World Neurosurg
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The rhomboid fossa (RF) is a crucial anatomical region in brainstem surgery as it contains essential structures such as the reticular formation and cranial nerve nuclei. This study aimed to provide a detailed understanding of the complex microsurgical anatomy of the RF, which is vital for the safe execution of neurosurgical procedures. ⋯ This comprehensive morphometric analysis of the RF enhances the understanding of its intricate anatomy. By describing safe entry zones, the suprafacial and infrafacial triangles, and providing precise measurements of key anatomical features, this study serves as a valuable resource for neurosurgeons in planning and executing brainstem surgeries.
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Observational Study
Trends in hospitalisation and mortality rates associated with subarachnoid haemorrhage and unruptured cerebral aneurysms in Brazil.
Epidemiology of spontaneous subarachnoid hemorrhage (SAH) and unruptured intracranial aneurysm (UIA) is valuable for determining neurosurgical and general health care effectiveness. There is an information gap regarding these conditions in middle- and low-income countries. Therefore, we aimed to investigate hospitalization and mortality rates for SAH and UIA in Brazil from 2011 to 2019. ⋯ In Brazil, the SAH hospitalization trend is stable, although there is a worrisome increasing SAH-related mortality trend. A better scenario was observed for UIA, with an increase in hospitalizations and decrease in mortality.
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The link between tethered cord syndrome (TCS) and neurofibromatosis type 1 (NF1) remains unclear. To date, only 2 studies have indicated a high occurrence of TCS in the pediatric NF1 patient population. Our study aims to ascertain the incidence of TCS among Chinese pediatric patients with NF1. ⋯ In the group of pediatric patients with NF1, the incidence of TCS, presenting to the pediatric neurosurgery clinic for any reason, is significantly higher than that of the general population. However, the pathophysiological relationship between NF1 and TCS is still not clear. It is essential to provide counseling to NF1 patients and their families about the symptoms of TCS to make sure they are aware and can seek the necessary care when needed. This underscores the importance of not only diagnosing NF1 but also staying alert for related conditions like TCS, which may have a higher occurrence in this demographic.
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Surgical treatment is an effective strategy for cervical pyogenic spondylodiscitis (CPS). However, the optimal surgical approach is uncertain. This study was conducted to evaluate the clinical efficacy of debridement, reconstruction, and instrumentation via the anterior-only approach for CPS. ⋯ One-stage debridement, reconstruction, and instrumentation via the anterior approach is an effective surgical strategy for CPS. In addition to surgery, targeted and prolonged antibiotic therapy is of crucial importance.
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Primary gliosarcoma is a rare form of malignant central nervous system tumor, with limited understanding regarding its prognostic determinants and effective therapeutic interventions. ⋯ The present study's findings suggest that optimal management of primary gliosarcoma entails maximal safe resection, combined with adjuvant radiotherapy and chemotherapy with temozolomide, followed by salvage therapy in case of recurrence. However, the risk of metastases should be carefully monitored during the treatment course.