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Neurological outcome after surgical management of adult tethered cord syndrome

Clinical article

Giannina L. Garcés-Ambrossi, Matthew J. McGirt, Roger Samuels, Daniel M. Sciubba, Ali Bydon, Ziya L. Gokaslan, and George I. Jallo

intradural tumors in 3 patients (10%). Six patients (20%) presented with an associated syrinx, 3 (10%) with scoliosis, 3 (10%) with cutaneous stigmata, and 1 (3%) with hip subluxation. The median (IQR) length of stay was 6 days (4–8 days). Perioperative complications included 3 cases (10%) of surgical site infection and 2 (10%) CSF leaks. There were no deep vein thromboses or pulmonary emboli. All patients were discharged home except 1 (3%). Two patients (7%) underwent a second untethering procedure at 42 and at 11 months. Postoperative Outcomes By 18 months

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Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project

Susan M. Chang, Ian F. Parney, Michael Mcdermott, Fred G. Barker II, Meic H. Schmidt, Wei Huang, Edward R. Laws Jr., Kevin O. Lillehei, Mark Bernstein, Henry Brem, Andrew E. Sloan, Mitchel Berger, and the Glioma Outcomes Investigators

M aximum , safe resection is the primary goal of surgical therapy for malignant glioma. 9, 24, 29 This allows for a definitive diagnosis 16 and can improve neurological outcome by relieving mass effect and pressure on normal brain structures. In many retrospective studies researchers have addressed the potential impact of the extent of resection on overall survival in these patients. Most have shown prolonged survival in response to more extensive surgery, 11, 22, 29, 36 although this remains controversial. 10, 21 Perioperative complications after

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Impact of Guglielmi detachable coils on outcomes of patients with intracranial aneurysms treated by a multidisciplinary team at a single institution

Mary K. Sturaitis, Jaakko Rinne, John C. Chaloupka, Mehmet Kaynar, Zhenqiu Lin, and Issam A. Awad

been reported extensively in several selected uncontrolled series, 6, 9, 12, 19, 27, 55, 57, 65, 66, 78, 84, 92, 101 and there are reports addressing the issues of failed GDC treatment followed by surgical therapy, failed aneurysm clipping followed by GDC therapy, and planned combined therapies for complex lesions. 7, 31, 37, 48, 100 However, the impact of this treatment modality on the overall multidisciplinary management outcome of intracranial aneurysms has not yet been investigated. A number of host and lesion factors have been correlated with management

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Factors associated with progression-free survival and long-term neurological outcome after resection of intramedullary spinal cord tumors: analysis of 101 consecutive cases

Clinical article

Giannina L. Garcés-Ambrossi, Matthew J. McGirt, Vivek A. Mehta, Daniel M. Sciubba, Timothy F. Witham, Ali Bydon, Jean-Paul Wolinksy, George I. Jallo, and Ziya L. Gokaslan

cases (88 [87%]), surgery was used alone without adjuvant radiotherapy. Short-Term Neurological Outcome Acute perioperative neurological decline occurred in 34 patients (34%). Of these, 14 (41%) returned to their preoperative baseline by 1 month. Increasing age and an intraoperative change in MEPs were associated with increased odds of acute decline (OR 1.04, p = 0.02, and OR 7.4, p = 0.003, respectively). The incidence of acute decline was not statistically different among tumor types (ependymoma 33%, hemangioblastoma 33%, pilocytic astrocytoma 25%, Grade II

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Outcome after severe head injury

Relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients

Anthony M. Alberico, John D. Ward, Sung C. Choi, Anthony Marmarou, and Harold F. Young

considerably from series to series. To make sound conclusions from a comparison of pediatric and adult patients with severe head injury, one would obviously want to minimize the effect of as many variables as possible. The situation at our institution has afforded a unique opportunity to compare outcome from head injury in pediatric and adult patients. The Medical College of Virginia (MCV) Hospital contains a complete pediatric service within the same facilities. Our formula for management of severe head injury has been consistently applied to all patients regardless of

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Adult scoliosis surgery outcomes: a systematic review

Sanjay Yadla, Mitchell G. Maltenfort, John K. Ratliff, and James S. Harrop

nonoperative management are lacking. 13 Outcomes for adult deformity surgery are largely reported in reference to a specific surgical technique or in relation to a particular surgeon or surgical group. Investigators have used varying classifications of clinical outcomes and procedure-related complications, making analysis of the literature difficult. The purpose of this systematic review was to synthesize existing data on the outcomes of surgical intervention for adult spine deformity. Four specific questions regarding outcome were proposed as follows: 1) What is the

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Long-term outcomes in children with glioblastoma

Clinical article

Kyung Sun Song, Ji Hoon Phi, Byung-Kyu Cho, Kyu-Chang Wang, Ji Yeoun Lee, Dong Gyu Kim, Il Han Kim, Hyo Seop Ahn, Sung-Hye Park, and Seung-Ki Kim

prognosis than the adult disease remains under debate. In addition, the prognostic factors that influence the long-term outcome of glioblastoma in children are unclear. In this study, we retrospectively analyzed the long-term outcome of 27 pediatric patients harboring a glioblastoma who were treated in a single institution. The OS rate was calculated, and the clinical factors that affected the outcome were analyzed. Methods Patient Inclusion and Data Collection We searched our operation database for pediatric patients in whom glioblastoma had been newly

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Epilepsy surgery in children: outcomes and complications

Seung-Ki Kim, Kyu-Chang Wang, Yong-Seung Hwang, Ki Joong Kim, Jong Hee Chae, In-One Kim, and Byung-Kyu Cho

E pilepsy surgery is a viable option for intractable epilepsy, which comprises 10–20% of the cases of pediatric epilepsy. 14 , 18 Experience derived from such surgery shows that children present with different features than adults. Children have a higher proportion of neoplastic and malformation lesions in the epileptogenic substrate and more frequent extratemporal foci of epileptogenesis, and they require surgical treatment of the developing brain. 8 , 11 , 14 , 15 , 19 , 27 Evaluation of surgical outcome and complications is important when selecting

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Temporal lobectomy in children: cognitive outcome

Michael Westerveld, Kimberlee J. Sass, Gordon J. Chelune, Bruce P. Hermann, William B. Barr, David W. Loring, Esther Strauss, Max R. Trenerry, Kenneth Perrine, and Dennis D. Spencer

favorable outcome in younger patients and have established a pathological similarity between the substrate of temporal lobe seizures in children and adults. However, although anecdotal mention of cognitive and behavioral outcome is noted, no systematic evaluation of cognitive outcome was performed. More recent series have provided increasing evidence of pathological similarity between childhood and adult temporal lobe epilepsy, 12–14 and have demonstrated that temporal lobectomy performed during childhood produces favorable results, with similar or greater frequency

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Outcome in pediatric hydrocephalus: a comparison between previously used outcome measures and the Hydrocephalus Outcome Questionnaire

Marc Platenkamp, Patrick W. Hanlo, Kathelijn Fischer, and Rob H. J. M. Gooskens

T he incidence of hydrocephalus in newborn infants is 1 in 1000. 4 Since an appropriate symptomatic therapy for hydrocephalus has become available (shunts), mortality rates have fallen and morbidity rates have improved. 5 Many of the studies detailing the outcome of children with hydrocephalus are older studies that involved heterogeneous populations. 6 , 9 , 12 , 15 Recent studies contain mostly small sample sizes. 4 , 7 , 10 Consequently, little information is available on the outcome of children recently treated for hydrocephalus. In the past