Minimally Invasive Drainage of Intracerebral Hemorrhage. A South American Experience with the MISTIE Procedure.

Background: Intracerebral hemorrhage (ICH) is the second most common subtype of stroke but is associated with greater rates of disability or mortality. One of the factors of a poor prognosis is large hematoma volume. The MISTIE III trial with the aim of decreasing clot size showed that the greater the ICH reduction, the higher likelihood of lower mortality without a net increase in the proportion of patients with severe disability.

Navigated multiplanar osteotomies for spinal primary bone tumors.

Background: Establishing the proper diagnosis and rendering appropriate treatment of spinal primary bone tumors (SPBT) can result in definitive cures. Notably, malignant, or benign SPBT (i.e.

Surgical Indication Optimization of Brain Metastases Based on the Evolutionary Analysis of Karnofsky Performance Status.

Background And Objective:  Surgical resection of brain metastases (BM) offers the highest rates of local control and survival; however, it is reserved for patients with good functional status. In particular, the presence of BM tends to oversize the detriment of the overall functional status, causing neurologic deterioration, potentially reversible following symptomatic pharmacological treatment. Thus, a timely indication of surgical resection may be dismissed.

Early Report on the Impact of COVID-19 Outbreak in Neurosurgical Practice Among Members of the Latin American Federation of Neurosurgical Societies.

Background: The COVID-19 pandemic has caused severe economic consequences by local governmental measures to contain the outbreak. We provide insight on the impact that health care restriction has made on neurosurgical activity in Latin Iberoamerica.

Methods: We performed an internet-based survey among presidents and members of the societies of the Latin American Federation of Neurosurgical Societies (FLANC).

Endoscopic versus Microscopic Pituitary Adenoma Surgery: A Single-center Study.

Background: Transsphenoidal approach became the gold standard in the surgical treatment of pituitary adenomas in the past years, but the comparative efficacy of microscopic and endoscopic transnasal surgery has not been fully studied.

Aims: To compare the microscopic and endoscopic transnasal approaches for the treatment of pituitary adenomas.

Settings And Design: A retrospective analysis was performed, comparing adult patients with pituitary adenomas who had undergone transnasal microscopic surgery between January 2006 and December 2014 with the patients operated on with endoscopic surgery between March 2011 and December 2014 at Hospital Italiano de Buenos Aires.

[Minimally invasive resection of spinal synovial cysts: Technical note].

Objective: To present the treatment algorithm, surgical technique, and results of a series of patients with spinal synovial cysts operated with minimally invasive techniques (MIS).

Introduction: Spinal synovial cysts originate from the dilation and potential rupture of the synovial sheath of a facet joint. Surgical resection is considered the treatment of choice in symptomatic patients.

[Usefulness of minimally invasive spine surgery for the management of thoracolumbar spinal metastases].

Objective: To describe the surgical results and evolution of patients who underwent minimally invasive spine surgery (MISS) for the treatment of thoracolumbar spinal metastases, using the NOMS (Neurological, Oncological, Mechanical, Systemic) assessment for the therapeutic decision.

Methods: Patients who underwent MISS technique for the treatment of thoracolumbar spinal metastases were prospectively enrolled at the Hospital Italiano de Buenos Aires, from June 2014 to June 2017. In all cases, the NOMS assessments were performed for therapeutic decision making.

Safety margin for the preservation of the nasoseptal artery during trans-nasal endoscopic approach.

Background: The introduction of the nasoseptal flap for the reconstruction of extended endoscopic approaches decreased the incidence of postoperative fistula. In order to preserve the septal vascular pedicles, many have started to prepare the flap systematically, prior to the opening of the sphenoid rostrum. The aim of this study is to obtain an average measure of the location of the posterior septal artery using the upper edge of the choana as a landmark.

Flow Diverter for the Treatment of Pseudoaneurysms of the Extracraneal Vertebral Artery: Report of Two Cases and Review of the Literature.

Background: Pseudoaneurysms (PAs) of the extracranial vertebral artery (VA) are rare lesions, representing less than 1% of all aneurysms. Although these lesions may resolve spontaneously, they present a high rupture rate, so early preventive treatment is advised.

Case Description: Case 1: A 48-year-old woman presented with pain and cervical rigidity.

Accuracy in Percutaneous Transpedicular Screws Placement Using Biplane Radioscopy: Systematic Review and Meta-Analysis.

Study Design: Systematic review and descriptive data meta-analysis.

Objective: The objective of this study was to appropriately establish the accuracy in the percutaneous transpedicular screws (PTS) placement using biplane radioscopy (Rx-2D).

Summary Of Background Data: The Rx-2D is a widely-used technique for PTS as it is practical, ubiquitous, and cost-effective.

[Optical coherence tomography as a predictor of visual recovery in patients with pituitary macroadenomas].

Background: With pituitary macroadenomas, there is a high incidence of visual loss from optic pathway compression. Surgical removal of the tumor usually prevents progression and allows visual recovery. Our objective was to evaluate if optical coherence tomography (OCT) predicts visual outcomes after surgical decompression.

Minimally Invasive Single-Stage Removal of a Thoracic Dumbbell Tumor from a Posterior Approach: 2-Dimensional Operative Video.

Dumbbell-shaped thoracic tumors usually involve the spinal canal and the posterior thoracic cavity. Gross total resection is the treatment of choice, but techniques for surgical excision remain controversial. An anterolateral transthoracic approach may remove the paravertebral component of the tumor, but has limited or no control of the intracanal lesion.

