World Neurosurg
-
Identification of Biomarkers in Intracranial Aneurysm and Their Immune Infiltration Characteristics.
Intracranial aneurysm (IA), known as the intracranial "unscheduled bomb," is one of the most dangerous cerebrovascular diseases, with unclear pathogenesis. This study aimed to show the mechanisms and identify the new biological targets by applying bioinformatics analysis. ⋯ We explored the contributing factors involving IA, which may generate a better understanding of the complex interactions among them and inspire a promising strategy for clinical works.
-
Despite holding soft tissue away from high-speed drills during surgery, tissue can unexpectedly wrap around the drill shaft. We performed experiments to examine what precipitates such mishaps. ⋯ The pulling force generated by revolving high-speed drill shafts may result in tissue wraparound even when soft tissue is held away from the shaft.
-
Microscopic microvascular decompression (MVD) of the trigeminal nerve is the gold standard surgical treatment for medically refractory classical trigeminal neuralgia. Endoscopy has significantly advanced surgery and provides enhanced visualization of the cerebellopontine angle and its critical neurovascular structures. We present our initial experience of fully endoscopic microvascular decompression (e-MVD). ⋯ Our study demonstrated that e-MVD is a safe, possibly effective method of performing MVD with the added benefit of improved visualization of the operative field for the operating surgeon and the surgical team. Larger prospective studies are required to evaluate whether performing e-MVD confers any additional benefits in long-term clinical outcome of patients with trigeminal neuralgia.
-
Dorsal instrumentation and decompression are the mainstays of spinal tumor treatment. Replacing titanium screws with carbon fiber-reinforced polyetheretherketone (CFRP) screws can reduce imaging artifacts on neural structures and perturbations of radiation dose. Further reduction of metal content in such screws might enhance the benefit. The aim of this study was to assess the artifacts produced by all-titanium screws (Ti-Ti), CFRP thread-titanium screw heads (C-Ti), and all-CFRP screws (C-C). ⋯ CFRP pedicle screws reduced the artifact intensity in spinal structures compared with titanium screws, and may be beneficial for planning radiotherapy and for follow-up imaging. C-C demonstrated an enhanced effect on dorsal structures.
-
Microvascular decompression (MVD) has grown as a first-line surgical intervention for severe facial pain from trigeminal neuralgia and/or hemifacial spasm. We sought to examine the safety and cost-benefits of discharging patients with MVD within 1 day of admission. ⋯ In our experience, MVDs are a safe, elective intervention. Our findings suggest that postoperative day 1 discharge in patients with an uncomplicated postoperative course may be safe while improving hospital resource use.