World Neurosurg
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Observational Study
Diagnosis and Treatment of Intracranial Aneurysms using 320-detector Row Volumetric CT Angiography.
The objective of the study was to determine the clinical utility of 320-detector row volume-computed tomographic angiography (VCTA) in the management of intracranial aneurysms. ⋯ The 320-detector row subtracted VCTA technique is an effective, first-line diagnostic imaging modality for surgical and endovascular treatment of aneurysms. The nonsubtracted VCTA was less accurate than the subtracted VCTA, especially for intracranial aneurysms adjoining bone tissue.
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Meningiomas without dural attachment (MWODA) located in the posterior fossa are an unfrequent entity. They are usually located in the fourth ventricle, and their occurrence outside of this anatomic structure is an even more uncommon finding. Chordoid meningiomas are a rare subtype of meningioma, and they have been reported to account for 0.5%-1% of all meningiomas. ⋯ We performed a thorough review of the literature, and we found 10 reported cases describing extraventricular MWODA in the posterior fossa. To our knowledge, this is the first reported case of retroclival MWODA with pathologic findings consistent with chordoid meningioma.
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Treatment-related chronic neuropathic pain represents a major and increasing cause of discomfort in cancer survivors. Unfortunately, in approximately 10%-15% of cases, pain is scarcely relieved by opioids and common painkillers. Thus, alternative measures to manage pain have recently been adopted in these patients. ⋯ To the best of our knowledge, this is the first report in literature describing peripheral nerve field stimulation as a treatment option for intractable cancer treatment-related chronic neuropathic pain. Peripheral nerve field stimulation appears to be a safe and effective procedure.
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Although previous reports suggest that surgery can improve the pain and disability of cervical spinal deformity (CSD), techniques are not standardized. Our objective was to assess for consensus on recommended surgical plans for CSD treatment. ⋯ Among a panel of deformity surgeons, there was marked lack of consensus on recommended surgical approach, osteotomies, and fusion levels for CSD. Further study is warranted to assess whether specific surgical treatment approaches are associated with better outcomes.
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The evaluation of postoperative magnetic resonance imaging (MRI) in glioma with no or minimal enhancement is controversial because the evaluation of residual tumor volume can be biased. The purpose of this study was to clarify the value of early postoperative and 3-month MRI regarding its validity in predicting recurrent disease. ⋯ Early postoperative FLAIR volume assessment in gliomas with no or minimal enhancement is susceptible to a systematic overestimation of residual tumors. Nevertheless, early FLAIR volume dynamic is an independent factor for tumor recurrence that should be evaluated in order timely adapt surveillance and therapy regimens accordingly.