (CNS). The cerebrospinal fluid (CSF) can be collected by the EVD or by lumbar puncture (LP). If only one sample is analyzed, the diagnosis might be dubious or false-negative. The objective of this study was to compare the diagnosis accuracy of CNS infection of CSF samples collected from EVD and LP. ⋯ The CSF analysis exclusive from the EVD has a low sensibility and negative predictive value. CSF collected from LP has a sensibility 2.18 times higher than EVD.
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Review Meta Analysis
Transcorporeal Tunnel Approach for Cervical Radiculopathy and Myelopathy: a Systematic Review and Meta-Analysis.
The transcorporeal tunnel approach is a relatively new alternative of anterior cervical decompression and fusion for the treatment of cervical radiculopathy and myelopathy, with its main presumed advantage being the preservation of the intervertebral space. The aim of the present article is to present the outcomes of the systematic review and meta-analysis regarding the short-term outcomes of this surgical technique. ⋯ Although technically challenging, like all minimally invasive methods, the transcorporeal tunnel approach seems to be a safe and efficient option for the treatment of cervical radiculopathy and myelopathy, presenting comparable outcome profiles to alternative open or less invasive techniques.
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Review Case Reports
Minimally invasive resection of intracerebral amyloidoma; case report and systematic review of the literature.
Management of cerebral amyloidomas has lacked consensus owing to their rarity. We present a case and review 39 reported cases of amyloidomas in the literature, comparing their initial presentation, imaging characteristics, treatment, and progression. ⋯ To our knowledge, this is the first documented case of the use of diffusion tractography in preoperative planning for cerebral amyloidoma resection. Our systematic review of 39 reported cases of amyloidomas in the literature provided insight regarding how these rare lesions have manifested and progressed and further understanding of current theories regarding their etiology and pathophysiology. Cerebral amyloidomas are rare, localized, proteinaceous aggregates with variable presentation and prognosis and no apparent relationship to systemic amyloidosis. Biopsy may be useful in determination of progression. Diffusion tractography is a valuable tool for minimizing complications associated with resection.
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Case Reports
Lessons from China when Performing Neurosurgical Procedures During the COVID-19 Pandemic.
The novel coronavirus disease 2019 (COVID-19) pandemic poses a substantial threat to the health of health care personnel on the front line of caring for patients with COVID-19. The Centers for Medicare and Medicaid Services have announced that all nonessential planned surgeries and procedures should be postponed until further notice and only urgent procedures should proceed. Neurologic surgeries and procedures should not be delayed under the circumstance in which it is essential at saving a life or preserving functioning of the central nervous system. ⋯ Following the proposed guidance, urgent neurosurgical surgeries and procedures can be safely performed for the benefit of critical patients with or suspected for COVID-19.