World Neurosurg
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Case Reports
Minimally invasive contralateral over the top approach for lumbar calcified foraminal lesions: a technical note.
Various surgical techniques have been described to address intraforaminal/extraforaminal lumbar lesions. They vary from the classic posterior open approaches to minimally invasive techniques with tubular retractors and even endoscopy. These lesions have been approached from either an ipsilateral or a contralateral approach. Only a few reports have described a contralateral minimally invasive tubular approach to address these lesions. However, none of them have been able to address calcified pathologies. ⋯ To our knowledge, this is the first report of the expanded use of fixed tubular retractors to address calcified lumbar intraforaminal disc herniations. This approach allows a satisfactory access and view of the contralateral foramen and offending lesion. It permits a wide decompression while preserving the facet joint and thus prevents iatrogenic instability. It can also avoid the iliac crest, which does not allow an ipsilateral extraforaminal approach at the L5-S1 level. This approach is a safe and effective way to treat this specific pathology.
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Juvenile nasopharyngeal angiofibromas (JNAs) are highly vascularized benign lesions that mainly arise in adolescent male patients. Current treatment options include observation, radiotherapy, or surgical resection. Surgical resection is the treatment of choice as it achieves immediate and complete results, thereby minimizing the risk of recurrence. ⋯ The sinonasal cavity was widely patent and no tumor recurrence was noted 5 months postoperatively. JNAs can be challenging to treat as they can invade extensively into local structures. A careful consideration of treatment options and approaches are necessary when faced with these lesions.
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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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It has been proposed that Tourette syndrome is associated with dysfunction in widespread cortical areas and globus pallidus externus hyperactivity secondary to dopaminergic hyperactivity and serotonergic/dynorphinergic hypoactivity. The main objective of this study was to test this hypothesis by developing an animal model of Tourette syndrome via striatotomy, followed by administration of drugs that mimic the neurotransmitter environment, so as to induce globus pallidus externus hyperactivity. ⋯ These results show that striatotomy, followed by administration of levodopa/benserazide alone or associated with ergotamine and naloxone, is efficacious in inducing IM, supporting the hypothesis that led to this study.
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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.