Clinical Neurology and Neurosurgery最新文献

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Functional hearing impairment common in Parkinson’s disease: Insights from a pilot study 帕金森病常见的功能性听力障碍:试点研究的启示
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-09-02 DOI: 10.1016/j.clineuro.2024.108524
{"title":"Functional hearing impairment common in Parkinson’s disease: Insights from a pilot study","authors":"","doi":"10.1016/j.clineuro.2024.108524","DOIUrl":"10.1016/j.clineuro.2024.108524","url":null,"abstract":"<div><h3>Introduction</h3><p>Hearing impairments in Parkinson’s Disease (PD) have received limited attention in the past, possibly because PD patients often report no perceived hearing disability, yet negative consequences of hearing impairment might aggravate communication difficulties and social withdrawal.</p></div><div><h3>Objective</h3><p>Our aim was to investigate functional hearing (speech in noise recognition) in PD and evaluate its relationship to neuropsychiatric symptoms, cognition and quality of life.</p></div><div><h3>Methods</h3><p>Participants with PD were recruited in a tertiary movement disorder clinic. Demographic, audiological, neuropsychiatric and quality of life data were collected. Participants underwent pure tone audiometry (PTA) and Hearing in Noise test (HINT) as a part of their audiological evaluation.</p></div><div><h3>Results</h3><p>A total of 29 participants (mean age: 65.8±8.3 years, M:F= 1.6:1, mean disease duration 5.2 ± 4.0 years) completed the study. All assessments were done in the ON state. 19/29 (65.5 %) participants had normal tone audiometry for age; functional hearing loss, however, was present in 17/29 (58.6 %) according to the HINT. 65 % (11/17) of the affected participants had a disease duration of &lt;4 years. The majority (72.4 %) with poor functional hearing did not perceive any hearing impairment. Hearing deficits did not correlate with non-motor symptoms (NMS), including cognition or other quality of life measures.</p></div><div><h3>Conclusions</h3><p>Functional hearing loss is common in PD, often presents early in the disease and the majority of PD patients are unaware of their functional hearing loss. Its potential impact on cognition, communication and quality of life requires further investigation and tailored treatment.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0303846724004116/pdfft?md5=4abee363d096fd475b2102a3ca7137eb&pid=1-s2.0-S0303846724004116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurological long-COVID: Associations among fatigue, dysautonomia, depression, and subjective memory complaints 神经系统长期 COVID:疲劳、自律神经失调、抑郁和主观记忆抱怨之间的关联
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-31 DOI: 10.1016/j.clineuro.2024.108522
{"title":"Neurological long-COVID: Associations among fatigue, dysautonomia, depression, and subjective memory complaints","authors":"","doi":"10.1016/j.clineuro.2024.108522","DOIUrl":"10.1016/j.clineuro.2024.108522","url":null,"abstract":"<div><h3>Introduction</h3><p>Long-COVID is a multisystem disease characterized by a varied presentation of symptoms. According to most recent research, the most common symptom of long-COVID is fatigue, which up to this date lacks a universally accepted definition. This study aimed to investigate neurocognitive and physical manifestations of neurological long-COVID, particularly fatigue and its relation with autonomic disfunction, cognitive impairment (known as, brain fog), and depressive symptoms. Furthermore, the study provided insights into predictors of fatigue in long-COVID.</p></div><div><h3>Methods</h3><p>The included patients (n=141) were referred to the neuro-long-COVID ambulatory service of Trieste from 30 September 2021–02 March 2022. Patients were given self-reporting questionnaires to screen for fatigue, autonomic dysfunction, cognitive impairment and depressive symptoms. The questionnaires adopted for these conditions to be assessed were Fatigue Severity Scale (FSS), COMPASS-31, Prospective-Retrospective Memory Questionnaire (PRMQ), and Beck Depression Inventory (BDI). Participants were divided into two groups, fatigued and non-fatigued patients, based on FSS scoring (scores &gt; 4.67 indicate fatigued patients). The questionnaire scores of the two groups were then compared.</p></div><div><h3>Results</h3><p>Fatigued patients had significantly higher scores in COMPASS (p&lt;0.001, Cohen’s d=1.077), BDI (p&lt;0.001, Cohen's d=0.862), and PRMQ ( p&lt;0.001, Cohen's d=1.159).