World Neurosurg
-
The aim of this study was to evaluate the occurrence and factors predisposing to delirium following brain tumor resection. ⋯ Many factors were associated with the occurrence of delirium after brain tumor resection. Therefore, clinicians should identify high-risk patients prone to delirium in a timely manner and take effective management measures to reduce adverse outcomes.
-
Double lumen balloon catheters (DLBCs) have emerged as a potential alternative to single lumen balloon catheters for endovascular embolization of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs). This study describes our preliminary experience with the Eclipse 2L DLBC in treating AVMs and dAVFs. ⋯ Our preliminary experience using the Eclipse 2L balloon catheter for Onyx embolization reported procedural outcomes comparable to other DLBCs despite relatively higher procedure times and radiation doses. Further long-term studies on its efficacy as primary modality in treating AVMs and dAVFs are encouraged.
-
The estimation of survival is extremely important for metastatic disease in the spine. The aim of this study was to determine the factors affecting the outcome of patients with spinal metastasis, primarily the character of neurologic deficit and the histopathology of the tumor. ⋯ The neurologic and ambulatory status, the Tomita and Tokuhashi scores, intradural localization, and gender are the factors with a significant effect on prognosis.
-
A significant dilemma exists for the surgical plan of spinal metastases with a spinal instability neoplastic score (SINS) of 7-12. Our aim is to trim down this range of "potential instability" and find a virtual cut-off value for instrumentation. ⋯ SINS 9-10 seems to be the actual ambiguous subset in the wider subgroup of the 'potentially unstable' category SINS 7-12, like a 'Matryoshka doll'. A SINS value of 9 can be seen as a cut-off value for instrumentation.
-
Meningiomas involving the dural venous sinuses present unique therapeutic challenges. While gross total resection remains the mainstay of treatment for meningiomas, involvement of critical vascular structures may limit extent of resection and increase the risk of recurrence. Optimal management of meningiomas with venous sinus involvement has been discussed in the literature, with some advocating for subtotal resection with postoperative surveillance and radiation, if necessary, while others recommend total resection with reconstruction of resection of the involved sinus. ⋯ Maximal safe resection, including resection and reconstruction of involved sinuses, may be a safe and effective treatment for many patients. Careful preoperative assessment of venous anatomy and planning extent of resection and reconstruction are essential for safe and successful surgery in these patients.