Journal of neurosurgery
-
Journal of neurosurgery · Apr 2024
Minimally invasive keyhole approach for supramaximal frontal glioma resections: technical note.
The authors aimed to review the frontal lobe's surgical anatomy, describe their keyhole frontal lobectomy technique, and analyze the surgical results. ⋯ Keyhole approaches enabled successful SMR of frontal gliomas without added risks. Robust anatomical knowledge and meticulous surgical technique are paramount for obtaining successful resections.
-
Journal of neurosurgery · Apr 2024
Healthcare disparities in deep brain stimulation access and utilization: a systematic review.
Since FDA approval of deep brain stimulation (DBS) for essential tremor over 2 decades ago, indications and utilization of this modality have rapidly expanded worldwide. However, certain patient populations are known to be underrepresented among those undergoing DBS for various indications. ⋯ As the indications and utilization continue to grow, addressing healthcare disparities related to DBS has become increasingly important. The authors suggest that increasing patient and provider education, expanding the role of telemedicine within DBS care, and improving support services for DBS patients may improve access and utilization.
-
The objective was to assess the performance of a context-enriched large language model (LLM) compared with international neurosurgical experts on questions related to the management of vestibular schwannoma. Furthermore, another objective was to develop a chat-based platform incorporating in-text citations, references, and memory to enable accurate, relevant, and reliable information in real time. ⋯ The present study, with its subspecialist-level performance in generating written responses to complex neurosurgical problems for which evidence-based consensus for management is lacking, suggests that context-enriched LLMs show promise as a point-of-care medical resource. The authors anticipate that this work will be a springboard for expansion into more medical specialties, incorporating evidence-based clinical information and developing expert-level dialogue surrounding LLMs in healthcare.
-
Journal of neurosurgery · Apr 2024
Association of persistent postoperative hyperglycemia with mortality after elective craniotomy.
The influence of persistent postoperative hyperglycemia after craniotomy has not yet been explored. This study aimed to investigate the hypothesis that persistent postoperative hyperglycemia is associated with mortality in patients undergoing an elective craniotomy. ⋯ In patients undergoing an elective craniotomy, moderate and severe persistent postoperative hyperglycemia were associated with an increased risk of mortality compared with normoglycemia, regardless of preoperative hyperglycemia.
-
Journal of neurosurgery · Apr 2024
Monopolar stereoelectroencephalography-guided radiofrequency thermocoagulation.
Stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) has the advantage of producing a lesion in the epileptogenic zone (EZ) at the end of SEEG. The majority of published SEEG-guided RFTCs have been bipolar and usually performed between contiguous contacts of the same electrode. In the present study, the authors evaluate the safety, efficacy, and benefits of monopolar RFTC at the end of SEEG. ⋯ The use of monopolar SEEG-guided RFTC provides more freedom in terms of choosing the SEEG contacts for thermocoagulation and a larger thermolesion volume. Monopolar thermocoagulation seems particularly beneficial in cases with an insular EZ, in which vascular constraints could be partially avoided by making noncontiguous lesions within the EZ.