This retrospective study aimed to find a predictive factor associated with postoperative hemorrhage after stereotactic biopsy (STB). Intratumoral susceptibility signal (ITSS) refers to linear or dot-like areas of low signal within the tumor on non-contrast-enhanced susceptibility-weighted imaging. The authors found that ITSS assessed by preoperative MRI is associated with hemorrhage after STB. ITSS can be used to predict postoperative hemorrhage risk, which can assist with preoperative planning and explaining risks to the patient.
Researchers analyzed risk factors for proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) in patients with spinal fusions extending from the pelvis to the upper thoracic spine. They found low bone density at the top of the intended construct, as estimated by Hounsfield units (HU), to be the only independent predictor of PJK and PJF. Low HU in the upper thoracic spine is a novel and modifiable risk factor for PJK and PJF.
In a single-center cohort of 90 patients who had undergone minimally invasive endoscopic evacuation of spontaneous supratentorial intracerebral hemorrhage, long-term functional independence was associated with a shorter time to evacuation. In fact, 36% of patients undergoing evacuation within 24 hours of ictus attained functional independence (modified Rankin Scale score= 2). This is the first study to report factors associated with functional independence after minimally invasive endoscopic evacuation of intracerebral hemorrhage and can be used to better guide protocols of future clinical trials.
Caregiver stress from a child's diagnosis can impact a caregiver's ability to participate in treatment decisions, comply, and manage long-term illness. The authors sought to compare caregiver stress in children with craniosynostosis at diagnosis and postoperatively. Stress levels ranged from normal to clinically significant in the caregivers, with sex, uninsured status, and open repair predicting higher stress. Stress decreased at 3 months postoperatively before increasing at 6 months. Intervention targeting caregiver stress should be explored to maintain lower stress observed at 3 months after surgery.
Researchers studied differences among patients regarding which spinal nerves supply muscles in the legs. They electrically stimulated nerves during placement of electrodes for the treatment of chronic pain and mapped patterns of muscle activation in individual patients. They showed a large degree of variation, which is essential to keep in mind when diagnosing and treating patients.
Revascularization surgery for moyamoya is a specialized procedure for a rare condition that requires specific tissue-handling and microsurgical skills. In this paper, the authors demonstrate that in a high-volume center a newly appointed surgeon can be trained by an experienced one safely with no drop in quality and outcomes, and they also discuss the methods by which this can be achieved.
Featuring presentations on selected papers published in this issue by Drs. Michael Sughrue, Saman Shabani, Laura Salgado-Lopez, and Walter Jean. Moderated by Constantinos Hadjipanayis. With William Couldwell (Editor-in-Chief) and Aaron Cohen-Gadol (Associate Editor).
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