World Neurosurg
-
Deep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD). However, infection following DBS surgery is a serious complication that can lead to the recurrence and worsening of Parkinson's symptoms or related hardware reimplantation, causing considerable patient suffering and financial burden. ⋯ Scalp incision infections following DBS surgery can affect deep tissues, and the implementation of a comprehensive treatment strategy involving local debridement and removal of potentially affected implants can significantly reduce the risk of infection recurrence and its spread.
-
Persistent spinal pain syndrome (PSPS) poses a significant medical challenge, often leading to diminished quality of life for affected individuals. In response to this clinical dilemma, spinal cord stimulation (SCS) has emerged as a promising intervention aimed at improving the functional outcomes and overall well-being of patients suffering from this debilitating syndrome. In case a therapy with percutaneous lead fails (e.g., due to a dislocation), surgical lead can be used as a stable alternative. This results in a more invasive procedure and does not allow for intraoperative monitoring. The aim of this study is to investigate the efficacy and safety of the use of surgical leads, as there have been only a few case series published so far. ⋯ SCS with surgical leads is a safe secondary technique to treat PSPS, where treatment with percutaneous leads fail. The results show a promising long-term effect concerning pain intensity and functional outcome.
-
Tuberous sclerosis complex (TSC)-related skeletal abnormalities are understudied. Awareness of skull thickening in patients with TSC is important from the surgical standpoint because a thick skull might complicate craniotomy. This study aimed to discover if patients with TSC are generally prone to skull thickening by retrospectively investigating the frequency and characteristics of skull thickening in these patients. ⋯ Patients with TSC have skull thickening, which is often linked to intracerebral calcification. The presence of skull thickening may require modification of surgical approach during craniotomy. Skull thickening and the underlying intracerebral calcification likely share a common precipitating factor given their relationship. Future studies are warranted to clarify the genetic underpinnings of this relationship and even broader skeletal abnormalities in TSC.
-
The demographics of the population with spinal cord injury (SCI) have been dynamic over time, especially as a result of aging. This study investigated the patterns of SCI admissions by age in the United States over the past decade. ⋯ The incidence of SCI increased. High cervical and incomplete injuries increased, whereas complete SCIs declined. In-hospital and 1-year mortality decreased. There was recovery in select cases of complete SCIs within 1 year.
-
Case Reports
An Extremely Rare Case of Collision Tumor: A Craniopharyngioma Coexists Pilocytic Astrocytoma.
A 21-year-old man presented with a 2-day history of cephalalgia and a 1-day history of nausea and vomiting. Neuroradiologic imaging revealed a lesion in the third ventricle accompanied by hydrocephalus. ⋯ Histopathological examination identified it as a rare collision tumor, composed of a mixture of craniopharyngioma and pilocytic astrocytoma. This is an exceedingly rare type of tumor, with no similar cases reported in the existing literature.