World Neurosurg
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Trigeminal neuralgia (TN) has been described as one of the worst pains known to humankind. However, pain severity in TN has been measured using several different scales, resulting in difficulty comparing illness burden and response to TN surgery across studies. We examined the degree of concordance between standardized scales evaluating pain severity in a cohort of patients undergoing surgery for TN. ⋯ TN patients with residual mild-moderate pain after surgery are often discordantly classified by different pain measurement scales. These findings argue for a more standardized method of reporting postoperative pain outcomes in the TN literature.
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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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Video-assisted debriefing (VAD) is promising for medical skill training, but its effectiveness requires further exploration. The aim of this study was to investigate the effectiveness of point-of-view VAD in spinal surgery training. ⋯ VAD is more effective than traditional verbal debriefing for improving residents' surgical skills, particularly for obtaining a more comprehensive understanding of anatomical structures, imitating detailed surgical techniques as well as promoting initiative. However, in terms of mastery of surgical skills, VAD is not significantly beneficial for tactile perception of the surrounding tissue, indicating that a certain amount of practice is still necessary.
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The purpose of this study was to determine the efficacy and safety of combined intravenous and topical use of tranexamic acid (TXA) in patients undergoing separation surgery for thoracolumbar spinal metastases by evaluating perioperative blood loss and complications. ⋯ The application of TXA in separation surgery of spinal metastases can obviously reduce drain days, perioperative blood loss, an dintraoperative transfusion rate. The combination of intravenous infusion and topical use of TXA is more effective than intravenous use alone, which showed a strong synergistic effect; additionally, it does not increase the risk of venous thromboembolism and wound infection.
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Trigeminal neuralgia is usually associated with vascular compression of the nerve entry zone. However, a dolichoectatic basilar artery represents the cause in only up to 3% of cases.1 This is characterized by dilation, elongation, or tortuosity of the vertebrobasilar arteries.2 In 10%-30% of cases, pain relief is not achieved with medical treatment. Thus, microvascular decompression techniques have been proven the most effective. ⋯ This surgical video illustrates anatomic nuances and critical aspects of the retrosigmoid approach as a safe and adequate access for microvascular decompression in a rare case of a megadolichoectatic basilar artery (Video 1). The patient consented to the procedure and the publication of his images. Institutional review board/ethics committee approval was not required nor sought due to the nature of this paper.