Volume 131: Issue 6 (Dec 2019): Pages 1683-1994
in Journal of NeurosurgeryIllustration from Miki et al (pp 1905–1911). Copyright Koichi Miki (right panel). Published with permission.
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In Brief
The authors assessed the anatomical feasibility and limitations of approaching the paraclinoid carotid region via an endoscopic endonasal approach as an alternative to the traditional transcranial approaches to the region. This alternative route may provide superior exposure of the medial aspect of the paraclionid carotid artery during aneurysm dissection and clipping.
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In Brief
In this study the long-term effect of stereotactic radiosurgery on seizure control was assessed. Management options for patients with arteriovenous malformations include conservative management, embolization, radiosurgery, and surgery. The finding that radiosurgery increases the likelihood of seizure control is important because it helps physicians in selecting the best treatment option for patients with arteriovenous malformations who present with seizures.
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In Brief
In this study, the authors looked at the results of treating 20 recurrent previously irradiated meningiomas in 19 patients with implantable Cs-131 brachytherapy seeds spaced using a modular collagen spacing system. After 15.4 months, 10% of patients had local tumor regrowth where they were treated. Two patients had surgical complications, and two became symptomatic from radiation and were treated medically. These results support that this therapy is potentially safe and effective for treating this aggressive tumor.
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In Brief
Being diagnosed with a benign brain tumor and confronted with undergoing surgery may impose acute distress on the patients’ mental health, often resulting in a severe psychological burden. By employing an assortment of psychopathological assessments before and after surgery, the authors analyzed the implications of the preoperative emotional state of patients on their postoperative health-related quality of life and outcome.
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In Brief
This study of patient quality of life (QOL) after stereotactic radiosurgery (SRS), using data from the first prospective, multicenter US SRS registry, revealed that QOL typically improved in patients with early SRS treatment and worsened in patients with greater numbers of brain metastases, but was unchanged in patients with high levels of anxiety and depression, who may benefit from treatment for these conditions. The current study demonstrates the scientific value of the US SRS registry.
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In Brief
The authors analyzed the position of the lateral femoral cutaneous nerve (LFCN) in 36 cadavers and also evaluated its course ultrasonography in 34 healthy volunteers. Their findings are important for surgical decompression of the LFCN, showing that it may be necessary 1) to incise the oblique aponeurosis and fascia iliaca medial to the nerve and 2) to free the iliolata ligaments from the anterior superior iliac spine.
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In Brief
The authors devised an index that may identify the events of severe cerebral hypoperfusion, which was defined as the cumulative duration of decreased cerebral perfusion pressure, systemic hypotension, and worsened cerebrovascular reactivity. Findings of this study indicate that 25 or higher cumulative minutes of such hypoperfusion event is highly predictive of 24-hour mortality in traumatic brain injury patients.
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In Brief
The authors found that a double-crescent sign—a CT image finding—is a warning sign for recurrence of chronic subdural hematoma. This finding is important because it can be easily identified on CT, and clinicians are alerted to the recurrence of the lesion by seeing this sign after surgery in a patient with chronic subdural hematoma.
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In Brief
We reported the history of Charles Locke Jr.'s career as the first neurosurgeon at the Cleveland Clinic. This is the first such report and an important historical topic.
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