World Neurosurg
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Opportunity exists for improved local control rates of grade 2 meningiomas that recur despite maximal surgical resection and adjuvant fractionated radiotherapy (RT). We describe a dose escalation strategy of increasing the total tumor radiation dose by adding a stereotactic radiosurgery (SRS) boost targeting gross disease to fractionated RT. ⋯ We found 100% in-field local control at 3 years from an SRS boost to fractionated RT targeting gross disease with an acceptable toxicity profile, suggesting this may be an effective and improved adjuvant treatment strategy in patients with grade 2 meningioma.
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Surgery is the preferred option for lumbar spinal stenosis (LSS) when conservative methods cannot meet the needs. Recent advancements in surgical techniques have brought various new methods for treating LSS. ⋯ Endoscopic decompression can effectively improve short-term back VAS scores and reduce hospital stays, while IPSD is effective in reducing long-term back VAS scores with minimal surgical duration and blood loss.
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This study aims to evaluate the prognostic factors and survival outcomes of pediatric patients with pineal region tumors (PRTs) using a large population-based registry. ⋯ Early age at diagnosis and aggressive histological types such as pineoblastomas are associated with poorer outcomes. Future research should focus on refining therapeutic protocols that integrate the histological and molecular profiles of these tumors.
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Neurosurgical procedures require meticulous preparation, including extra measures to ensure patient safety and the appropriate setup of the operating room, which must be fully established before the surgeon can initiate the first incision. Neurosurgical delay encompasses the time from anesthesia induction start to when the neurosurgeon makes the first incision. ⋯ Operational neurosurgical delays can be improved using sequential checklists by constraining the variability in each phase. The article provides a conceptual novel checklist that provides a modular approach and completion of all steps in a phase reduces the variability of error to the next phase. This approach eventually reduces the patient's time under anesthesia.
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Dystonia is common in Parkinson disease patients, affecting about 30% of them. Bilateral subthalamic nucleus deep brain stimulation (DBS) can sometimes lead to dystonia, but this relationship is not well understood. Our aim was to provide a better understanding of dystonia's causes and its connection to DBS. ⋯ Patients with off-dystonia before surgery tend to improve after DBS. Otherwise, DBS could have the role of "additive boost" in the process of sensitization of striato-pallidal pathways and lead to on-dystonia in particular patients.