World Neurosurg
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Review Case Reports
Microvascular decompression for oculomotor nerve palsy due to non-aneurysmal neurovaslur conflict: 5 cases report and literature review.
Oculomotor nerve palsy (ONP) is frequently caused by aneurysm compression and diabetes mellitus. However, nonaneurysmal compression (nAVC) of the oculomotor nerve is a condition rarely reported in the literature. Cases treated with microvascular decompression (MVD) for nAVC-induced ONP (nAVC-ONP) are exceptionally rare. ⋯ Neurovascular conflict has been proposed as another possible cause of ONP in a limited number of cases. Based on our findings, MVD is a potentially effective solution for patients experiencing oculomotor nerve palsy resulting from nonaneurysmal neurovascular conflicts. It holds great promise for significantly alleviating symptoms and improving overall quality of life.
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Artificial intelligence (AI) is increasingly significant in neurosurgery, enhancing differential diagnosis, preoperative evaluation, and surgical precision. A recent study in World Neurosurgery evaluated AI's role in aneurysm detection, comparing conventional computed tomography angiography images with AI analysis. AI identified 33 potential aneurysms, with 16 confirmed by radiologists, demonstrating a sensitivity of 36%, specificity of 97.6%, and a negative predictive value of 96.2%. ⋯ However, sensitivity for smaller aneurysms remained lower, indicating the need for further research. In conclusion, AI integration in aneurysm detection and management enhances diagnostic accuracy and precision. While current AI technologies show significant strengths, ongoing research is essential to address limitations and fully realize AI's potential in neurosurgery.
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Review
Stem Cells in the Treatment of Spinal Cord Injury: A Review of Currently Registered Clinical Trials.
Spinal cord injury (SCI) affects around 18,000 individuals annually, representing nearly one-third of all paralysis cases. Stem cell therapy, a focal point in contemporary neuroregeneration research for SCI treatment, holds potential in leveraging undifferentiated stem cells to regenerate damaged tissues. This study seeks to comprehensively analyze current clinical trials exploring the potential use of stem cells in treating spinal cord injuries. ⋯ The promising potential of stem cells in neuroregenerative SCI treatment necessitates further exploration through large-scale, multicenter clinical trials to enhance understanding and guide wider adoption of this emerging treatment paradigm.
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This review aims to comprehensively summarize the application of electrophysiological methods, specifically repetitive nerve stimulation (RNS) and single fiber electromyography (SFEMG), in the diagnosis of neuromuscular junction (NMJ) disorders, including myasthenia gravis, Lambert-Eaton syndrome, and sarcopenia in the elderly. Both RNS and SFEMG have demonstrated high sensitivity and specificity in detecting NMJ abnormalities. ⋯ Increased fiber density and jitter value, along with pulse blocking, are often observed in patients with NMJ disorders. However, despite the extensive application of these techniques in various NMJ-related diseases, their role in aging, particularly in sarcopenic patients, remains underexplored, highlighting the need for future research.
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There is a well-documented association between Cushing's syndrome (CS) and hypercoagulability. However, there is limited data on the risk of venous thromboembolic events (VTEs) after surgery for Cushing's disease (CD). There is no consensus on optimal postoperative anticoagulation strategies in this group. This review gathers information on the rates of VTE after surgery for CD, as well as reported prophylaxis strategies in this population. ⋯ Postoperative VTE in CD is a source of morbidity, with a rate of 2% and mortality rate of 0.2%, highlighting that surgical resection of the corticotroph adenoma does not necessarily result in immediate resolution of hypercoagulability. Increased production of coagulation factors, impaired fibrinolysis, inflammation, and CS-associated metabolic risk factors all factor into the pathogenesis of CS-associated hypercoagulability. Further study is needed on an optimal pharmacologic prophylaxis strategy.