World Neurosurg
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Dysembryoplastic neuroectodermal tumor (DNT) is a rare neoplasm. Though the pathology is commonly considered benign, there have been various reports documenting rapid growth, recurrence/progression, sudden death, and malignant transformation. Most studies have addressed outcomes regarding seizure control, but limited data exist regarding incidence and survival. Consequently, we explore the Surveillance, Epidemiology, and End Results (SEER) database to explore the epidemiology of DNT. ⋯ Although the prognosis for DNT is generally favorable, the pathology can lead to poor outcomes in rare cases. Common demographic factors, treatment with surgery, and the extent of surgical resection did not show significant associations with OS. In contrast, treatment with radiation was associated with poorer OS.
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The International Subarachnoid Aneurysm Trial heralded a paradigm shift in the treatment of intracranial aneurysms. During this same time frame, neurosurgical training programs increased in size and scope. The present study examines the impact of trends in surgical clipping and the endovascular treatment of intracranial aneurysms, over one decade, and the neurosurgical resident complement on the resident teaching environment using the Nationwide Inpatient Sample (NIS). ⋯ There has been a significant decrease in opportunity for operative exposure to craniotomy for ruptured aneurysm clipping over the past decade, whereas the volume of endovascular procedures for aneurysms has dramatically increased, highlighting the need for a shift in training strategy for those neurosurgeons graduating from residency desiring to subspecialize in neurovascular neurosurgery.
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A 30-year-old man was admitted for sudden loss of consciousness. On angio-CT, a ring-like vascular formation arising from the anterior communicating artery with a low-density center was visualized. This finding was consistent with a giant arterial aneurysm presenting with a central thrombus, also called "donut aneurysm".
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Transoral penetrating injury from a blunt-tipped chopstick is unusual and should be promptly dealt with because it is associated with high morbidity and mortality. ⋯ Preoperative and postoperative imaging and extensive monitoring of the patient's condition are mandatory for evaluation of possible development of complications. An optimal result can be obtained by a tailored management and treatment approach for each specific patient.
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To evaluate bilateral constant-current globus pallidus internus (GPi) deep brain stimulation using an 8-contact lead. ⋯ Constant-current GPi deep brain stimulation proved safe and efficacious for treatment of primary dystonia. Motor scores improved by 54%, mostly within the first month. No phenotype-specific stimulation could be achieved, despite the capability of the new lead to stimulate specific loci within the GPi.