World Neurosurg
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Arteriovenous malformations (AVMs) pose a risk of neurologic deterioration, particularly when located in eloquent areas. While awake surgery is well-established for treating low-grade gliomas near eloquent areas, its efficacy for AVMs is less conclusively reported. ⋯ AC for eloquent AVMs showed promising results. A significant rate of postoperative neurological deficits was found, which was reduced at follow-up. A small mean length of hospitalization was also found. These results suggest that AC for AVMs should be considered in eloquent lesion cases.
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Meningiomas are the most common primary central nervous system tumors, often requiring surgical resection. Presurgical embolization (PSE) is used to reduce intraoperative bleeding, although its effectiveness varies. This study evaluates the safety and efficacy of PSE using ethyl-vinyl alcohol (EVOH) in meningioma surgeries. ⋯ PSE using EVOH significantly decreases surgical bleeding and time in meningioma resections without associated complications. The proposed PSE grading system (Preoperative Embolization of Meningiomas, Mexican Classification) may enhance the predictability of intraoperative bleeding control. While we acknowledge the relatively small sample size of 48 cases, we believe this study serves as a foundation to encourage the inclusion of more patients and collaboration with additional centers, aiming to further validate and standardize the classification.
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Spinal metastasis from salivary gland malignancies is a rare clinical entity with only several reports in the literature. There is no clear guidance for its optimal management. ⋯ Spinal metastasis from salivary gland malignancies necessitates a comprehensive and multidisciplinary treatment approach due to the complex nature and variability in presentation. Long-term follow-up is essential for early detection and management of spinal metastases, given the extended latency period observed in many cases. The potential for metastasis is not solely dependent on tumor grade, emphasizing the need for ongoing vigilance in all patients with salivary gland malignancies.
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Postsurgical recovery following spine surgeries poses challenges for Muslim patients wishing to resume Salah (Islamic prayer), which involves physical movements like kneeling and prostration. This study aims to examine spine surgeons' perspectives on the appropriate timing and conditions for resuming Salah after spine surgery without restrictions. ⋯ Surgeons' recommendations for resuming Salah vary significantly, influenced by specialty, experience, and educational level. Standardized guidelines could improve consistency in postoperative care for Muslim patients.
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Traumatic brain injury is a major cause of disability and mortality worldwide. Acute traumatic subdural hematoma (TSDH) accounts for a large proportion of all traumatic brain injury cases. However, factors to predict postoperative prognosis in patients with acute TSDH are limited. Recently, it has been reported that inflammatory markers increase the accuracy of prognosis in various diseases. The neutrophil-to-lymphocyte ratio (NLR) is a marker for inflammation, which is easy to test, inexpensive, and can be performed quickly. However, the prognostic value of NLR in patients with acute TSDH remains controversial. This study therefore aimed to assess the predictive value of the admission and postoperative NLR in patients with acute TSDH who underwent surgical treatment. ⋯ Initial NLR was not strongly associated with 1-month mortality in patients with acute TSDH who underwent surgery. However, the postoperative 48-hour NLR was associated with 1-month mortality.