Publications by authors named "Giovanni Grasso"

Objective: Advances in surgical technology and microneurosurgery have led to increased utilization of so-called minimally invasive approaches, including the supraorbital eyebrow (SE) and minipterional (MPT) approaches for lesions involving the interpeduncular region. This study aimed to describe and compare anatomical landmarks, along with highlighting the advantages and disadvantages of the SE and MPT approaches to the interpeduncular region.

Methods: Ten formalin-fixed, latex-injected cadaveric specimens were used to perform bilateral SE and MPT approaches to the interpeduncular region.

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Study Design: Retrospective Cohort.

Objective: To compare patient-reported outcomes and surgical outcomes after anterior cervical discectomy and fusion (ACDF) versus cervical laminoplasty for multilevel cervical spondylotic myelopathy.

Background: Treatment options for multilevel cervical spondylotic myelopathy include ACDF and cervical laminoplasty.

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Objective: One of the pressing constraints in the treatment of arteriovenous malformations (AVM) is the potential development of new neurologic deficits, mainly when the AVM is in an eloquent area. The risk of ischemia when an en passage arterial supply is present is not negligible. In this regard, awake surgery holds promise in increasing the safety of low-grade AVM resection.

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(1) Background: Gangliogliomas are rare tumors accounting for about 0.4% of all central nervous system tumors. They are usually located in the temporal lobes of children and young adults, though such tumors in the infratentorial region and adult-age patients rarely reported.

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Background: Enhanced recovery after surgery (ERAS) is a multidisciplinary approach aimed at reducing the length of hospital stay, improving patient outcomes, and reducing the overall cost of care. Although ERAS protocols have been widely adopted in various surgical fields, their application in cranial surgery remains relatively limited.

Methods: Considering that the aging of the population presents significant challenges to healthcare systems, and there is currently no ERAS protocol available for geriatric patients over the age of 65 requiring cranial surgery, this article proposes a new ERAS protocol for this population by analyzing successful ERAS protocols and optimal perioperative care for geriatric patients described in the literature.

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Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder characterized by the triad of gait disturbance, cognitive impairment, and urinary incontinence. The condition is diagnosed mainly in older adults and is associated with ventricular enlargement without an increase in cerebrospinal fluid pressure. The clinical assessment involves a detailed medical history, physical examination, and cognitive testing.

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Objective: Although shunting has been shown to ameliorate symptoms in idiopathic normal pressure hydrocephalus (iNPH), its impact on health-related quality of life (HRQoL) has yet to be fully elucidated. Patient and caregiver subjective life satisfaction and HRQoL represent crucial indicators for assessing the well-being of individuals facing chronic illnesses, including iNPH. This study aimed to systematically analyze the existing data about HRQoL in iNPH-treated patients to evaluate the role of surgical treatment in such a scenario.

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Although the therapeutic armamentarium for brain metastases (BMs) has been expanded from innovative surgical techniques and radiotherapy to include targeted therapies and immunotherapy, the prognosis of BMs remains poor. Despite the proven efficacy of numerous compounds in preclinical studies, the limited penetration of promising therapeutic agents across the blood-brain barrier (BBB) remains an unaddressed issue. Recently, low-intensity magnetic resonance-guided focused ultrasound (MRgFUS) in combination with microbubbles has been shown to overcome vascular and cellular transport barriers in the brain and tumor microenvironment, resulting in increased drug diffusion and preliminary effective results.

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Objective: To determine if dexamethasone administration reduced narcotic consumption during hospitalization and to evaluate if patients who received dexamethasone refilled fewer opioid prescriptions postoperatively.

Methods: All adult patients who underwent primary elective 1- to 4-level anterior cervical discectomy and fusion at a single center were retrospectively identified. Prescription opioid use was collected from governmental online prescription drug monitoring programs, and in-hospital opioid use was collected from each patient's medication administration record and recorded as morphine milligram equivalents (MMEs).

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Article Synopsis
  • The study aims to assess changes in the spinal canal and contralateral foramen areas before and after uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF), as there is limited existing literature on this topic.
  • A retrospective analysis of 120 patients showed significant improvements in clinical scores and substantial increases in the measurements of the spinal canal and foramen post-surgery, with statistical significance (p < 0.001).
  • The results suggest that EPTLIF can effectively achieve indirect decompression of both the spinal canal and the contralateral foramen, even in cases where there are no prior symptomatic issues.
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Objective: Idiopathic normal pressure hydrocephalus (iNPH) represents an insidious type of dementia considered reversible after shunt placement. Although the clinical outcome has been widely studied, few studies have reported on quality of life (QOL) after surgery. This study evaluated the long-term clinical and QOL outcomes of iNPH patients after ventriculoperitoneal shunt (VPS) implantation.

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Article Synopsis
  • Nondysraphic intramedullary lipomas in the cervical spine are very rare, and this study reviews existing literature and provides a case study to better understand patient characteristics, treatment options, and outcomes.
  • The analysis included 24 patients, mainly male (70.8%) with an average age of 30.3; the study found various symptoms like quadriparesis (33.3%) with most patients undergoing surgical treatment, leading to mixed outcomes in terms of improvement.
  • The findings suggest that while surgical intervention can relieve spinal cord pressure and improve neurological function, careful resection techniques are preferable to avoid severe complications.
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Study Design: Systematic review and meta-analysis.

Objective: To perform a systematic review and meta-analysis to identify if intraoperative or postoperative differences in outcomes exist between orthopedic and neurological spine surgeons.

Summary Of Background Data: Spine surgeons may become board certified through orthopedic surgery or neurosurgical residency training, and recent literature has compared surgical outcomes between surgeons based on residency training background with conflicting results.

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Glioblastoma multiforme (GBM) represents the most common and aggressive central nervous system tumor associated with a poor prognosis. The aim of this study was to depict the role of intraoperative imaging techniques in GBM surgery and how they can ensure the maximal extent of resection (EOR) while preserving the functional outcome. The authors conducted a systematic review following PRISMA guidelines on the PubMed/Medline and Scopus databases.

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