World Neurosurg
-
Case Reports
Oblique positioning of the stereotactic frame for biopsies of cerebellar and brainstem lesions.
Frame-based stereotactic biopsy has proven to be a safe procedure with a high diagnostic yield for patients. Different supratentorial localizations can easily be accessed by standardized stereotactic approaches. Cerebellar and brainstem lesions, however, are not easy to reach because the positioning of the frame pins often makes it impossible to address the entry point properly. ⋯ Modification of the standardized positioning of the frame allows for safe and straightforward stereotactic access even to cerebellar and brainstem lesions.
-
During brain surgery, there are difficulties associated with identifying subcortical fibers with no clear landmarks. We evaluated the usefulness of cortical evoked potentials with subcortical stimuli (subcortico-cortical evoked potential [SCEP]) in identifying subcortical fibers intraoperatively. ⋯ SCEP was useful for identifying subcortical fibers and confirmed the preservation of these fibers. This technique is expected to contribute to the effectiveness and safety of resective surgery in patients with lesions close to eloquent areas.
-
Long-lived inhabitants of the plateau region have a higher hemoglobin concentration, which is the leading cause of damage in various organs, especially the nervous system. The aim of this study was to investigate the effect of hemoglobin concentration on mortality and neural functions after decompressive craniectomy in patients with hypoxia. ⋯ Elevated hemoglobin concentration has a serious impact on neurologic recovery and mortality, as seen in patients with acute severe head trauma after decompressive craniectomy.
-
Cervical spine sagittal malalignment has been demonstrated to correlate with the severity of disease in patients with cervical spondylotic myelopathy (CSM). The impact of spinal alignment on neurologic recovery has not been investigated thoroughly. The goal of this study was to evaluate the variable impact of preoperative sagittal alignment on neurologic recovery among surgical myelopathic patients. ⋯ The majority of patients with CSM showed postoperative neurologic improvement. Patients with preoperative lordotic alignment exhibited greater improvement than those with preoperative kyphotic alignment. Furthermore, the choice of surgical approach impacted neurologic recovery among kyphotic patients, with those patients who were approached anteriorly or with a combined approach faring better.
-
To investigate the outcomes of jugular foramen schwannomas (JFSs) and to evaluate the risk factors for tumor recurrence and poor final outcomes. ⋯ Quality of life and preservation of neurologic function are the goals of surgical treatment of JFSs. Favorable long-term surgical outcomes for JFSs can be achieved. Morbidity of cranial nerves IX and X is significant, and patients with nontotal resection or pathologic mitosis should be followed closely.