World Neurosurg
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To describe a single-layer fascia patchwork closure (FPWC) without nasoseptal flap (NSF) and compare postoperative cerebrospinal fluid (CSF) leakage between FPWC using NSF and single-layer FPWC without NSF for the extended endoscopic transsphenoidal transtuberculum transplanum approach. ⋯ Single-layer FPWC may be a viable technical option for effective skull base reconstruction after the extended endoscopic transsphenoidal transtuberculum transplanum approach.
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Cortical spreading depolarization (CSD), cortical spreading ischemia (CSI), and early brain injury are involved in the occurrence of delayed brain ischemia after subarachnoid hemorrhage (SAH). We tested whether local application of magnesium (Mg) sulfate solution suppressed CSD and CSI, and decreased brain damage in a rat SAH-mimicking model. ⋯ Local application of Mg suppressed CSI and reduced brain damage in a rat SAH-mimicking model. Mg irrigation therapy may be beneficial to suppress brain damage due to CSI after SAH.
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The far-lateral suboccipital approach and its variants, including the transcondylar, supracondylar, and paracondylar approaches, are essential skull base techniques for the neurosurgeon to expose and treat pathologies located at the ventral and ventrolateral craniovertebral junction. An understanding of the surgical anatomy and technical nuances of these approaches is vital for preventing catastrophic brainstem or spinal cord injury, neurovascular injury, and/or cranial nerve injury. This is achieved by carefully studying the location, the rostral-caudal and lateral extents of the lesion itself, and the anatomy of the surrounding structures on preoperative imaging. ⋯ A thorough knowledge of the anatomy of the extradural and intradural segments of the vertebral artery, and the lower cranial nerves, in relation to the lesion is also critical. For almost all lesions, the far-lateral suboccipital route with no or minimal condylar drilling is more than adequate for removing the most ventral lesions. Herein, we discuss the indications, general and preoperative considerations, and surgical anatomy and technical nuances of this approach.
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To investigate racial disparities in 30-day postoperative outcomes of craniotomy for glioma resection. ⋯ African American patients who undergo a craniotomy for glioma resection have almost twice the odds of Caucasian patients of having a postoperative major cardiovascular complication, pulmonary complication, or urinary tract infection. All minority groups have higher odds of an extended length of stay as compared with Caucasian patients.
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To identify risk factors for significant blood loss (SBL) in cervical laminoplasty, especially regarding thrombocytopenia and coagulopathy resulting from non-alcoholic fatty liver disease (NAFLD). ⋯ Thrombocytopenia is an independent predictor of perioperative SBL in cervical laminoplasty. Thus, patients with mild thrombocytopenia that may be associated with NAFLD must be carefully monitored to avoid perioperative SBL.