</p><p>Furthermore, the multivariate regression analysis showed that predictors of fatigue in long-COVID were symptomatological burden in acute infection (OR=1.38, 95 % CI 1.020–1.887, p=0.037) and in long-COVID (OR=1.78, 95 % CI 1.133–2.2824, p=0.013), COMPASS-31&gt;16 (OR=3.44, 95 % CI 1240–9.560, p=0.018) and BDI&gt;15 (OR=5.1, 95 % CI 1.715–15.164, p=0.003).</p></div><div><h3>Conclusion</h3><p>This study showed associations between fatigue, dysautonomia and depression, as well as with symptom burden in acute and long-COVID.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utility of combining frailty and comorbid disease indices in predicting outcomes following craniotomy for adult primary brain tumors: A mixed-effects model analysis using the nationwide readmissions database 结合虚弱指数和合并疾病指数预测成人原发性脑肿瘤开颅手术后预后的实用性:利用全国再入院数据库进行混合效应模型分析
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-30 DOI: 10.1016/j.clineuro.2024.108521
{"title":"Utility of combining frailty and comorbid disease indices in predicting outcomes following craniotomy for adult primary brain tumors: A mixed-effects model analysis using the nationwide readmissions database","authors":"","doi":"10.1016/j.clineuro.2024.108521","DOIUrl":"10.1016/j.clineuro.2024.108521","url":null,"abstract":"<div><h3>Objective</h3><p>The escalating healthcare expenditures in the United States, particularly in neurosurgery, necessitate effective tools for predicting patient outcomes and optimizing resource allocation. This study explores the utility of combining frailty and comorbidity indices, specifically the Johns Hopkins Adjusted Clinical Groups (JHACG) frailty index and the Elixhauser Comorbidity Index (ECI), in predicting hospital length of stay (LOS), non-routine discharge, and one-year readmission in patients undergoing craniotomy for benign and malignant primary brain tumors.</p></div><div><h3>Methods</h3><p>Leveraging the Nationwide Readmissions Database (NRD) for 2016–2019, we analyzed data from 645 patients with benign and 30,991 with malignant tumors. Frailty, ECI, and frailty + ECI were assessed as predictors using generalized linear mixed-effects models. Receiver operating characteristic (ROC) curves evaluated predictive performance.</p></div><div><h3>Results</h3><p>Patients in the benign tumor cohort had a mean LOS of 8.1 ± 15.1 days, and frailty + ECI outperformed frailty alone in predicting non-routine discharge (AUC 0.829 vs. 0.820, p = 0.035). The malignant tumor cohort patients had a mean LOS of 7.9 ± 9.1 days. In this cohort, frailty + ECI (AUC 0.821) outperformed both frailty (AUC 0.744, p &lt; 0.0001) and ECI alone (AUC 0.809, p &lt; 0.0001) in predicting hospital LOS. Frailty + ECI (AUC 0.831) also proved superior to frailty (AUC 0.809, p &lt; 0.0001) and ECI alone (AUC 0.827, p &lt; 0.0001) in predicting non-routine discharge location for patients with malignant tumors. All indices performed comparably to one another as a predictor of readmission in both cohorts.</p></div><div><h3>Conclusion</h3><p>This study highlights the synergistic predictive capacity of frailty + ECI, especially in malignant tumor cases, and further suggests that comorbid diseases may greatly influence perioperative outcomes more than frailty. Enhanced risk assessment could aid clinical decision-making, patient counseling, and resource allocation, ultimately optimizing patient outcomes.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stroke pattern in giant-cell arteritis mostly involves watershed areas 巨细胞动脉炎的卒中模式大多涉及分水岭区域
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-26 DOI: 10.1016/j.clineuro.2024.108520
{"title":"Stroke pattern in giant-cell arteritis mostly involves watershed areas","authors":"","doi":"10.1016/j.clineuro.2024.108520","DOIUrl":"10.1016/j.clineuro.2024.108520","url":null,"abstract":"<div><h3>Context</h3><p>Stroke related to giant cell arteritis (GCA) is rare and is associated with a poor outcome. One of the putative ischemic mechanisms is narrowing of the arterial lumen due to wall infiltration by inflammation and intimal proliferation, leading to reduced distal blood flow. It was hypothesized that GCA-related stroke could predominate in watershed areas (WA).</p></div><div><h3>Methods</h3><p>Literature review including all cases of GCA-related stroke with brain images.</p></div><div><h3>Results</h3><p>Among 75 cases of GCA-related stroke, the anterior and posterior territories were involved in 48 % and 62.6 %, respectively. Up to 88.9 % of cases of anterior stroke probably involved WA. WA lesions in the posterior territories were as follows: uni/bilateral middle cerebellar peduncle (MCP) lesions in 25.5 %, and with less confidence, non-wedge-shaped cerebellar lesions in 46.8 %, or combined lesions in 61.7 %. Stenosis or occlusion of the afferent artery was almost always observed. A few lesions were not easily explained by low flow.</p></div><div><h3>Discussion</h3><p>Despite the limitations of arterial territory allocation especially in the posterior circulation, ischemic lesions mainly occurred in WA. MCP lesions, which were typically WA, were highly characteristic of GCA. Low flow downstream focal stenosis was the main, but not the unique, ischemic mechanism of GCA stroke.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brain disorders in euthyroid Hashimoto’s thyroiditis patients 甲状腺功能正常的桥本氏甲状腺炎患者的脑部疾病
