This study investigated the outcome after repeat epilepsy surgery in patients with unsatisfactory results after their first operation. In a mixed cohort of different epilepsy syndromes, 71% of patients became seizure free after the reoperation, a higher proportion than what is usually reported. Subgroups were analyzed, and details of the presurgical reevaluation and their contribution to the good outcome are discussed. These results encourage reevaluation and reoperation after failed initial epilepsy surgery.
Researchers describe the development process of a novel, hands-on cerebral hemispheric surgery simulator and evaluate its usefulness in teaching epilepsy surgeries. The hemispherectomy simulator was found to be a reasonable epilepsy surgery training tool in the quest to increase preoperative practice opportunities for neurosurgical education. This early technology could potentially optimize the learning of neurosurgical cases with a high technical skill quotient and improve surgeon intraoperative performance.
The modified Delphi method was used to develop 17 consensus statements regarding the modality, frequency, and duration of hydrocephalus surveillance following surgical treatment. Consensus could not be achieved for 19 statements, highlighting areas without clear data to guide clinical practice. These findings may guide future efforts to develop standardized clinical protocols for the postoperative surveillance of patients with hydrocephalus, which has the potential to improve patient care and optimize the use of healthcare resources.
Researchers set out to determine if retrospective analysis of prospectively collected patient-reported outcomes (PROs) following surgery for cervical spondylotic myelopathy (CSM) differed when stratified by preoperative myelopathy status. Three months after surgical decompression for CSM appears to be an adequate time to achieve maximum improvement in PROs in most patients. This study adds value by providing new insight and more accurate time resolution into how and when patients can be expected to achieve clinical improvement following surgical decompression for CSM and provides the surgeon and patient with more accurate information for counseling and expected postoperative recovery time course.
The authors explored the possibility of directly stimulating the cochlear nerve in a surgical cohort of large vestibular schwannomas and recording the postauricular muscle responses (PAMRs) with electrodes placed at Cz and A1/A2. PAMRs have a higher signal-to-noise ratio, require much less averaging than brainstem auditory evoked potentials, and have an absence of recorded responses from other nerves. PAMR monitoring may be useful in mapping the position and trajectory of the cochlear nerve to enable hearing preservation during surgery.
This study was intended to fill the gap in the literature by investigating the effect of rod diameter on the stability and kinematics of the lateral mass fixation construct. An increase in rod diameter improved the rigidity of the construct but resulted in an increase in the kinematics of the adjacent segments. This study can provide surgeons with data to help guide implant selection during posterior cervical fusion surgery.
Featuring presentations on selected papers published in this issue by Ms. Audrey Grossen, Dr. Pranay Soni, and Dr. Nicole Frank. Moderated by Dr. Caitlin Hoffman. With Drs. William Couldwell (Editor-in-Chief) and Aaron Cohen-Gadol (Associate Editor).
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