World Neurosurg
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The aim of this study was to determine if baseline frailty was an independent predictor of adverse events (AEs) and in-hospital mortality in patients being treated for acute cervical spinal cord injury (SCI). ⋯ Increasing frailty is associated with an increased risk of AEs and in-hospital mortality in patients undergoing treatment for cervical SCI.
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Middle meningeal artery embolization (MMAE) has been used as an effective minimally invasive treatment for chronic subdural hematoma (cSDH). The demographics and clinical outcomes after MMAE treatment for cSDH have not yet been studied using a national database. ⋯ MMAE is a safe and effective minimally invasive procedure for treatment of cSDH. This is the first analysis of patients undergoing MMAE for cSDH using a national database.
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Giant pituitary adenomas (GPAs) with subarachnoid extension can be challenging to achieve a gross total resection through a single endonasal or transcranial approach, and any residual tumor is at risk for postoperative apoplexy. Intraoperative venous congestion of the suprasellar tumor can occur following resection of the sellar tumor, limiting tumor descent, and leading to suprasellar residual. We propose a technique for resecting the suprasellar component first, which we call the "second floor" strategy (SFS) for GPA. ⋯ Postoperative apoplexy of residual adenoma is a rare but serious complication after GPA resection. The proposed SFS allows early access to the suprasellar tumor and may improve the ability to safely achieve a gross total resection without need for additional procedures.
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Social media has become ubiquitous in modern medicine. Academic neurosurgery has increased adoption to promote individual and departmental accomplishments, engage with patients, and foster collaboration. We sought to quantitatively evaluate the adoption of one of the most used social media platforms, Twitter, within academic neurosurgery. ⋯ We demonstrate rapid uptake in Twitter use among U.S. academic neurosurgical departments, accelerated by COVID-19. With the impact of COVID-19, it is clear that there will be continued rapid adoption of this platform within neurosurgery, and future studies should explore the outcomes of peer collaboration, patient engagement, and dissemination of medical information.
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Orbital schwannomas are a rare disease, representing about 1% of orbital tumors, potentially involving any subsite within the orbit. They usually present with painless, nonpulsatile proptosis, while diplopia and vision impairment due to extrinsic ocular muscles or optic nerve involvement are rarely observed.1 A wait-and-see policy is advocated in case of small asymptomatic lesions. However, if progressive dimensional increase or symptoms are observed, surgical resection represents the treatment of choice.2 Different surgical approaches have been proposed, mainly depending on tumor dimension and location inside the orbit, as well as surgical expertise. ⋯ The lesion was completely removed with an endoscopic transnasal approach (Video 1), without evidence of postoperative sequelae or visual impairment. Magnetic resonance imaging performed 3 months after surgery showed good surgical results without evidence of persistence of disease. A multidisciplinary approach, involving different specialists familiar with orbital anatomy and physiology, is required for a proper management of patients affected by orbital pathologies.