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-26 DOI: 10.1016/j.clineuro.2024.108519
{"title":"Brain disorders in euthyroid Hashimoto’s thyroiditis patients","authors":"","doi":"10.1016/j.clineuro.2024.108519","DOIUrl":"10.1016/j.clineuro.2024.108519","url":null,"abstract":"<div><p>Hashimoto’s thyroiditis (HT) is an autoimmune disorder characterized by the destruction of thyroid follicular cells by thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), leading to hypothyroidism. Hashimoto’s encephalopathy (HE) is associated with elevated levels of antithyroid antibodies. An important question is whether brain alterations precede the development of HE and are present in euthyroid patients with HT, and what pathomechanisms could be responsible for these changes. A PubMed search was conducted to identify studies addressing this issue. Numerous questionnaire studies confirmed impairments in cognitive functioning, mental and physical health, and overall well-being in euthyroid HT patients. Additionally, some imaging and mouse model studies indicate that euthyroid patients with HT likely have central nervous system alterations. Antibodies may be involved in the development of these changes. Some research suggests the role of TPOAb and TgAb, while other studies highlight the involvement of coexisting antibodies. Determining whether antibodies are assessed in serum or cerebrospinal fluid (CSF) is crucial. Antibody-specific indices (ASIs) can differentiate between antibodies passively diffusing from the serum and brain-derived antibodies, and could serve as biomarkers for brain alterations in HT patients. Much more research is needed to identify reliable biomarkers and treatments that could improve the quality of life for these patients.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0303846724004062/pdfft?md5=da7c0d53deea9634b1644a2ba5c879b7&pid=1-s2.0-S0303846724004062-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cerebral venous thrombosis after lumboperitoneal shunting: A case report 腰腹腔分流术后脑静脉血栓形成:病例报告
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-23 DOI: 10.1016/j.clineuro.2024.108518
{"title":"Cerebral venous thrombosis after lumboperitoneal shunting: A case report","authors":"","doi":"10.1016/j.clineuro.2024.108518","DOIUrl":"10.1016/j.clineuro.2024.108518","url":null,"abstract":"<div><p>Lumboperitoneal shunt (LPS) has been an effective treatment of idiopathic normal pressure hydrocephalus (iNPH) but sometimes causes serious complications. Here we present the first reported case of cerebral venous thrombosis (CVT) after LPS. A 76-year-old man underwent LPS for iNPH and a week later developed weakness of the right arm and a generalized tonic-clonic seizure. Brain computed tomography and magnetic resonance imaging showed bilateral subdural hematoma (SDH) and left cortical vein thrombosis. Intravenous heparin was administered, followed by surgical evacuation of the SDH. The patient experienced gradual improvement and was subsequently discharged. It is conceivable that overdrainage of cerebrospinal fluid led to the development of both SDH and CVT. CVT is potentially fatal and should be recognized early as a possible complication after LPS to allow prompt treatment.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biopsy of the anterior interosseous motor branch for the pronator quadratus muscle: a safe and minimally invasive diagnostic tool for peripheral neuropathies. Anatomical surgery and surgical technique 前股四头肌肌间运动支活检:一种安全、微创的周围神经病诊断工具。解剖手术和手术技巧。
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-22 DOI: 10.1016/j.clineuro.2024.108508
