World Neurosurg
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Observational Study
Head injury and Pregnancy- Does the outcome differ? A descriptive analysis of fifteen years from a single tertiary care center.
There are conflicting data about the outcome of head injury in pregnant patients. Since they comprise a small proportion of the traumatic brain-injured (TBI) patients, the literature is sparse on true evidence on this issue. ⋯ Pregnant TBI patients have better long-term outcomes than their similar-aged counterparts. However, radiologic severity of injury does not seem to predict outcome in this cohort.
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While surgery is a critical treatment option for craniopharyngiomas, the optimal surgical approach remains under debate. Herein, we studied a large cohort of craniopharyngioma patients to identify predictors of endoscopic surgery (ES) and to compare survival outcomes between patients undergoing ES versus nonendoscopic surgery (NES). ⋯ ES of craniopharyngioma was associated with reduced mortality and shorter inpatient stays compared to NES. Factors including tumor size, extent of resection, facility type, and year of diagnosis may predict receiving ES. There is a trend towards increased usage of ES for surgical management of craniopharyngiomas.
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Anemia is a modifiable risk factor for postoperative complications following surgery. This study aimed to determine the impact of preoperative anemia severity on 30-day postoperative complications following adult spinal deformity (ASD) surgery. ⋯ We found a stepwise and approximately two-fold increase in the odds ratio of postoperative transfusion and length of stay with increasing severity of anemia. Moderate-to-severe anemia was associated with increased odds of death and organ space infection. Patients with moderate-to-severe anemia should be medically optimized before ASD surgery.
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Treatment of an unruptured brain arteriovenous malformation (bAVM) is a matter of debate, especially for low-grade bAVM (Spetzler-Martin grade I and II). The aim is to compare the outcomes of patients with low-grade unruptured bAVM after interventional or medical management in a pragmatic manner. ⋯ This study shows no differences between treated and untreated low-grade bAVM. Embolization seems to carry a high risk of complication and should be used with caution. The small number of cases must encourage cautious interpretations especially because of the spontaneous high-rupture rate. One major interest is to investigate center habits in pathology when treatment standards are limited.
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During the pterional-transsylvian approach, we sometimes encounter the proximal Sylvian fissure (SF) deviating laterally beyond the fold of the sphenoidal ridge (SR) and experience difficulty dissecting the SF due to the deep and oblique dissection plane. In the present study, we explored the association between the height of the SR and lateral deviation of the SF during the pterional-transsylvian approach. ⋯ Small SR was associated with lateral deviation of the proximal SF.