Surgical Neurology International最新文献

{"title":"A retrospective cohort study of stereotactic radiosurgery for vestibular schwannomas: Comparison of two age groups (75 years or older vs. 65–74 years)","authors":"Shinya Watanabe, Masaaki Yamamoto, Hitoshi Aiyama, Narushi Sugii, M. Matsuda, Hiroyoshi Akutsu, Eiichi Ishikawa","doi":"10.25259/sni_148_2024","DOIUrl":"https://doi.org/10.25259/sni_148_2024","url":null,"abstract":"\u0000\u0000Treatment outcome data of stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) in patients ≥75 years (late elderly) are lacking. Approximately 39% of patients ≥75 years with VS were reported to experience severe facial palsy after surgical removal. This study compared the treatment outcomes post-SRS for VS between patients ≥75 and 65–74 years (early elderly).\u0000\u0000\u0000\u0000Of 453 patients who underwent gamma knife SRS for VS, 156 were ≥65 years old. The late and early elderly groups comprised 35 and 121 patients, respectively. The median tumor volume was 4.4 cc, and the median radiation dose was 12.0 Gy.\u0000\u0000\u0000\u0000The median follow-up periods were 37 and 56 months in the late and early elderly groups, respectively. Tumor volume control was observed in 27 (88%) and 95 (83%) patients (P = 0.78), while additional procedures were required in 2 (6%) and 6 (6%) patients (P = 1.00) in the late and early elderly groups, respectively. At the 60th and 120th months post-SRS, the cumulative tumor control rates were 87%, 75%, 85%, and 73% (P = 0.81), while the cumulative clinical control rates were 93% and 87%, 95%, and 89% (P = 0.80), in the late and early elderly groups, respectively. In the early elderly group, two patients experienced facial pain, and one experienced facial palsy post-SRS; there were no adverse effects in the late elderly group (both P = 1.00).\u0000\u0000\u0000\u0000SRS is effective for VS and beneficial in patients ≥75 years old as it preserves the facial nerve.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined pterional burr hole and coagulation of middle meningeal artery for chronic subdural hematoma","authors":"Erico R. Cardoso, Radwa Abbas, Emily M. Stone, Shivali Patel","doi":"10.25259/sni_180_2024","DOIUrl":"https://doi.org/10.25259/sni_180_2024","url":null,"abstract":"\u0000\u0000There are many surgical techniques to treat chronic subdural hematomas (CSHs). However, they all have high recurrence rates. Recently, embolization of the middle meningeal artery (MMA) following surgical evacuation of CSH has reduced the recurrence rate. We investigated the feasibility of combining the surgical obliteration of the MMA at the same time as the placement of a burr hole for evacuation of the CSH.\u0000\u0000\u0000\u0000We report on nine patients who underwent 11 of these combined procedure by the same surgeon in two hospitals, including clinical data and images during the perioperative and postoperative periods. Cardoso had previously reported details of the surgical technique. Two patients underwent bilateral procedures. Two patients had two burr holes because the hematomas did not extend caudally to the pterion, where the MMA enters the calvarium. Intraoperative fluoroscopy was used to locate the point of entry of the MMA into the calvarium in most cases, except in two instances when navigation was utilized.\u0000\u0000\u0000\u0000This small series of nine cases suggests the feasibility of using this combined procedure as an additional option to the treatment of CSHs, especially where endovascular treatment might not be readily available. Furthermore, it has the potential advantages of safety, efficacy, avoidance of a second endovascular procedure, faster disappearance of the subdural collection, lesser exposure to radiation, and cost containment. Larger prospective controlled series are needed to identify its potential usefulness.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"54 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-endoscopic discectomy utilizing an interlaminar approach for gas-containing herniation at L5–S1","authors":"Yoshihiko Ioroi, Toshinari Kawasaki, Jun Hashimoto, Tamaki Kobayashi, Hisashi Koga, M. Takayama","doi":"10.25259/sni_508_2024","DOIUrl":"https://doi.org/10.25259/sni_508_2024","url":null,"abstract":"\u0000\u0000Intradiscal gas is frequently observed in older patients with disc degeneration and can occasionally result in nerve root compression.\u0000\u0000\u0000\u0000A 79-year-old male patient presented with increasing left lower extremity sciatica. Lumbar computed tomography (CT) and magnetic resonance (MR) images revealed a left paramedian L5–S1 gas-containing disc herniation. Utilizing an interlaminar approach, a full-endoscopic discectomy (FED) was performed at L5–S1. During disc removal, we countered intradiscal gas bubbles. Postoperatively, the patient’s symptoms/signs fully resolved, and follow-up MR and CT images revealed total resection of the disc herniation, and no further gas.\u0000\u0000\u0000\u0000Through an interlaminar FED, we effectively removed an L5–S1 MR/CT-documented gas-containing disc herniation.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"44 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple primary diffuse large B-cell lymphoma masquerading as meningioma","authors":"Sivaraman Kumarasamy, K. Garg, Satish Kumar Verma, M. C. Sharma, Ajay Garg, P. S. Chandra, Shashank Sharad Kale","doi":"10.25259/sni_360_2024","DOIUrl":"https://doi.org/10.25259/sni_360_2024","url":null,"abstract":"\u0000\u0000Primary non-Hodgkin’s lymphoma with multiple extra- and intra-calvarial extensions without systemic spread in an immunocompetent patient is extremely rare. They masquerade commonly as meningioma and can present as mass lesions with raised intracranial pressure.