Cyberknife radio-neurosurgery for secreting pituitary adenomas treated with single fraction radio-neurosurgery: A systematic review and meta-analysis.

Introduction: Stereotactic radiosurgery (SRS) is one of the treatment options for the management of residual or recurrent secreting pituitary adenomas (PA). While the role of radiosurgery (RS) by Gamma Knife (GK) has been clearly established, Cyberknife (CK) RS has been evaluated in fewer series.

Material And Methods: To perform a systematic review of the literature and meta-analysis, with the aim of focusing on the effect of CK RS on secreting PA.

Evaluating gait and postural responses to subthalamic stimulation and levodopa: A prospective study using wearable technology.

Background: The efficacy of subthalamic stimulation on axial signs of Parkinson's disease (PD) is debated in the literature. This study delves into the dynamic interplay of gait and posture, specifically probing their nuanced response to subthalamic stimulation and levodopa.

Methods: We used wearable sensor technology to examine alterations in the spatiotemporal parameters of gait and posture in individuals with PD before and 6 months after subthalamic deep brain stimulation (STN-DBS) surgery.

Experimental ex vivo characterization of the biomechanical effects of laminectomy and posterior fixation of the lumbo-sacral spine.

Laminectomy and posterior fixation are well-established surgical techniques to decompress nervous structures in case of lumbar spinal stenosis. While laminectomy is suspected to increase the instability of the spine, posterior fixation is associated with some complications such as adjacent segment degeneration. This study aimed to investigate how laminectomy and posterior fixation alter the biomechanics of the lumbar spine in terms of range of motion (ROM) and strains on the intervertebral discs.

Identifying Patients at Increased Risk for Poor Outcomes Among Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients: The IPOGRO Risk Model.

Background: A subarachnoid hemorrhage due to an aneurysmal rupture (aSAH) is a serious condition with severe neurological consequences. The World Federation of Neurosurgical Societies (WFNS) classification is a reliable predictor of death and long-term disability in patients with aSAH. Poor-grade neurological conditions on admission in aSAH (PG-aSAH) are often linked to high mortality rates and unfavorable outcomes.

How Accurate Is Frameless Fiducial-Free Deep Brain Stimulation?

Background And Objectives: Frameless deep brain stimulation (DBS) offers advantages in terms of patient comfort and reduced operative time. However, the need for bony fiducial markers for localization remains a drawback due to the time-consuming and uncomfortable procedure. An alternative localization method involves the direct tracking of an intraoperative 3-dimensional scanner.

Three-Dimensional Exoscope-Assisted Occlusion of a Foraminal Intradural Left L5-S1 Arteriovenous Fistula-Operative Video.

Spinal dural arteriovenous fistulas (dAVFs) are a rare type of spinal lesion that can cause severe clinical consequences. Early and accurate diagnosis and treatment are crucial to avoid severe complications such as radicular pain, weakness, sensory deficits, and loss of bowel and bladder control. Spinal dAVFs are commonly found in the lower thoracic or upper lumbar vertebrae.

Effect of two-level decompressive procedures on the biomechanics of the lumbo-sacral spine: an study.

Hemilaminectomy and laminectomy are decompressive procedures commonly used in case of lumbar spinal stenosis, which involve the removal of the posterior elements of the spine. These procedures may compromise the stability of the spine segment and create critical strains in the intervertebral discs. Thus, this study aimed to investigate if decompressive procedures could alter the biomechanics of the lumbar spine.

Enhancing palliative care in vulnerable patients: Robot-assisted radiofrequency ablation for multiple spinal metastases - Technical insights and preliminary outcomes.

Background: Radiofrequency thermal ablation (RFA) coupled with vertebroplasty or kyphoplasty offers a minimally invasive, safe, and efficacious approach to palliate polymetastatic spine disease, particularly in medically fragile individuals. However, the application of robotic assistance to RFA for spinal metastases remains unexplored. This study elucidates the technical viability of robot-assisted RFA combined with vertebroplasty in patients afflicted by multiple spinal metastases and presents preliminary outcomes.

Exoscopic versus Microscopic Surgery in 5-ALA-Guided Resection of High-Grade Gliomas.

Glioma surgery has been remarkably enhanced in the past 2 decades, with improved safety and limited but improved life expectations. The fluorescence-guided resection of high-grade gliomas (HGGs) plays a central role in this sense, allowing a greater extent of resection (EOR). The introduction of exoscopic-guided surgery may be considered in implementing fluorescence techniques over traditional microscopes.

Revitalizing neurosurgical frontiers: The EANS frontiers in neurosurgery committee's strategic framework.

Introduction: The field of neurosurgery faces challenges with the increasing involvement of other medical specialties in areas traditionally led by neurosurgeons. This paper examines the implications of this development for neurosurgical practice and patient care, with a focus on specialized areas like pain management, peripheral nerve surgery, and stereotactic radiosurgery.

Research Question: To assess the implications of the expanded scope of other specialties for neurosurgical practice and to consider the response of the EANS Frontiers in Neurosurgery Committee to these challenges.

Spinal Intramedullary Meningiomas: A Systematic Review with a Case Illustration.

Background: Intramedullary meningiomas are an exceptionally rare subtype of spinal tumors, accounting for only 5% of primary spinal neoplasms. Given their scarcity and unique characteristics, understanding optimal management approaches is crucial for improved clinical decision-making. This systematic review aims to consolidate existing literature and present a detailed case illustration to enhance understanding of this uncommon spinal tumor entity.

