World Neurosurg
-
Although anterior cerebral artery (ACA) and anterior communicating artery (AcomA) variations have been frequently investigated by contrast-enhanced angiography, the number of studies performed with magnetic resonance angiography is quite low. Our aim in this study is to investigate ACA and AcomA variations with time of flight magnetic resonance angiography (TOF MRA). ⋯ In this study, in which we used the TOF MRA technique, we detected high rates of anatomic variations of ACA and AcomA. This method, which is noninvasive, does not require contrast material and does not contain ionizing radiation, can be preferred especially in the evaluation of patients with kidney disease and contrast allergy.
-
There are few objective measures for evaluating individual performance throughout surgical residency. Two commonly used objective measures are the case log numbers and written board examination scores. The objective of this study was to investigate possible correlations between these measures. ⋯ Identifying which objective measures correlate most closely with resident education could help optimize the structure of residency training programs. We believe that early exposure to focused aspects of neurosurgery helps the young resident learn quickly and efficiently and ultimately score highly on standardized examinations. Therefore program directors may want to ensure focused exposure during the early years of residency, with particular attention to worthwhile rotations in spine neurosurgery.
-
Endoscopic transnasal transclival intradural surgery is limited by a high postoperative cerebrospinal fluid leak rate. The aim of this study was to investigate the role of three-dimensional printing to create a personalized, rigid scaffold for clival reconstruction. ⋯ In this preclinical setting, additive manufacturing allows the creation of customized scaffolds that are effective in reconstructing even large and geometrically complex clival defects.
-
Given the vasculopathic nature of moyamoya disease (MMD) and high susceptibility to ischemic events, patients with MMD often require surgical revascularization via an indirect or direct bypass, and analysis of disparities in receipt of appropriate management is critical. ⋯ Further investigation into socioeconomic disparities in adult and pediatric patients with MMD is warranted given the potential for inequities in access to appropriate intervention.
-
Spinal meningiomas constitute 10% of all meningiomas. They most commonly rise in the thoracic spine and are most common in middle aged women; symptoms include progressive myelopathy.1,2 Radiation induced/radiotherapy-associated cranial meningiomas are well described with aggressive behavior; however, radiation-induced spinal meningiomas are extremely rare in the literature.3-7 Our patient had a history of Hodgkin lymphoma treated with neck radiation, and thyroid cancer treated with radioactive iodine/thyroidectomy. He presented with neck pain and myelopathy from a large intradural, extramedullary tumor compressing the spinal cord (C3-C5). ⋯ Cervical spine meningiomas with spinal cord compression and myelopathy should be resected to prevent further neurological decline. Dural splitting can be utilized to achieve "radical" tumor resection to prevent recurrence, which is particularly important if the tumor is aggressive and recurrent, as is the case in radiation-induced/radiotherapy-associated meningiomas. Upon dural closure, we applied autologous fat tissue along with fibrin glue to avoid spinal fluid leak as we published earlier.8 The patient consented to the procedure and publication of his image.