Vestibular Prehabilitation-A Single UK Center Experience and Literature Review.

 To assess whether vestibular prehabilitation with intratympanic gentamicin is a useful preoperative adjunct in allowing for early mobilization and short length of stay in patients with vestibular schwannoma (VS).  Retrospective single-center study and literature review.  Tertiary neurosurgical center.

A systematic review of middle meningeal artery embolization for minimally symptomatic chronic subdural haematomas that do not require immediate evacuation.

Introduction: Embolization of the Middle Meningeal Artery (EMMA) is an emerging treatment option for patients with Chronic Subdural Haematoma (CSDH).

Questions: (1) Can EMMA change the natural history of untreated minimally symptomatic CSDH which do not require immediate evacuation? (2) What is the role of EMMA in the prevention of recurrence following surgical treatment? (3) Can the procedure be performed under local anaesthetic?

Material And Methods: Systematic literature review. No randomised clinical trials available on EMMA for meta-analysis.

Posterior cervical foraminotomy versus anterior cervical discectomy for Cervical Brachialgia: the FORVAD RCT.

Background: Posterior cervical foraminotomy and anterior cervical discectomy are routinely used operations to treat cervical brachialgia, although definitive evidence supporting superiority of either is lacking.

Objective: The primary objective was to investigate whether or not posterior cervical foraminotomy is superior to anterior cervical discectomy in improving clinical outcome.

Design: This was a Phase III, unblinded, prospective, United Kingdom multicentre, parallel-group, individually randomised controlled superiority trial comparing posterior cervical foraminotomy with anterior cervical discectomy.

Feasibility of comparing medical management and surgery (with neurosurgery or stereotactic radiosurgery) with medical management alone in people with symptomatic brain cavernoma - protocol for the Cavernomas: A Randomised Effectiveness (CARE) pilot trial.

Introduction: The top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was 'Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people diagnosed with a cavernoma?' This pilot randomised controlled trial (RCT) aims to determine the feasibility of answering this question in a main phase RCT.

Methods And Analysis: We will perform a pilot phase, parallel group, pragmatic RCT involving approximately 60 children or adults with mental capacity, resident in the UK or Ireland, with an unresected symptomatic brain cavernoma. Participants will be randomised by web-based randomisation 1:1 to treatment with medical management and with surgery (neurosurgery or stereotactic radiosurgery) versus medical management alone, stratified by prerandomisation preference for type of surgery.

Risk of Aneurysm Rupture (ROAR) study: protocol for a long-term, longitudinal, UK multicentre study of unruptured intracranial aneurysms.

Introduction: Unruptured intracranial aneurysms (UIA) are common in the adult population, but only a relatively small proportion will rupture. It is therefore essential to have accurate estimates of rupture risk to target treatment towards those who stand to benefit and avoid exposing patients to the risks of unnecessary treatment. The best available UIA natural history data are the PHASES study.

Middle meningeal artery embolisation for chronic subdural haematomas: the first prospective UK study.

MMA embolisation has emerged in recent years as a safe endovascular treatment for chronic subdural haematoma. We report the first UK series of endovascular treatment of chronic subdural haematomas. Prospective case series.

A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom.

Objective: Unruptured intracranial aneurysms (UIA) are common. For many the treatment risks outweigh their risk of subarachnoid haemorrhage and patients undergo surveillance imaging. There is little data to inform if and how to monitor UIAs resulting in widely varying practices.

Treatment of low flow, indirect cavernous sinus dural arteriovenous fistulas with external manual carotid compression - the UK experience.

External manual carotid compression (EMCC) is a treatment option for indirect cavernous sinus dural arteriovenous fistulas (CS-DAVF). The exact mechanism of how this works is unclear but compression of the carotid and jugular produces thrombus in the cavernous sinus (CS). Although compression of the superior ophthalmic vein (SOV) has been described as a treatment option this technique is not always amenable.

Observed rupture of unruptured intracranial aneurysms.

To study the aneurysms where pre and post-rupture imaging was available to determine the impact of rupture on morphology and size of the aneurysm. A retrospective case series where all cases of ruptured aneurysms over a 5-year period were evaluated and cases identified where pre and post rupture imaging was available. These were then studied in detail.

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery.

Surgery of complex cranial base lesions carries a high risk of damage to main vessels, often resulting in life-changing or even life-threatening injuries. We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery.

Meningioma and mood: exploring the potential for meningioma to affect psychological distress before and after surgical removal.

Much of the research exploring psychological distress with meningioma stem from studies including several brain tumour types (including malignant tumours) meaning that focus on meningioma is limited and that conclusions are based on small samples. Moreover, contradictory findings have been reported regarding the effects of meningioma on mood. Here, the authors present a study exploring pre and post mood scores in meningioma only patients using a sample size larger than any previous research attempt.

Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: an alternative technique.

One of the challenges faced by the modern-day NHS is workplace shortages, and experienced radiographers for intra-operative neurosurgical imaging is one such scenario. We describe our method for Percutaneous Retrogasserian Glycerol Rhizotomy (PRGR) using frameless neuronavigation which can be used effectively in such scenarios. Stealth neuronavigation is used for needle placement within the foramen ovale and injection of glycerol, under sedation.