{"title":"Biopsy of the anterior interosseous motor branch for the pronator quadratus muscle: a safe and minimally invasive diagnostic tool for peripheral neuropathies. Anatomical surgery and surgical technique","authors":"","doi":"10.1016/j.clineuro.2024.108508","DOIUrl":"10.1016/j.clineuro.2024.108508","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Choosing the correct site for a nerve biopsy remains a challenge due to nerve sacrifice and major donor site complications, such as neuroma, as seen in sural nerve biopsy. Selecting a deeper donor nerve can help in burying nerve stumps in deep soft tissues, preventing neuroma. Moreover, using an expendable, deeply situated motor nerve can aid indiagnosis when a motor neuropathy is suspected. The authors propose using the pronator quadratus (PQ) branch for this purpose, as it is located deep between the bellies of the flexor muscles and the interosseous membrane in the forearm. This branch is expendable since the denervation of the PQ has a negligible effect on forearm pronation, which is primarily sustained by the pronator teres.</p></div><div><h3>Methods</h3><p>The surgical approach is the same as the approach for anterior interosseous nerve transfer to the motor component of the ulnar nerve in the distal forearm: access is in the midline in the middle third of the forearm under local anesthesia Blunt dissection is performed, separating and retracting the flexor musculotendinous junction to reach the interosseous membrane where the PQ branch is identified. A careful dissection of the nerve branch is performed, allowing a 2 cm long segment to be cut and removed. The proximal stump is then buried into an adjacent muscle belly and the surgical site is closed.</p></div><div><h3>Results</h3><p>The technique is safe and reproducible in experienced hands.</p></div><div><h3>Conclusion</h3><p>This technique may be especially applicable in cases where neurologists need to study motor neuropathies. Contraindications of the technique include wrist instability and high median nerve palsies.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Body image and social anxiety in hemifacial spasm: Examining self-esteem and fear of negative evaluation as mediators 半面痉挛患者的身体形象和社交焦虑:将自尊和对负面评价的恐惧作为中介进行研究
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-22 DOI: 10.1016/j.clineuro.2024.108516
{"title":"Body image and social anxiety in hemifacial spasm: Examining self-esteem and fear of negative evaluation as mediators","authors":"","doi":"10.1016/j.clineuro.2024.108516","DOIUrl":"10.1016/j.clineuro.2024.108516","url":null,"abstract":"<div><h3>Background</h3><p>Individuals diagnosed with hemifacial spasm (HFS) frequently undergo noticeable alterations in their facial appearance. Such changes can detrimentally influence both their physical and psychological well-being. While prior studies have identified self-esteem and fear of negative evaluation (FNE) as key elements in social anxiety, their role in studies concerning body image and its correlation with social anxiety has been seldom explored. This research seeks to explore how self-esteem and FNE concurrently mediate the relationship between body image and social anxiety among Chinese individuals with HFS.</p></div><div><h3>Methods</h3><p>Chinese patients with HFS (n=151) completed a cross-sectional questionnaire on the first day of admission that assessed body image, social anxiety, self-esteem, and FNE over the past week. Path analysis was used to test the hypothesis of the mediation model.</p></div><div><h3>Results</h3><p>The hypothesized model showed that FNE was positively correlated with body image and social anxiety, while negative associations were found among body image, self-esteem and social anxiety. Self-esteem and FNE play a mediating role between body image and social anxiety.</p></div><div><h3>Conclusion</h3><p>Our findings suggest that self-esteem and FNE may be important psychological pathways that affect body image and social anxiety in Chinese patients with HFS. Supplementing mental health services that help increase self-esteem and reduce FNE should be considered to improve the psychological quality of patients with HFS.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Simultaneous combined keyhole mini-transcranial approach and endoscopic transsphenoidal approach to remove multi-lobulated pituitary neuroendocrine tumor with suprasellar extension 同时采用锁孔微型经颅入路和内窥镜经蝶窦入路切除星状上扩展的多叶垂体神经内分泌肿瘤
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-21 DOI: 10.1016/j.clineuro.2024.108512