Minimally Invasive Resection of a Cervical Anterolateral Meningioma: 2-Dimensional Operative Video.

Intradural extramedullary spinal tumors were historically managed through traditional midline approaches. Although conventional laminectomy or laminoplasty provides a wide tumor and spinal cord exposure, they may cause prolonged postoperative neck pain and late kyphosis deformity. Minimally invasive ipsilateral hemilaminectomy preserves midline structures, reduces the paraspinal muscle disruption, and could avoid postoperative kyphosis deformity.

Lateral Transpsoas Approach for Lumbar Indirect Lateral Recess Decompression: 2-Dimensional Operative Video.

Neurogenic claudication is a common symptom of lumbar spinal stenosis; its pathophysiology is thought to be ischemia of the nerve roots secondary to compression from surrounding structures. The stenosis of the lateral recesses and neuroforamen can cause these symptoms and its surgical treatment is decompression. The placement of interbody cages that restore the disc space height may indirectly decompress the neuroforamen and alleviate the nerve impingement symptoms.

Application of Fibrin Rich in Leukocytes and Platelets in the Reconstruction of Endoscopic Approaches to the Skull Base.

Background: The objective of this work is to report the feasibility and results of an institutional protocol for the application of an innovative biologically active hemoderivative autologous material, denominated leukocyte- and platelet-rich fibrin (L-PRF), in the reconstruction of endoscopic approaches to the sellar region.

Methods: L-PRF membranes were produced from centrifuged autologous venous blood. They were used for the reconstruction of transsphenoidal endoscopic approaches to the sellar region in 12 patients.

[IgG4 related disease presenting as panhypopituitarism and perimacular scotoma].

IgG4-related disease (IgG4-RD) is a recently described systemic entity of unknown origin. It predominantly affects older men and has distinctive histopathologic features as storiform fibrosis, obliterative phlebitis, dense lymphoplasmacytic infiltrate with immunostaining for IgG4, and it may be associated with elevated serum levels of IgG4. Although any organ can be affected, pituitary gland is rarely involved.

[Learning curve of minimally invasive pedicle screw placement].

Objective: The aim of this study was to estimate the learning curve needed for correct placement of minimally invasive percutaneous pedicle screws (PPS).

Introduction: PPS are the most common system used for instrumentation of spinal lesions that require stabilization.

Methods: We retrospectively assessed the insertion of 422 PPS (T5 to S1) in 75 patients operated between 2013-2016 under two-dimensional fluoroscopic guidance.

[Minimally invasive extraforaminal lumbar interbody fusion].

Objectives: The objective of the present study was to determine the indications, surgical technique, results, and complications of minimally invasive extraforaminal lumbar interbody fusion (ELIF).

Introduction: ELIF is characterized as removal of the superior articular process (SAP) to access the intra-canalicular root and disc through Kambin's triangle.

Methods: A retrospective study was conducted of 40 patients operated upon between 2013 and 2015.

[Relevance of Simpson's grades in the resection of grade I meningiomas].

Objective: Compare the number of recurrences in patients with WHO Grade I meningiomas that underwent microsurgical resection.

Introduction: In 1957 Simpson established five grades for surgical resection for intracranial meningiomas and recurrence rate. He thought that an aggressive removal of these tumors with dura and bone was necessary to cure them.

Intraoperative monitoring for spinal radiculomedullary artery aneurysm occlusion treatment: What, when, and how long?

Background: Spinal radiculomedullary artery aneurysms are extremely rare. Treatment should be tailored to clinical presentation, distal aneurysm flow, and lesion anatomical features. When a surgical occlusion is planned, it is necessary to evaluate whether intraoperative monitoring (IOM) should be considered as an indispensable tool to prevent potential spinal cord ischemia.

Pathological changes of the hippocampus and cognitive dysfunction following frontal lobe surgery in a rat model.

Background: Postoperative cognitive dysfunction (POCD) is a known complication after intracranial surgery. Impaired hippocampal neurogenesis has been associated with cognitive dysfunction in animal models.

Methods: In order to assess hippocampal changes after brain surgery, a frontal lobe corticectomy was performed in ten adult Wistar rats (group 4).

[Endoscopic treatment of 140 pituitary tumors, results and complications].

Objective: To present the clinical and radiographic outcomes of 140 patients with pituitary adenomas treated by an endoscopic endonasal approach (EEA) over a period of 4 years.

Material And Methods: A retrospective analysis was performed between 2011 and 2014. Pre and post operative MRI, ophtalmological assessment, endocrinological laboratory evaluation and surgical morbidity and mortality were assessed.

Construction and in vitro testing of a cellulose dura mater graft.

Introduction: Cerebrospinal fluid (CSF) leaks are a common complication after cranial and spinal surgery and are associated with increased morbidity. Despite continuous research in this field, this problem is far from solved. In this paper, we describe the construction and testing of a bacterial cellulose (BC) membrane as a new dural patch.

Unsuccessful pulsed radiofrequency of the sphenopalatine ganglion in patients with chronic cluster headache and subsequent successful thermocoagulation.

We present the results of pulsed and continuous radiofrequency (CRF) of the sphenopalatine ganglion in a case series of 3 patients with chronic cluster headache (CCH). Three patients were referred to our neurosurgical department because of CCH, which was refractory to pharmacological treatment. They underwent pulsed radiofrequency of the sphenopalatine ganglion (PRF-SPG), and the procedure was performed through an infrazygomatic approach.