Volume 130: Issue 4 (Apr 2019)
in Journal of NeurosurgeryIllustration from Ferrareze Nunes et al. (pp 1304–1314). Copyright Juan C. Fernandez-Miranda. Published with permission.
In Brief
A multiphasic, mixed-method analysis was used to measure the burden of essential neurosurgical disease worldwide and the current workforce capable of addressing it. By quantifying the more than 5 million unmet neurosurgical cases each year, a foundation, purpose, and direction is given to ongoing and future collaborative efforts aimed at expanding the neurosurgical workforce and increasing access to neurosurgical care, especially in low- and middle-income countries.
In Brief
To further characterize the global burden of infectious diseases with neurosurgical relevance, the authors conducted a systematic review and meta-analysis of 154 studies. The results elucidated the epidemiology of neurocysticercosis, bacterial meningitis, intracranial abscess, tuberculous meningitis/osteomyelitis, and nontuberculous spinal osteomyelitis and underscored the disproportionate burden of central nervous system infections in the developing world, where there is a concomitant dearth of neurosurgical personnel and resources.
In Brief
This study was done to prove the feasibility of long-term ECoG recording. The results are very promising for the use of wireless long-term ECoG recording in humans that is aimed toward restorative neurosurgery and responsive stimulation treatments for epilepsy.
In Brief
This study demonstrated an experimental model of hemispherotomy in laboratory animals, based on cortical ablation and neural pathway disconnections, mimicking the hemispherotomy used in children for the treatment of refractory epilepsy. This model was also a putative approach to the study of neural plasticity in young animals, as well as the physiotherapy technique applied in hemispherotomized children aimed at postsurgical recovery. This neurosurgical intervention allows new strategies for the study of brain response to injuries.
In Brief
The authors showed that MRI artifacts of new adjustable shunt devices can be dramatically reduced by changing the setting pressure. These large artifacts on MR images can be shrunk when they overlap with the region of interests.
In Brief
The authors studied overall survival (OS) in patients who underwent surgery for a wild-type IDH WHO grade II astrocytoma, without early adjuvant treatment. Survival was 77.27% at 5 years. None of the patients with long-term follow-up of more than 5 years died. The huge heterogeneity in OS suggests that IDH mutation alone is not sufficient to predict risk of malignant transformation and survival at the individual level. The decision to administer early postoperative chemotherapy/radiotherapy should not solely rely on molecular markers.
In Brief
Researchers used a novel myelin imaging technique to quantitatively evaluate changes in myelin after mild traumatic brain injury in contact sports players. Myelin increased after each injury, and the contact sports players had higher amounts of myelin at baseline compared with a control population of non–contact sports players. The full clinical significance of increased myelin and whether this reflects disorderly remyelination leading to increased overall myelin has yet to be determined.
In Brief
Using specialized software and ICG videoangiography, the authors evaluated local cerebral blood flow before and after anastomosis in patients undergoing revascularization for moyamoya disease. They found that postoperative transient neurological events (TNEs) could be predicted intraoperatively and that TNEs were more likely to occur in patients who had larger changes in blood flow. Using this method to screen patients at high risk for TNEs could allow adjustment of perioperative management, potentially reducing complications.
In Brief
The objective of this pilot study was to detect microbleeds associated with sentinel headache using MRI-QSM and to clarify the morphological characteristics of unstable aneurysms with microbleeds. MRI-QSM allowed for objective detection of microbleeds associated with sentinel headache and therefore identification of unstable aneurysms. Aneurysms with slightly greater undulation indices were associated with positive MRI-QSM results and hence with micro bleeds.
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