World Neurosurg
-
High-grade glioma surgery has evolved around the principal belief that a safe maximal tumor resection improves symptoms, quality of life, and survival. Mapping brain function has been recently improved by resting-state functional magnetic resonance imaging (rest-fMRI), a novel imaging technique that explores networks connectivity at "rest." ⋯ Resting-state fMRI can reliably detect common functional connectivity networks in patients with glioma and has the potential to anticipate network alterations after surgical resection.
-
The effect of expandable versus static cage type on radiographic outcomes in transforaminal lumbar interbody fusion (TLIF) has not been well studied in the literature. We studied the effect of 3 cage types on change in foraminal height (FH), disk height (DH), subsidence, and segmental lordosis (SL). ⋯ The average increase in the foraminal height in TLIF is small (0.7 mm) and is not different between the cage types; therefore, direct decompression is crucially important in this procedure. Although TLIF is often considered to be a kyphotic procedure, an expandable cage demonstrated superiority in terms of segmental lordosis improvement.
-
Malignant peripheral nerve sheath tumors (MPNSTs) occur sporadically, in patients with neurofibromatosis 1, and in patients with prior radiation therapy. The incidence of unrelated prior malignancies and family history of malignancy in patients with MPNSTs has not been previously described. ⋯ Patients with sporadic MPNSTs had a high incidence of personal and family history of malignancy. The genetics associated with sporadic MPNSTs include RAS and p53 mutations, which are found in multiple oncologic processes and tumor-forming syndromes. This suggests an underlying genetic predisposition to formation of malignancies, including MPNSTs.
-
We sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data. ⋯ ASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.
-
Case Reports
Pediatric giant craniopharyngioma, surgical field soak in diluted nimodipine solution reduces cerebral vasospasm.
Craniopharyngioma is a slow-growing benign tumor, accounting for 5.6%-13% of primary intracranial tumors in children. The present patient showed a huge cyst, and computed tomography scan of the brain revealed a 9.2- × 8.7- × 7.0-cm giant cystic lesion with calcification located in the suprasellar cistern. ⋯ The surgical field was soaked in diluted nimodipine solution for 12 minutes, including the exposed nerve and blood vessel, especially the optic nerve and middle cerebral artery, which led to vasospasm recovery. At 3-month follow-up, there was slight subdural hygroma; contrast magnetic resonance imaging scan did not reveal any residual tumor or recurrence.