World Neurosurg
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The use of intraoperative ultrasound in emergency cranial neurosurgical procedures is not well described. It may improve surgical outcomes and is useful when other neuro-navigation systems are not readily available. We provide a practical guide for neurosurgical trainees to utilize ultrasound for various emergency cranial neurosurgical procedures, including lesion localization, insertion of an external ventricular drain, and shunt revision surgery. Intraoperative ultrasound is a useful modality for urgent neurosurgical procedures.
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Gamma Knife radiosurgery (GKRS) is a safe and effective treatment option for trigeminal neuralgia (TN). However, there is no objective, noninvasive tool to identify nonresponders or late responders to GKRS and to facilitate longitudinal patient management. We hypothesized that diffusivity metrics obtained 3 months after GKRS may correlate with response to treatment. ⋯ Diffusivity metrics changes on the treated trigeminal nerve at the 3-month time point after GKRS for TN correlated with pain relief at last follow-up. Further, well-designed studies are warranted to establish the clinical application of diffusion tensor imaging as a noninvasive, prognostic tool in patients with TN managed with GKRS.