World Neurosurg
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Detecting increased intracranial pressure early in pediatric patients is essential, as early initiation of therapy prevents morbidity and mortality. The objective of this study was to determine the diagnostic accuracy of the optic nerve sheath diameter (ONSD) measured via ultrasound for the prediction of increased intracranial pressure. ⋯ Optic nerve ultrasonography stands out as a precise and valuable diagnostic tool applicable across diverse patient populations and clinical scenarios. We recommend routine ocular ultrasound for optic nerve sheath diameter measurement in pediatric patients to increase the accuracy of diagnosing increased intracranial pressure.
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Labrune syndrome is a rare white matter disease characterized by angiomatous leukoencephalopathy, diffuse intracranial calcifications and supratentorial and infratentorial parenchymal cysts. The clinical worsening is often related to cyst expansion, and surgery may be advocated for symptomatic management in about one third of cases. However, no consensus exists on the surgical timing, the most effective procedure, and the long-term results. ⋯ Leukoencephalopathy with cerebral calcifications and cysts is a rare neurodegenerative disorder for which effective medical treatment is lacking. Surgery remains the only therapeutic option to control the disease to reduce the mass effect of growing cystic lesions. Almost half of the patients who underwent surgery required further approaches, with great concern for the associated disabilities. Several procedures have been described, with no evidence regarding which procedure is the most effective. Individual-based surgical planning must be advocated, tailoring the approach to limit side effects. Mini-invasive neuroendoscopic approaches may be considered to achieve satisfactory results.
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Health care in developing countries often lacks adequate bookkeeping and national cancer registries, means of information that have proven to impact disease research and care. The true burden of brain tumors therefore remains unchecked and so does the extent of the problem. Therefore, this study aims to explore the challenges and potential strategies related to information management of brain tumors in low- and middle-income countries (LMICs). ⋯ In LMICs, improving patient outcomes and quality of life postneurosurgical intervention for brain tumors requires coordinated efforts to enhance information systems. The support of the government and public health professionals is vital in implementing strategies to achieve this goal.
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There is a need for refined methods to detect and quantify brain injuries that may be undetectable by magnetic resonance imaging and neurologic examination. This review evaluates the potential efficacy of circulating brain injury biomarkers for predicting outcomes following elective neurosurgical procedures. ⋯ Circulating brain injury biomarkers show promise for providing objective insights into the extent of perioperative brain injury and improving prognostication of postsurgical outcomes. However, the heterogeneity in study designs and outcomes along with the lack of standardized biomarker thresholds underscore the need for further research.
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Review Historical Article
The History of the Development and Use of Suction Devices in Neurosurgery.
This article reviews the major devices, individuals, and other historical landmarks in the development of suction in the field of neurosurgery, where the operating fields are characteristically deep and narrow. Our review spans the 159 years since the first use of aspiration in surgery to modern applications. This report exemplifies a comprehensive history of suction, the minute iteration of devices, and the massive impact this technological development has had on medicine and neurosurgery.