{"title":"Simultaneous combined keyhole mini-transcranial approach and endoscopic transsphenoidal approach to remove multi-lobulated pituitary neuroendocrine tumor with suprasellar extension","authors":"","doi":"10.1016/j.clineuro.2024.108512","DOIUrl":"10.1016/j.clineuro.2024.108512","url":null,"abstract":"<div><h3>Background</h3><p>Transsphenoidal surgery (TSS) is the main method to remove pituitary neuroendocrine tumor (PitNET), but large or multi-lobulated one is still challenging.</p></div><div><h3>Objective</h3><p>The less invasive simultaneous combined keyhole mini-transcranial approach and standard transsphenoidal approach was used to remove multi-lobulated or hourglass-shaped non-functioning PitNET to avoid the specific complications related to extended TSS.</p></div><div><h3>Methods</h3><p>Twenty-one patients of large multi-lobulated or hourglass-shaped PitNET (6 patients were recurrent cases after TSS or transcranial approach) were treated by this simultaneous combined approach. The supraorbital or midline keyhole approach was performed under the operating microscope so that the fine arteries feeding optic apparatus were dissected from the tumor capsule safely and securely and the suprasellar part of the tumor was removed in the extra-capsular fashion in combination with transsphenoidal approach.</p></div><div><h3>Results</h3><p>Visual function improved after the surgery in 14 (74 %) of 19 patients with preoperative disturbance of the visual fields. Four patients (19 %) developed postoperative deterioration of pituitary endocrine functions requiring permanent hormonal replacement. One patient (4.2 %) suffered cortical laminar necrosis without permanent disorders and another patient (4.2 %) suffered cerebrospinal fluid rhinorrhea but neither was permanent. Postoperative computed tomography detected no subarachnoid hemorrhage in any patient. Gross total removal was achieved in 15 patients (71 %). Five patients (24 %) with subtotal removal and one patient (4.2 %) with partial removal had lateral tumor extension with Knosp classification 3 or 4.</p></div><div><h3>Conclusion</h3><p>The combined method is an effective treatment option to remove complex PitNET safely and securely with dissecting fine arteries on the tumor capsule.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic approaches to the posterior wall of the third ventricle: An anatomical comparison 第三脑室后壁的内窥镜方法:解剖学比较
IF 1.8 4区 医学
Clinical Neurology and Neurosurgery Pub Date : 2024-08-19 DOI: 10.1016/j.clineuro.2024.108511
{"title":"Endoscopic approaches to the posterior wall of the third ventricle: An anatomical comparison","authors":"","doi":"10.1016/j.clineuro.2024.108511","DOIUrl":"10.1016/j.clineuro.2024.108511","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgery of lesions in the posterior wall of the third ventricle requires great expertise due to its deep location and important surrounding structures. This region has been traditionally reached through a supracerebellar infratentorial approach, but new options have emerged, especially with the development of neuroendoscopy.</p></div><div><h3>Methods</h3><p>One formalin-fixed cadaver human head was dissected. Five different endoscopic approaches were performed: interhemispheric transcallosal transchoroidal, frontal transforaminal transchoroidal, supraorbital subfrontal translamina terminalis, expanded endonasal, and supracerebellar infratentorial. An anatomical description of the different approaches was conducted and quantitative measurements (craniocaudal and latero-lateral distances) were taken using the StealthStation ® workstation after performing a CT scan of the specimen.</p></div><div><h3>Results</h3><p>The interhemispheric transcallosal transchoroidal, frontal transforaminal transchoroidal, and supraorbital subfrontal translamina terminalis approaches provided great view of all the structures of the posterior wall of the third ventricle. Maximum craniocaudal distance was obtained through the supraorbital subfrontal translamina terminalis approach (10.6 mm), with great difference from the expanded endonasal approach (5.2 mm). The widest latero-lateral distance from inside the third ventricle was achieved through the interhemispheric transcallosal transchoroidal approach (4.6 mm), similar to the expanded endonasal (4.1 mm), and differing from the supraorbital subfrontal translamina terminalis (2.4 mm).</p></div><div><h3>Conclusions</h3><p>The endoscopic approaches provided an adequate alternative to more traditional microsurgical approaches to the posterior wall of the third ventricle, with a great view of all its structures. The selection of the approach must be taken under consideration in each case.</p></div>","PeriodicalId":10385,"journal":{"name":"Clinical Neurology and Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0303846724003986/pdfft?md5=5b7a4c22381eb8cd85a6d3184cec9209&pid=1-s2.0-S0303846724003986-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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