Awake Craniotomy for Gliomas in the Non-Dominant Right Hemisphere: A Comprehensive Review.

Awake surgery has become a standard practice for managing diffuse low-grade gliomas (LGGs), particularly in eloquent brain areas, and is established as a gold standard technique for left-dominant-hemisphere tumors. However, the intraoperative monitoring of functions in the right non-dominant hemisphere (RndH) is often neglected, highlighting the need for a better understanding of neurocognitive testing for complex functions in the right hemisphere. This article aims to comprehensively review the current literature on the benefits of awake craniotomy in gliomas of the non-dominant right hemisphere.

Factors affecting 30-day mortality in poor-grade aneurysmal subarachnoid hemorrhage: a 10-year single-center experience.

Background: The management of patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is burdened by an unfavorable prognosis even with aggressive treatment. The aim of the present study is to investigate the risk factors affecting 30-day mortality in poor-grade aSAH patients.

Methods: We performed a retrospective analysis of a prospectively collected database of poor-grade aSAH patients (World Federation of Neurosurgical Societies, WFNS, grades IV and V) treated at our institution from December 2010 to December 2020.

Connectome-Based Neurosurgery in Primary Intra-Axial Neoplasms: Beyond the Traditional Modular Conception of Brain Architecture for the Preservation of Major Neurological Domains and Higher-Order Cognitive Functions.

Despite the therapeutical advancements in the surgical treatment of primary intra-axial neoplasms, which determined both a significative improvement in OS and QoL and a reduction in the incidence of surgery-induced major neurological deficits, nowadays patients continue to manifest subtle post-operative neurocognitive impairments, preventing them from a full reintegration back into social life and into the workforce. The birth of connectomics paved the way for a profound reappraisal of the traditional conception of brain architecture, in favour of a model based on large-scale structural and functional interactions of a complex mosaic of cortical areas organized in a fluid network interconnected by subcortical bundles. Thanks to these advancements, neurosurgery is facing a new era of connectome-based resections, in which the core principle is still represented by the achievement of an ideal onco-functional balance, but with a closer eye on whole-brain circuitry, which constitutes the foundations of both major neurological functions, to be intended as motricity; language and visuospatial function; and higher-order cognitive functions such as cognition, conation, emotion and adaptive behaviour.

Is simultaneous occurrence of meningioma and glioblastoma a mere coincidence?

Background: It is extremely unusual for multiple tumors to arise from different cell types and occur at the same time inside the brain. It is still unknown whether or not the coexistence of meningioma and glioblastoma is connected in any way or if their simultaneous appearance is merely a coincidence.

Objective: We conduct a comprehensive literature review on cases of concurrent meningioma and glioblastoma occurrence to elucidate the underlying concepts that may constitute this coexistence.

Vertebral artery dissection caused by atlantoaxial dislocation in a patient with Marfan syndrome.

A small number of case reports have documented a link between atlantoaxial dislocation (AAD) and vertebral artery dissection (VAD), but this association has never been described in patients with hereditary connective tissue disorders. We present a case of an 18-year-old female patient, diagnosed with Marfan syndrome since the age of one, who underwent brain MRA for intracranial aneurysm screening revealing tortuosity of the internal carotid and vertebral arteries as well as atlantoaxial dislocation. Since the patient was asymptomatic, a wait-and-see approach was chosen, but a follow-up MRA after 18 months showed the appearance of a dissecting pseudoaneurysm of the V3 segment of the left vertebral artery.

Single fraction and hypofractionated radiosurgery for perioptic meningiomas-tumor control and visual outcomes: a systematic review and meta-analysis.

Perioptic meningiomas, defined as those that are less than 3 mm from the optic apparatus, are challenging to treat with stereotactic radiosurgery (SRS). Tumor control must be weighed against the risk of radiation-induced optic neuropathy (RION), as both tumor progression and RION can lead to visual decline. We performed a systematic review and meta-analysis of single fraction SRS and hypofractionated radiosurgery (hfRS) for perioptic meningiomas, evaluating tumor control and visual preservation rates.

Intramedullary sclerosing meningioma: operative video.

Sclerosing meningiomas (SMs) represent a rare histological variant of meningiomas, first described in 1989 as invasive bulking masses of whorling collagen bundles with a minimum percentage of meningothelia-resembling cells, and they are often misdiagnosed. The literature reports only 30 cases of SMs, with only two of them being intramedullary. The authors present the case of a patient with a cervical intramedullary SM who presented with gait disturbances, sensory deficits, weakness in four extremities, and hyperreflexia.

Corrigendum: What if: a retrospective reconstruction of resection cavity stereotactic radiosurgery to mimic neoadjuvant stereotactic radiosurgery.

[This corrects the article DOI: 10.3389/fonc.2023.

Resection of the contrast-enhancing tumor in diffuse gliomas bordering eloquent areas using electrophysiology and 5-ALA fluorescence: evaluation of resection rates and neurological outcome-a systematic review and meta-analysis.

Independently, both 5-aminolevulinic acid (5-ALA) and intraoperative neuromonitoring (IONM) have been shown to improve outcomes with high-grade gliomas (HGG). The interplay and overlap of both techniques are scarcely reported in the literature. We performed a systematic review and meta-analysis focusing on the concomitant use of 5-ALA and intraoperative mapping for HGG located within eloquent cortex.