Spinal intradural microsurgery in a nascent neurosurgical department: Lessons learned from the first 25 cases.

Background: Between 2017 and 2021, the newly established Department of Neurosurgery at Shaare Zedek Medical Center in Jerusalem, a high volume metropolitan hospital, operated on 25 intradural lesions in 24 patients (one patient had multiple tumors). In this retrospective study, we review results and lessons learned as experienced surgeons opened a new service line.

Methods: A multidisciplinary team was assembled and led by experienced neurosurgeons with skills in both microneurosurgery and complex spine care.

Non-invasive assessment of normal and impaired iron homeostasis in the brain.

Strict iron regulation is essential for normal brain function. The iron homeostasis, determined by the milieu of available iron compounds, is impaired in aging, neurodegenerative diseases and cancer. However, non-invasive assessment of different molecular iron environments implicating brain tissue's iron homeostasis remains a challenge.

[AUDITORY BRAINSTEM IMPLANTS (ABI) IN CHILDREN: CASE SERIES IN SHAARE ZEDEK MEDICAL CENTER].

Background: Cochlear implants (CI) are the treatment of choice for individuals with severe to profound sensorineural hearing loss. A small group of patients, with pathology central to the cochlea, cannot benefit from CI. Examples in children include absence of the cochlear-nerve or cochlear aplasia.

Utility of MRI in surgical planning for parasagittal meningiomas.

Background: Surgical resection is the standard treatment for parasagittal meningioma (PSM), but complete resection may be challenging due to superior sagittal sinus (SSS) involvement. The SSS may be partially or completely obstructed, and collateral veins are commonly present. Thus, knowing the status of the SSS in PSM cases prior to treatment is essential to a successful outcome.

[INTRAOPERATIVE ELECTROPHYSIOLOGY MAPPING OF CORTICAL FUNCTION: A BRIEF HISTORY AND EVOLVING ALTERNATIVE].

Multiple studies have demonstrated that the improved extent of resection for patients with glioma is associated with improved survival. The use of intraoperative electrophysiology cortical mapping to demonstrate function became a standard of care in modern neurosurgery and an indispensable tool to achieve the goal of maximal safe resection in tumor surgery. In this study, we review the brief history of intraoperative electrophysiology cortical mapping from the first cortical mapping study back in 1870 to the innovative tool of broad gamma cortical mapping used today.

[COMPARISON OF HIGH GAMMA ELECTROCORTICOGRAPHY AND DIRECT CORTICAL STIMULATION MAPPING OF CORTICAL FUNCTION IN AWAKE CRANIOTOMY: INITIAL EXPERIENCE].

Introduction: The use of intraoperative electrical cortical stimulation (ECS) to map function is the standard of care in modern neurosurgery. Recently, high gamma electrocorticography (hgECOG) mapping has had encouraging results. In this study we aim to compare hgECOG and fMRI with ECS for motor and language mapping.

[ESTABLISHING A NEW TEAM FOR ENDOSCOPIC ENDONASAL SKULL BASE SURGERY: THE LEARNING CURVE FROM BASIC TO ADVANCED COMPLEXITY LEVEL].

Introduction: Establishing a new team for endoscopic endonasal skull base surgeries (EES) requires a period of adjustment. Our team was established 4 years ago and consists of surgeons with previous experience. Our objective was to examine the learning curve associated with the establishment of such a team.

Comparison of matched formalin-fixed paraffin embedded and fresh frozen meningioma tissue reveals bias in proteomic profiles.

Tissue biopsies are most commonly archived in a paraffin block following tissue fixation with formaldehyde (FFPE) or as fresh frozen tissue (FFT). While both methods preserve biological samples, little is known about how they affect the quantifiable proteome. We performed a 'bottom-up' proteomic analysis (N = 20) of short and long-term archived FFPE surgical samples of human meningiomas and compared them to matched FFT specimens.

Skull Base Reconstruction with Multilayered Fascia Lata: A Single-Center 17 Years Experience.

 Reconstruction after open surgery of anterior skull base lesions is challenging. The fascia lata graft is our workhorse for achieving dural sealing and preventing cerebrospinal fluid leak and meningitis. This study seeks to analyze the donor and recipient site complication rates after fascia lata reconstruction.

Traumatic cerebral dural sinus vein thrombosis/stenosis in pediatric patients-is anticoagulation necessary?

Introduction: Cerebral dural vein thrombosis/stenosis (CDVT/S) is a condition that affects the venous drainage of the brain. Risk factors and causes associated with CDVT/S include systemic risk factors that cause hypercoagulability, or local factors such as head trauma. While consensus is that non-traumatic sinus vein thrombosis should be treated with anticoagulation therapy, treatment of patients with TBI-induced CDVT is not yet established.

The Outcome of Intracranial Meningioma Surgery in Octogenarians: Matched Cohort Study.

Background: Previous studies compared outcomes of intracranial meningioma surgery in octogenarians with outcomes in younger patients without accounting for different tumor locations and sizes. The aim of the current study was to evaluate outcomes of intracranial meningioma surgery in octogenarians taking into account patient preoperative status and comorbidities as well as tumor properties.

Methods: The study cohort included all octogenarian patients who underwent elective craniotomies for intracranial meningiomas during 2008-2020 and patients <70 years old in the same time period matched for tumor size, tumor location, and preoperative Karnofsky scale score.

