World Neurosurg
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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.
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AtlasGPT represents an innovative generative pretrained transformer, trained using neurosurgery literature. Its ability to construct its response according to the training level of the user is unique; however, whether its responses can be comprehended at each user's training level remains unknown. This study aimed to analyze the readability of responses provided by AtlasGPT. ⋯ AtlasGPT-generated content demonstrates readability variations according to the user profile selected; however, the readability of patient content still exceeds recommendations set by United States departmental agencies, necessitating a call to action.
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This study investigates the prognostic value of the apparent diffusion coefficient (ADC) in magnetic resonance imaging for patients with acute posterior circulation stroke (PCS) undergoing endovascular therapy (EVT). ⋯ High ADC values and unilateral infarction are independent predictive factors for the prognosis of patients with PCS after EVT. Combining these factors provides the highest predictive accuracy, aiding in clinical decision making for PCS treatment.
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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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Cerebrospinal fluid diversion via shunt placement is a common neurosurgical intervention. Keen's Point is a widely used landmark for accessing the trigone of the lateral ventricle; however, it lacks clinical validation. This study re-evaluates Keen's Point scalp parameters using magnetic resonance imaging (MRI) to identify an ideal shunt entry point based on 3-dimensional reconstructions. ⋯ This modified Keen's Point is a reliable landmark for ventriculostomy. Incorporating PCA into preoperative planning enhances catheter placement accuracy, providing a prominent approach to shunting at Keen's Point.