Researchers used 3T 2-hydroxyglutarate (2HG)-optimized magnetic resonance spectroscopy (2HG-MRS) to evaluate its utility in diagnosing IDH-mutant adult brainstem glioma (BSG). This study showed that 2HG-MRS was able to detect 2HG in adult BSG, which was proved by histopathological and molecular examination. In addition, this study provided evidence that the preoperative 2HG status predicts the patient's overall survival. Therefore, noninvasive 2HG-MRS may be useful for evaluating molecular status and prognosis for adult BSG.
Transparency of data is a powerful way to improve patient outcomes and gain clinical efficiency. It is a driver in changing patient, provider, and institutional behaviors. Transparency is an essential element of quality improvement and safety, as well as building a culture of trust. Here, the authors utilized a living Pareto chart—an important tool in quality improvement, business, and visual management—as a platform for transparency and communication.
This study's aim was to compare external ventricular drain (EVD)-related infection rates and mechanical complications between long-tunneled EVD (LTEVD) with an interposed valve and short-tunneled EVD (STEVD) in a cohort of pediatric patients. LTEVDs reduced the odds of an EVD-related infection by 92% and the odds of a CSF leak by 69% compared to STEVDs. Neither CSF blockage nor displacement showed a statistically significant difference between groups. STEVDs required more resources than LTEVDs in most areas considered in this study. This is the first pediatric, 2-armed trial comparing results of LTEVDs and STEVDs in a population of nearly 50% infected patients.
This systematic review and meta-analysis investigated whether prolonged antibiotic prophylaxis, compared with 24 hours of prophylaxis for drains used in posterior spinal surgery, reduces the risk of surgical site infection. The authors found that a prolonged antibiotic regimen does not reduce the odds of surgical site infection. The findings of this investigation will help reduce excessive antibiotic use in spine surgery.
Based on a prospective study of 392 patients with unruptured intracranial aneurysms and hypertension, the authors found that calcium channel blocker (CCB) users had a lower incidence of aneurysm instability compared with non-CCB users. This result suggests that CCBs may be useful for aneurysm instability prevention in patients with hypertension.
Researchers used motion capture technology to conduct gait analysis of cervical spondylotic myelopathy (CSM) patients before and after surgical intervention. It was found that patients displayed significant improvement in several parameters following surgery, although the improvements were not to the levels of those of healthy control comparisons. This study adds value to the field by better quantifying improvements in gait parameters for CSM patients after surgery and providing comparison points to other subjective myelopathy outcome measures.
Featuring presentations on selected articles published in this issue by Dr. Georg Widhalm, Dr. Lisa Wadiura, and Dr. David Hersh. Moderated by Dr. Howard Colman with Drs. William Couldwell (Editor-in-Chief) and Aaron Cohen-Gadol (Associate Editor).