Impact of seizure outcome and extent of neocortical resection on emotional well-being in patients with epilepsy one year after temporal lobe surgery.

Background: Seizure frequency and cognitive function are common parameters in assessing epilepsy surgery outcomes. However, psychobehavioral outcomes, such as symptoms of depression and quality of life (QOL), have not found equal attention yet.

Objective: To assess the effect of seizure frequency, the extent of resection, and cognitive function on the psychobehavioral outcome of patients after temporal lobe surgery for pharmacoresistant epilepsy.

Increased Body Mass Index Correlates with Less Favorable Postoperative Outcomes After Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea: A Retrospective Cohort Study.

Objective: Obstructive sleep apnea is associated with high morbidity. Hypoglossal nerve stimulation (HNS) has become a novel (neuro-) surgical treatment strategy for obstructive sleep apnea, demonstrating good success rates. Beyond predefined inclusion and exclusion criteria, no precise data are available, enabling individual preoperative risk assessment.

Necessity of MRI-compatible deep brain stimulation systems - Hits and hints for decision making.

Objectives: Deep brain stimulation (DBS) is a safe and effective treatment option for patients with movement disorders as Parkinson's disease, essential tremor and dystonia[1]. For many of these patients the need for imaging may arise in the following years after implantation. The study's aim was to get an overview of the amount of patients with a DBS system who needed an MRI after successful implantation, and if they did, whether the imaging led to a surgical consequence.

Tissue expansion for challenging DBS hardware erosions in patients with Parkinson's disease.

•Consider tissue expanders for challenging DBS cases in PD patients with hardware erosion.•Placement of tissue expander is essential in planning the reconstruction.•MRI-compatibility of the tissue expander is paramount for shortening the total duration of anesthesia.

Motor evoked potentials versus Macrostimulation in predicting the postoperative motor threshold in STN Deep brain stimulation.

Introduction: Accuracy is crucial in Deep Brain Stimulation (DBS). Electrophysiological and image-based techniques are used to avoid suboptimal positioning. Macrostimulation is the gold standard to delineate the therapeutic window intraoperatively.

Matching Quantitative MRI Parameters with Histological Features of Treatment-Naïve Wild-Type Glioma.

Quantitative MRI allows to probe tissue properties by measuring relaxation times and may thus detect subtle changes in tissue composition. In this work we analyzed different relaxation times (T1, T2, T2* and T2') and histological features in 321 samples that were acquired from 25 patients with newly diagnosed wild-type glioma. Quantitative relaxation times before intravenous application of gadolinium-based contrast agent (GBCA), T1 relaxation time after GBCA as well as the relative difference between T1 relaxation times pre-to-post GBCA (T1rel) were compared with histopathologic features such as the presence of tumor cells, cell and vessel density, endogenous markers for hypoxia and cell proliferation.

Two-step staged resection of giant olfactory groove meningiomas.

Background: The surgical treatment of giant olfactory groove meningiomas (OGMs) with marked perilesional brain oedema is still a surgical challenge. After tumour resection, increase of brain oedema may occur causing dramatic neurological deterioration and even death of the patient. The objective of this paper is to describe surgical features of a two-step staged resection of these tumours performed to counter increase of postoperative brain oedema.

Comparison of frame-less robotic versus frame-based stereotactic biopsy of intracranial lesions.

Objective: Robotic guidance might be an alternative to classic stereotaxy for biopsies of intracranial lesions. Both methods were compared regarding time efficacy, histopathological results and complications.

Methods: A retrospective analysis enrolling all patients undergoing robotic- or stereotactic biopsies between 01/2015 and 12/2018 was conducted.

Comparing Programming Sessions of Vim-DBS.

Essential Tremor (ET) is a progressive neurological disorder characterized by postural and kinetic tremor most commonly affecting the hands and arms. Medically intractable ET can be treated by deep brain stimulation (DBS) of the ventral intermediate nucleus of thalamus (VIM). We investigated whether the location of the effective contact (most tremor suppression with at least side effects) in VIM-DBS for ET changes over time, indicating a distinct mechanism of loss of efficacy that goes beyond progression of tremor severity, or a mere reduction of DBS efficacy.

Pre- and Post-Surgical Dysphagia in Adults with Tumors of the Posterior Fossa: A Prospective Blinded Study.

Background: While swallowing disorders are frequent sequela following posterior fossa tumor (PFT) surgery in children, data on dysphagia frequency, severity, and outcome in adults are lacking. The aim of this study was to investigate dysphagia before and after surgical removal of PFT. Additionally, we tried to identify clinical predictors for postsurgical swallowing disorders.

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life.

Objective: Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA.

Effect of thalamic deep brain stimulation on swallowing in patients with essential tremor.

Objective: Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) is a mainstay treatment for severe and drug-refractory essential tremor (ET). Although stimulation-induced dysarthria has been extensively described, possible impairment of swallowing has not been systematically investigated yet.

Methods: Twelve patients with ET and bilateral VIM-DBS with self-reported dysphagia after VIM-DBS were included.

Return to work and clinical outcome after surgical treatment and conservative management of patients with intramedullary spinal cord ependymoma.

The ability to return to work after treatment of diseases is an important issue. Aim of this study is to compare surgery and conservative management focusing on clinical outcome and ability to return to work in patients with intramedullary spinal cord ependymoma. Retrospective, single center study.

Thrombosis of the straight sinus and microbleedings due to deep seated arteriovenous fistula - Hemodynamic changes, cognitive impairment and improvement after microsurgery. A technical report.