When a Root Is the Cause of Infection.

Background: Sinorhizobium meliloti is a phytobacterium found in the root nodules of plants, where it is involved in fixing nitrogen for delivery to the roots in exchange for a photosynthate carbon source. There have been no reported cases of S. meliloti infection in humans.

Averting Delayed Complications of Open Anterior Skull Base Surgery.

 Despite its technical feasibility, anterior skull base surgery still carries the risk of severe postoperative complications, morbidity, and mortality. The reported rate of complications has diminished over the past two decades, but they continue to pose various challenges. This study aims to report late complications in a relatively large series of patients who underwent open anterior skull base surgery, and to propose methods for averting such complications.

Conservative management for pediatric patients with chiari 1 anomaly: A retrospective study.

Objective: To better understand the natural history of non-surgical management of chiari 1 anomaly.

Patients And Methods: After obtaining approval of the institutional review board, medical records and radiological exams of patients treated for CM1 at our institution between the years 2010 and 2016 were reviewed. Twenty-nine patients total were included in our study.

Surgical approaches for infratemporal fossa tumor resection: Fifteen years' experience of a single center.

Background: The aims of this study were to report our center's experience with infratemporal fossa (ITF) tumors, to review the treatment modalities and outcomes.

Methods: Data of patients that underwent resection of ITF tumors in a single tertiary referral medical center were collected and analyzed.

Results: Sixty-three patients were included.

Endoscopic skull base reconstruction with the nasoseptal flap: complications and risk factors.

Purpose: The endoscopic endonasal approach is increasingly being used for resection and reconstruction of anterior skull base lesions. The vascularized nasoseptal flap (NSF) has become the workhorse for reconstruction of anterior skull base defects, resulting in a significant decrease in the incidence of cerebrospinal fluid (CSF) leak. This study presents a single center's experience with NSFs and reports associated complications.

Outcomes of Craniofacial Open Surgery in Octogenarians.

 The steady increase in average life expectancy has led to a rise in the number of referrals of elderly patients for major operations. It is not clear whether age itself is a risk factor for morbidity and mortality after skull base operations. We investigated a possible link among a cohort of patients older than 80 years of age who underwent those surgeries in our department.

Continuous lumbar drainage and the postoperative complication rate of open anterior skull base surgery.

Objectives/hypothesis: Anterior skull base operations pose the risk for postoperative cerebrospinal fluid (CSF) leak. Routine lumbar continuous drainage catheter (LD) placement is intended to decrease CSF leaks and central nervous system (CNS) complications, but there are no sound evidence-based data on its efficacy. The primary goal of this study was to review CNS complications following anterior open skull base surgery and their association with LD placement.

Enhanced visualization of the surgical field in pediatric direct laryngoscopy using a three-dimensional endoscopic system.

Background: Direct laryngoscopy and rigid bronchoscopy are currently performed using 2-dimensional endoscopic systems. Our objective was to determine whether a 3-dimensional endoscopic system can enhance visualization of the surgical field in pediatric direct laryngoscopy and rigid bronchoscopy.

Methods: A prospective cohort study was conducted.

Nasoseptal Flap for Skull Base Reconstruction in Children.

 The endoscopic endonasal approach is being increasingly used for the resection and reconstruction of anterior skull base (ASB) lesions. Vascularized nasoseptal flaps (NSF) have become the workhorse for the reconstruction of ASB defects, resulting in a significant decrease in the incidence of cerebrospinal fluid (CSF) leaks. The objective of this study was to investigate the efficacy and safety of NSF in children.

Sphenoorbital meningioma: surgical series and design of an intraoperative management algorithm.

Current surgical removal of sphenoorbital meningiomas (SOM) mainly aims at reduction of proptosis and restoration of visual function; some stages of the surgical technique are controversial. In this study, we aim to present a surgical decision-making algorithm for SOM. A retrospective study of 27 patients who underwent resection of SOM in our center (2005-2014) was conducted.

Regression of intracranial meningioma following treatment with nivolumab: Case report and review of the literature.

The treatment of refractory meningiomas remains a challenge for both neurosurgeons and neuro-oncologists. There have been no clinical reports of the use or effects of anti-PD-1 therapy in patients with meningioma. We describe a patient whose intracranial meningioma decreased significantly in size after treatment with nivolumab, a monoclonal antibody targeting PD-1, for a concomitant advanced lung cancer.

Surgical resection of skull-base chordomas: experience in case selection for surgical approach according to anatomical compartments and review of the literature.

Background: Chordoma is a rare bony malignancy known to have a high rate of local recurrence after surgery. The best treatment paradigm is still being evaluated. We report our experience and review the literature.

Herpes Simplex Type 2 Encephalitis After Craniotomy: Case Report and Literature Review.

Background: Herpes simplex encephalitis (HSE) after neurosurgical procedures is extremely uncommon, and the few published case reports mainly described herpes simplex virus type 1 (HSV-1) as being culpable. We present a rare case of HSV-2 encephalitis after craniotomy and describe its pathophysiology and optimal management.

Case Description: A 70-year-old woman underwent an elective resection of a recurrent left sphenoid wing meningioma and clipping of a left middle cerebral artery aneurysm, the latter having been found incidentally.