\u0000\u0000\u0000\u0000We report one such case of primary diffuse large B-cell lymphoma (DLBCL) in a young female involving the scalp, dural involvement in the right frontal region, left parietal, and posterior fossa and mimicking both clinically and radiologically as meningioma. She was managed surgically. Histological examination showed features suggestive of DLBCL (germinal center type). She was planned for adjuvant therapy. However, at 2 months following surgery, she succumbed due to systemic involvement of the disease.\u0000\u0000\u0000\u0000DLBCL is seen rarely in neurosurgical practice. They can present as tumors with adjacent extra- and intra-cranial masses. They pose a diagnostic challenge as it can be easily confused with meningioma. Tumor resection is performed to confirm diagnosis and in patients who present with raised intracranial pressure. Chemotherapy is the preferred treatment, and adjuvant therapy should be started early.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"21 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary intracranial sarcoma, DICER-1 mutant, with hemorrhagic presentation: A case report","authors":"B. Edelbach, Vadim Gospodarev, Ravi Raghavan, Justin Dye","doi":"10.25259/sni_259_2024","DOIUrl":"https://doi.org/10.25259/sni_259_2024","url":null,"abstract":"\u0000\u0000Primary intracranial sarcomas (PIS) are rare tumors with mesenchymal origins. These tumors have a heterogeneous clinical presentation and are associated with a poor prognosis.\u0000\u0000\u0000\u0000This report highlights the complexities associated with PIS by focusing on a 26-year-old male with recurrent tumor growth facing unique challenges regarding diagnosis and treatment options . A high-grade spindle-celled neoplasm with sarcomatous features characterized the patient’s tumor. There were additional morphologic changes, including multinucleated giant cells and rare foci with eosinophilic spheroids. Genomic analysis revealed a DICER1-associated PIS. Treatment involved endovascular embolization, multiple surgical interventions, intrathecal etoposide injections, and oral pazopanib with adjuvant radiation therapy.\u0000\u0000\u0000\u0000This case additionally highlights an unusual association between PIS and anomalous hypervascularity, refractory hemorrhage, and subdural effusions, a presentation that is increasingly being reported in this type of tumor.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"30 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital varices: Epidemiology, clinical presentation, and treatment outcomes – A scoping review","authors":"Ahmed Shakir Ali Al-Wassiti, Danisha Kumar, Toka Elboraay, Mustafa Ismail","doi":"10.25259/sni_368_2024","DOIUrl":"https://doi.org/10.25259/sni_368_2024","url":null,"abstract":"\u0000\u0000Orbital varices are vein dilations in the orbit presenting various symptoms. This scoping review synthesizes existing evidence on their epidemiology, clinical features, and treatment efficacy.\u0000\u0000\u0000\u0000Literature was reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Scopus were searched until April 31, 2024, for articles on clinically diagnosed ocular varices detailing diagnostic methods, treatments, and outcomes. Exclusions were reviews, animal studies, and incomplete case reports. Data on study characteristics, diagnosis, management, and outcomes were extracted and assessed for quality and bias.\u0000\u0000\u0000\u0000Eight studies met the inclusion criteria, with sample sizes ranging from 4 to 30 and ages from 1 to 87 years. Diagnostic tools included magnetic resonance imaging and computed tomography, while treatments ranged from conservative methods to invasive procedures and radiosurgery. Notably, higher symptom resolution rates were associated with observational strategies and minimally invasive surgeries. However, Gamma Knife radiosurgery, although promising, posed risks of vision impairment in some cases.\u0000\u0000\u0000\u0000The management of orbital varices has evolved significantly with newer, less invasive techniques improving outcomes and reducing recovery times. Despite advancements, challenges such as disease recurrence and the need for personalized treatment regimens persist, underscoring the ongoing need for research to refine and standardize treatment approaches.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"54 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative surgical precision: The electronic pen needle holder based on neurophysiological principles","authors":"Moneer K. Faraj, R. I. Abed, Sadiq J. Hamandi, Mustafa Ismail","doi":"10.25259/sni_505_2024","DOIUrl":"https://doi.org/10.25259/sni_505_2024","url":null,"abstract":"\u0000\u0000The electronic pen needle holder (EPNH) was developed to enhance surgical precision, reduce operative time, and improve patient outcomes. By integrating microergonomics, penization, and electronics with surgical instruments, the EPNH aims to provide surgeons with a tool that minimizes hand strain and maximizes control during delicate procedures.\u0000\u0000\u0000\u0000The EPNH was ergonomically designed to fit the surgeon’s hand, using titanium for its strength and biocompatibility. It was manufactured through industrial-grade 3D printing, and its mechanical properties were verified using finite element analysis. A force-sensitive resistor and vibratory mechanism were integrated to provide real-time feedback and assistance during surgeries.