Volume 132: Issue 1 (Jan 2020): Pages 1-332
in Journal of NeurosurgeryFigure from Minchev et al. (pp 150–158).
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In Brief
The authors assessed outcomes in stroke patients after removal of nonfunctional tissue of the brain and found that this procedure was associated with improved neurological outcome in some cases, especially young stroke patients with large infarction areas. This important finding indicates that aggressive operative decompression, including resection of nonfunctional brain tissue, leads to better neurological outcomes in selected patients.
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In Brief
Patients with an aneurysm rupture are at increased risk of stroke. The tool we currently have for stroke detection is a specialized ultrasound of brain vessels that is not always reliable. The authors used a special camera called a pupillometer that can detect pupil variations to identify patients at higher risk for stroke after an aneurysm bleed. They found that pupillometry could potentially identify patients at a higher risk and could predict strokes by 4 to 8 hours.
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In Brief
The authors sought to demonstrate that upregulation of IGFBP3 is correlated with advanced tumor grades and unfavorable prognoses in glioma patients and that suppression of IGFBP3 induces cell apoptosis, delays in vivo tumor growth, and prolongs survival in a mouse model. The study results indicate that depleting IGFBP3 may be a useful therapy for high-grade gliomas, which have long been considered incurable and have little response to current therapies.
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In Brief
The authors demonstrated the ability to recognize an important mutation in brain tissue during surgery using a rapid (< 5-minute) chemical test made by mass spectrometry in the operating room. Better patient outcomes are associated with more complete tumor resection.This mutation permits more aggressive resection, but the mutation status must be known at the time of surgery for the surgeon to be able to act on this knowledge and so that outcomes are improved.
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In Brief
The authors developed a novel simple scoring system to predict the results of microsurgical decompression in patients with trigeminal neuralgia by using preoperative clinical and radiological findings. The resulting assessment tool has a numeric scale ranging from 3 to 0, with higher scores indicating better results, and allows surgeons to predict patient outcomes based on individual patient findings and provide pretreatment counseling to patients based on their own specific predicted outcomes.
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In Brief
In a preclinical model of neuropathic pain, the authors sought to understand the therapeutic mechanisms of motor cortex stimulation used to treat patients with refractory neuropathic pain syndromes. The results show that the neurotransmitters glycine and GABA released in the periaqueductal gray are the key factors responsible for analgesia induced by cortical stimulation.
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In Brief
The history of nerve stretching is a fascinating history: as a treatment for various disorders, repair of long nerve gaps, and augmenting regeneration. Yet, the detrimental effects of nerve stretching are well researched. In this paper, the overlap between these opposing positions is explored through the lens of time.
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