World Neurosurg
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Currently, arterial spin labeling (ASL) and amide proton transfer (APT) imaging have shown potential for distinguishing glioblastoma from brain metastases. Thus, a meta-analysis was conducted to investigate this further. ⋯ This meta-analysis suggest that both ASL and APT imaging exhibit high accuracy in distinguishing between glioblastoma and brain metastasis.
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To analyze preoperative predictors of ambulatory recovery after surgical treatment in metastatic spinal cord compression (MSCC) patients with delayed surgical timing and progressive paraplegia. ⋯ The significant predictive factor for ambulatory recovery was the preoperative lower-extremity motor grade. The preoperative knee extensor motor grade was identified as a more important factor than hip flexor motor grade in predicting ambulatory recovery.
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Case Reports
Gout-Induced Cervical Deformity and Progressive Myelopathy Mimicking Infection Requiring Cervical Reconstruction.
This study describes a rare case where gout, a condition primarily associated with joint inflammation, initially manifested as a progressive cervical kyphotic deformity, mimicking infection and causing myelopathy. The patient, a previously healthy 56-year-old woman, presented with severe jaw pain and a temporomandibular joint abscess, alongside 2 months of worsening balance and arm/hand tingling. Extensive clinical and radiographic assessments revealed a severe cervical kyphotic deformity with bony erosion at multiple vertebral levels, raising suspicion of an infectious cause of compressive myelopathy. ⋯ This report underscores the significance of considering gout as a potential cause when encountering unusual spinal pathologies, especially in cases where gout-related symptoms are atypical. The presented 540-degree surgical approach effectively addressed both the cervical deformity and gout-induced myelopathic symptoms. To the best of our knowledge, this study represents the first documented instance of a patient with undiagnosed gout-induced severe cervical deformity successfully treated through cervical spine deformity correction, emphasizing the importance of vigilance and innovative management approaches in such rare clinical scenarios. As of the 2-year follow-up, the patient exhibited significant symptom improvement and overall well-being.
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The natural history, treatment options, and clinical outcomes of pancreatic metastases to the brain remain largely unknown. Here, we seek to investigate characteristics that influence OS in pancreatic metastases to the brain. ⋯ Median OS is influenced by age, multiorgan metastases, and treatment of the primary tumor. These data highlight the marginal benefit of treatment, yet improved quality of life (QOL) remains to be elucidated.
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To evaluate the relationships between Doximity rankings (Doximity, Inc.) of residency programs and 2 new ranking systems based on publication rates and academic pursuits. ⋯ We introduced 2 new methods to rank residency programs based on the number of graduates pursuing an academic position and the median number of published manuscripts per resident. By taking a comprehensive approach, neurosurgery applicants can ensure that they select a residency program that meets their needs and offers them the best opportunity for success.