Dural arteriovenous fistulas (dAVF) are rare vascular malformations accounting for only 10-15% that may lead to life threatening deficits due to hemodynamic changes in blood supply and pressure conditions. We present a 64-year old patient who was admitted with disorientation and aphasia. Following images confirmed an infratentorial dural fistula draining into the straight sinus.

Academic output of German neurosurgical residents in 35 academic neurosurgery residency programs.

Background: The scientific activity of neurosurgeons and neurosurgery residents as measured by bibliometric parameters is of increased interest. While data about academic output for neurosurgeons in the USA, the UK, and Canada have been published, no similar results for German neurosurgical residents exist. Within this study, we aim to evaluate the academic output of German neurosurgery residents in 35 academic residency programs.

Differences in bleeding patterns and outcome after intracerebral hemorrhage due to vascular malformations.

Background: Atypical intracerebral hemorrhage is a common form of primary manifestation of vascular malformations.

Objective: The aim of the present study is to determine clues to the cause of bleeding according to hemorrhage pattern (lobar, basal ganglia, infratentorial).

Methods: We retrospectively evaluated 343 consecutive neurosurgical patients with intracerebral hemorrhage (ICH), who were admitted to our neurosurgical department between 2006 and 2016.

First clinical experience with the new noninvasive transfontanelle ICP monitoring device in management of children with premature IVH.

We previously introduced a novel noninvasive technique of intracranial pressure (ICP) monitoring in children with open fontanelles. Within this study, we describe the first clinical implementation and results of this new technique in management of children with hydrocephalus caused by intraventricular hemorrhage (IVH). In neonates with posthemorrhagic hydrocephalus (PHH), an Ommaya reservoir was implanted for initial treatment of hydrocephalus.

Cerebral Vasospasm Due to Arteriovenous Malformation-Associated Hemorrhage: Impact of Bleeding Source and Pattern.

Objective: Cerebral vasospasm (CVS) after a ruptured arteriovenous malformation (AVM) is rarely reported. This study is aimed at evaluating the predictive variables in AVM hemorrhage for CVS.

Methods: A total of 160 patients with ruptured AVMs were admitted to our neurosurgical department from 2002 to 2018.

Significant Impact of Implantable Functional Electrical Stimulation on Gait Parameters: A Kinetic Analysis in Foot Drop Patients.

Objective: Neurogenic drop foot is a common result of acquired damage of the central nervous system and can cause severe restriction of mobility. ActiGait, an implantable functional electrical stimulation device, restores ankle dorsiflexion by active peroneal nerve stimulation. The aim of our study was to evaluate its effect on foot contact pattern during normal walk.

The Extent of Neurologic Improvement and Social Life in Young Patients with Ruptured and Unruptured Brain AVM: A Long-Term Follow-Up.

Background: Intracerebral hemorrhage, seizures, neurologic deficits, and cognitive impairments due to brain AVM in childhood are incriminating for brain and executive function with sequelae for further social life. Long-term follow-up data on brain AVM in young patients are rare, making it difficult to compare and evaluate treatment risks and outcomes.

Methods: We studied young patients with brain AVM who were referred to our institution between 2005 and 2012 and for whom follow-up data were available.

Prognostic variables and outcome in relation to different bleeding patterns in arteriovenous malformations.

Subarachnoid hemorrhage as bleeding pattern occurs rarely in ruptured arteriovenous malformations (AVM). The aim of the present study is to evaluate different bleeding patterns in hemorrhages due to an AVM and their impact on outcome in terms of risk and treatment stratification. We evaluated 158 patients with ruptured AVMs who were admitted to our neurosurgical department from 2002 to 2017.

Predictive variables for the presence of vascular malformations as the cause of basal ganglia hemorrhages.

To evaluate potential bleeding sources and predictive variables for basal ganglia hemorrhage. Fifty-seven patients with basal ganglia hemorrhage admitted to our neurosurgical ICU between 2005 and 2016 were retrospectively reviewed. Univariate and multivariate logistic analyses were used to assess predictive variables for identifying the bleeding source and outcome.

Prognostic risk factors for postoperative hemorrhage in stereotactic biopsies of lesions in the basal ganglia.

Objective: The risk of hemorrhages after stereotactic biopsy is known to be low. Nevertheless hemorrhages in eloquent areas result in neurological deficit for the patients. Since the basal ganglia resemble a particularily high vascularized and eloquent location, which is often the source of hypertensive hemorrhages, we aimed to analyse possible risk factors for hemorrhage after stereotactic biopsy in this region.

The Value of Computed Tomography Imaging of the Head After Ventriculoperitoneal Shunt Surgery in Adults.

Background: Patients with a ventriculoperitoneal shunt for hydrocephalus often undergo multiple follow-up computed tomography (CT) scans of the head, increasing the risk for long-term effects of ionizing radiation. The purpose of our study was to evaluate the necessity as a routine diagnostic procedure and cost analysis of routine postoperative CT scan of the head after ventriculoperitoneal shunt surgery.

Methods: In this study, we comprised adults with ventriculoperitoneal shunt operations who underwent early CT scans within 48 hours postoperatively.

Impact of resection on overall survival of recurrent Glioblastoma in elderly patients.

Objectives: Glioblastoma multiforme (GBM) mostly affects elderly patients. Adequate therapy especially in case of tumor recurrence is still under discussion, since most studies focus on patients under 65 years. We evaluated the impact of second surgery in regard to progression free survival (PFS) and overall survival (OAS) in elderly patients.