World Neurosurg
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The use of thrombectomy in the treatment for acute ischemic stroke (AIS) affecting the anterior circulation is well established. Comparatively, fewer data exist on the effectiveness of these techniques in treating posterior circulation occlusions. This review analyzes and reports on the usefulness and outcomes of emergent thrombectomy in large-vessel occlusions affecting the posterior circulation. ⋯ In patients with AIS caused by large-vessel occlusion of the posterior circulation, successful reperfusion can be achieved via EMT, with approximately a third of these patients achieving a good functional outcome. However, with similar proportions of treated patients experiencing significant morbidity or mortality, respectively, there is urgent need for additional studies to identify predictive or modifiable factors for a positive outcome.
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The rare clinical entity of primary posterior pituitary tumors (PPTs) includes pituicytomas, granular cell tumors, spine cell oncocytomas, and sellar ependymomas. The recent World Health Organization classification of PPTs based on thyroid transcription factor 1 positivity has led to more investigations into the epidemiology, clinical presentation, nature history, histologic features, and operative characteristics of these tumors. The aim of this review is to summarize the characteristics of primary PPTs. ⋯ Primary PPTs are a rare group of pituicyte-derived low-grade nonneuroendocrine neoplasms that arise from the sellar region. The nondescript radiographic findings and subtle endocrine abnormalities also veil their accurate diagnostic prediction. As shown through the narrative as well as the literature review, there is still a lot to be understood about PPTs. A prospective multicenter registry of these rare tumors would benefit both the neurosurgical as well as the endocrinologic knowledge base.
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Review Historical Article
Trepanation of the Outer Table as a Treatment for Scalping Injuries: Historical Perspective and Modern Applications.
Complex cranial wounds represent complex surgical problems. In modern times, these are mostly due to accidental trauma. During the period of the American Frontier, violent scalping was a common practice. ⋯ This was accomplished as a byproduct of the violence of the scalping or as an application of the technique first described by Augustin Belloste in 1696. Application of this technique in a modern setting may allow for improved wound healing. Trepanation of the outer table to aid in healing and closure of complex cranial wounds has a long history of successful practice and can be successfully applied to modern practice.
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Multicenter Study Comparative Study
Comparative analysis of the Pipeline and the Derivo flowdiverters for the treatment of unruptured intracranial aneurysms - a multicentric study.
Flow diversion represents a safe and efficient technique for the endovascular treatment of complex intracranial aneurysms. This study compares 2 competing flow diverters, the Pipeline embolization device (PED) and the Derivo Embolization Device (DED) regarding technical aspects, clinical outcome, and angiographic results. ⋯ In regard to complication rates, functional outcome, and aneurysm occlusion, no significant differences were found between the PED and DED collective.
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With the evolution of endoscopic instruments and techniques, full-endoscopic spine surgery has attracted more attention worldwide in recent years. At the initial stage, surgeons conducted endoscopic lumbar discectomy using the transforaminal approach. Next, interlaminar endoscopic lumbar discectomy was developed to treat a herniation disc at the L5-S1 level. ⋯ However, the steep learning curve of endoscopic procedures has remained challenging. The use of interlaminar endoscopic lumbar discectomy entails many essential skills to manage the different anatomical structures of the spine. From the perspective of successful and safe interlaminar endoscopic lumbar discectomy, we have discussed the technical considerations for endoscopic procedures.