\u0000\u0000\u0000\u0000Testing by 10 neurosurgeons demonstrated significant precision, control, and efficiency improvements. The EPNH reduced hand strain and fatigue, allowing longer, more comfortable operation times. The time required for suturing tasks has decreased by 40% compared to traditional needle holders. Surgeons reported high satisfaction with the EPNH’s performance and usability.\u0000\u0000\u0000\u0000The EPNH represents a major advancement in surgical instrument design, offering enhanced precision, reduced hand strain, and increased efficiency. Its innovative features and ergonomic design make it a valuable tool for improving surgical outcomes and transforming microsurgical practices.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"54 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mature congenital intraventricular intracranial teratoma: A case report and literature review","authors":"B. Nery, Raivson Diogo Felix Fernandes, Emanuella Arruda do Rego Nobrega, Arthur Cellys Tavares da Silva, Maisa Souza Liebig, Clarissa Cartaxo Eloy Nóbrega, Julia Lopes Braga, Thayna Dantas Souto Fernandes, E. Quaggio, José Alencar de Sousa Segundo","doi":"10.25259/sni_289_2024","DOIUrl":"https://doi.org/10.25259/sni_289_2024","url":null,"abstract":"\u0000\u0000Intracranial teratomas represent a rare subset of neoplasms characterized by tissues derived from multiple germ layers within the cranial cavity. These tumors, originating from primordial germ cells, exhibit diverse clinical presentations and histopathological features. While predominantly located along the midline axis, including the suprasellar cistern and pineal region, they can also manifest in less common areas such as ventricles and hypothalamic regions. Histopathologically, they are classified as mature, immature, or malignant based on the degree of tissue differentiation.\u0000\u0000\u0000\u0000Male patient with prenatal care for congenital hydrocephalus born at 38 weeks gestation with a bulging fontanelle. Postnatal imaging revealed an intraventricular lesion, later diagnosed through magnetic resonance imaging as a mature teratoma invading the lateral ventricle and extending to the hypothalamus. Surgical resection achieved total macroscopic removal followed by successful postoperative ventriculoperitoneal shunting due to evolving hydrocephalus.\u0000\u0000\u0000\u0000Teratomas are uncommon tumors, and prognosis depends on tumor size and location, especially considering the rarity of mature teratomas. Complete surgical resection is paramount for treatment, leading to a better prognosis and quicker recovery. In cases where complete removal is challenging, adjuvant therapies and cerebrospinal fluid diversion may be required to enhance therapeutic outcomes and ensure successful resection.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"49 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the land where neurosurgery lost its pride: Can we find redemption?","authors":"Zahraa F. Al-Sharshahi, W. E. Matti","doi":"10.25259/sni_234_2024","DOIUrl":"https://doi.org/10.25259/sni_234_2024","url":null,"abstract":"","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"26 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative blood transfusion management in surgical resection of intracranial meningiomas: A meta-analysis","authors":"Mustafa Ismail, Ali Al-Shalchy, Younus M. Al-Khazaali, Abdelilah Lahmar, Liam V. Goldman, Mostafa H. Algabri, Danisha Kumar, Paolo Palmisciano, Samer S. Hoz","doi":"10.25259/sni_427_2024","DOIUrl":"https://doi.org/10.25259/sni_427_2024","url":null,"abstract":"\u0000\u0000Gross total resection (GTR) of intracranial meningiomas is curative in most cases. However, perioperative blood transfusions may be necessary for complex skull bases and/or high-grade meningiomas. Guidelines for blood transfusions during intracranial meningioma surgery remain unclear. This scoping review aims to delineate the main characteristics of patients who underwent intracranial meningioma surgery, the prevalence of the selected patients who required blood transfusions, and common causes for transfusion.\u0000\u0000\u0000\u0000A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guidelines to include studies reporting eligibility, protocols, and potential complications related to blood transfusion within the perioperative management of intracranial meningiomas.\u0000\u0000\u0000\u0000A total of 33 articles encompassing 3009 meningioma patients were included in the study. The most common symptom was headache (18%), and the most frequent type of meningioma was World Health Organization grade-1 meningothelial (50.4%). The lateral supraorbital approach was the most common surgical corridor (59.1%) in skull base meningiomas, and most patients underwent GTR (69%). Blood transfusion was required for 20% of patients, with a mean estimated intraoperative blood loss of 703 mL (ranging from 200 mL to 2000 mL). The main indications for blood transfusion in meningioma surgery were intraoperative blood loss (86%) and preoperative anemia (7.3%).\u0000\u0000\u0000\u0000This scoping found that 20% of the included patients required blood transfusion. It also points out that several factors could influence the necessity for a transfusion, encompassing surgical blood loss, pre-existing anemia, and the surgery’s length. This scoping review may provide surgeons with a potential guide to inform their decision-making process regarding blood transfusions during meningioma surgeries.\u0000","PeriodicalId":504441,"journal":{"name":"Surgical Neurology International","volume":"8 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}