World Neurosurg
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Case Reports
MALIGNANT TRANSFORMATION OF PREVIOULSY RADIATED VESTIBULAR SCHWANNOMA: 2D operative video.
Malignant transformation of vestibular schwannomas (VSs), though rare,1 demands a comprehensive, multidisciplinary treatment approach to optimize patient outcomes.2 We present a rare case of malignant transformation in a VS after radiation treatment in a 58-year-old woman (Video 1). Initially diagnosed with a right cerebellopontine angle VS, the patient underwent CyberKnife (Accuray, Madison, Wisconsin, USA) treatment 16 years ago, receiving 18 Gy across 3 fractions. Despite initial stability, the patient experienced progressive hearing loss, ultimately requiring a bone-anchored hearing aid implant. ⋯ This case underscores the importance of vigilant monitoring for patients with VS, particularly patients with rapid symptom progression and tumor growth, highlighting the crucial role of adjuvant radiotherapy in treatment regimens. This study received institutional review board approval. The patient provided informed consent for the use of their image and information.
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This study examined radiographic changes in local and global spinal alignments and clinical outcomes following tumor resection without spinal fixation in patients with lumbar dumbbell tumors (LDTs). ⋯ Tumor resection without spinal fixation had no substantial impact on local and global spinal alignments and led to satisfactory clinical outcomes, suggesting that spinal fixation may not always be necessary when resecting LDTs.
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Idiopathic normal pressure hydrocephalus (iNPH) is a reversible cause of dementia, typically treated with shunt surgery, although outcomes vary. Artificial intelligence (AI) advancements could improve predictions of shunt response (SR) by analyzing extensive datasets. ⋯ While AI shows promise for improving iNPH management, there is a need for standardized data and extensive validation of AI models to enhance their clinical utility. Future research should aim to develop robust and generalizable AI models for more effective diagnosis and management of iNPH.
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Aneurysmal subarachnoid hemorrhage (aSAH) is more prevalent in postmenopausal women, and it has been postulated that this relationship is hormonally driven by lower circulating levels of estrogens. We examined the association between circulating plasma estrogen levels and subsequent development of aSAH in women. ⋯ In this study, we did not find an association between estrogen levels and the incidence of aSAH in women.
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Aneurysmal subarachnoid hemorrhage (aSAH) has an incidence of 6-7 per 100,000 person-years. Despite advancements in treatment, 26% of patients die and 19% remain dependent after hemorrhage. Long-term neuropsychological sequelae affect about half of the survivors, significantly affecting their quality of life. This study aims to assess aSAH characteristics and identify predictive factors of clinical outcomes in young patients. ⋯ Young patients with aSAH show distinct characteristics and prognostic factors compared with older patients. Despite higher postoperative complications, young patients generally have better outcomes, emphasizing the need for age-specific management strategies in aSAH.