World Neurosurg
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The prevalence of BRAFV600E mutations in pleomorphic xanthoastrocytoma (PXA) World Health Organization (WHO) Grade 2 and PXA WHO Grade 3 reported varies from 60% to 80%, yet the prognostic implications remain unclear. ⋯ BRAFV600E mutations are less frequent in our population than reported in the literature. The BRAF mutation does not significantly impact OS and PFS. PXAs WHO Grade 3 are a distinct clinical entity, associated with worse PFS and OS than PXAs WHO Grade 2.
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Review Case Reports
Supratentorial Neurenteric Cysts: Systematic Literature Review and Case Report.
Neurenteric cysts (NC) are uncommon congenital lesions with histopathologic properties derived from the gastrointestinal or respiratory tract. They are typically located in the intradural extramedullary compartment but rarely seen in the supratentorial region. The occurrence of supratentorial NCs (S-NC) presents an interesting quandary regarding their embryopathogenesis. ⋯ If surgically resected, the cyst wall specimen should be sent for pathology review, because of the potential risk for malignancy. If conservatively managed, serial imaging is warranted to track for changes that may indicate transformation. The embryopathogenesis of these rare congenital lesions remains incompletely understood, but the most comprehensive theory involves enteric cell migration to the neuroectoderm during embryogenesis.
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It remains unclear how type of insurance coverage affects long-term, spine-specific patient-reported outcomes (PROs). This study sought to elucidate the impact of insurance on clinical outcomes after lumbar spondylolisthesis surgery. ⋯ Despite adjusting for potential confounding variables, Medicaid coverage was independently associated with worse 24-month PROs after lumbar spondylolisthesis surgery compared with other payer types. Although all improved postoperatively, those with Medicaid coverage had relatively inferior improvements.
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To compare perioperative outcomes, patient-reported outcome measures (PROMs), and minimum clinically important difference achievement after single-level transforaminal lumbar interbody fusion (TLIF) in patients stratified by preoperative comorbidity burden. ⋯ The results suggest that patients undergoing MIS TLIF with severe comorbidities can expect a similar postoperative trajectory for disability, leg and back pain, and physical function. However, long-term (1 year) mental health improvement from preoperative baseline was noted only in the mild to moderate comorbidity group.
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For patients undergoing brain surgery, once primary motor and sensory areas are identified by direct electrical stimulation, resection can be performed in the precentral and postsomatosensory areas while monitoring cognition. For this purpose, we developed a real-time neuropsychological testing (RTNT) protocol tapping sensorimotor cognition. ⋯ The sensory-motor RTNT is performed to assist surgery in the precentral and postsomatosensory areas.