Current trends and outcomes of non-elective neurosurgical care in Central Europe during the second year of the COVID-19 pandemic.

Reflecting the first wave COVID-19 pandemic in Central Europe (i.e. March 16th-April 15th, 2020) the neurosurgical community witnessed a general diminution in the incidence of emergency neurosurgical cases, which was impelled by a reduced number of traumatic brain injuries (TBI), spine conditions, and chronic subdural hematomas (CSDH).

Angiosomes of the Ulnar Nerve at the Elbow: A Cadaver Trial Using Contrast-Enhanced Ultrasound.

Three major arteries supplying the ulnar nerve in the cubital tunnel are commonly known. However, their vascular territories (angiosomes) have not been described yet. Contrast-enhanced ultrasound was used to identify the angiosomes of posterior ulnar recurrent artery, inferior ulnar collateral artery and superior ulnar collateral artery in 20 fresh, non-frozen human body donors.

Influence of preoperative corticosteroid treatment on rate of diagnostic surgeries in primary central nervous system lymphoma: a multicenter retrospective study.

Background: Corticosteroid therapy (CST) prior to biopsy may hinder histopathological diagnosis in primary central nervous system lymphoma (PCNSL). Therefore, preoperative CST in patients with suspected PCNSL should be avoided if clinically possible. The aim of this study was thus to analyze the difference in the rate of diagnostic surgeries in PCNSL patients with and without preoperative CST.

Trends and outcomes for non-elective neurosurgical procedures in Central Europe during the COVID-19 pandemic.

The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care.

Vascular endothelial growth factor: the major factor for tumor neovascularization and edema formation in meningioma patients.

Background: Peritumoral brain edema (PTBE) may be crucial in the clinical outcome of meningioma patients. The underlying pathogenetic key mechanism has so far not been determined. Sex, age, tumor size, location, involvement of other structures, or the histological appearance was not found to sufficiently explain PTBE formation in meningiomas.

Using ex vivo proton magnetic resonance spectroscopy to reveal associations between biochemical and biological features of meningiomas.

Object: The goal in this study was to determine if proton ((1)H) MR spectroscopy can differentiate meningioma grade and is associated with interpretations of biological behavior; the study was performed using ex vivo high-resolution spectra indicating metabolic characteristics.

Methods: Sixty-eight resected tissue samples of meningiomas were examined using ex vivo (1)H MR spectroscopy. Of these meningiomas, 46 were WHO Grade I, 14 were WHO Grade II, and 8 were WHO Grade III.

No association between intraoperative hypothermia or supplemental protective drug and neurologic outcomes in patients undergoing temporary clipping during cerebral aneurysm surgery: findings from the Intraoperative Hypothermia for Aneurysm Surgery Trial.

Background: Although hypothermia and barbiturates improve neurologic outcomes in animal temporary focal ischemia models, the clinical efficacy of these interventions during temporary occlusion of the cerebral vasculature during intracranial aneurysm surgery (temporary clipping) is not established.

Methods: A post hoc analysis of patients from the Intraoperative Hypothermia for Aneurysm Surgery Trial who underwent temporary clipping was performed. Univariate and multivariate logistic regression methods were used to test for associations between hypothermia, supplemental protective drug, and short- (24-h) and long-term (3-month) neurologic outcomes.

Tumor growth of suspected meningiomas in clinically healthy 80-year-olds: a follow up five years later.

Background: The incidence of clinically silent meningiomas in 75-year-old individuals was determined five years ago in the Vienna Transdanube Ageing Study (VITA). At the time a watch-and-wait approach was recommended in cases of incidentally discovered meningiomas.

Methods: 420 out of the initial cohort of 532 test persons underwent control investigations after 2.

Fiducial versus nonfiducial neuronavigation registration assessment and considerations of accuracy.

Objective: For frameless stereotaxy, users can choose between anatomic landmarks (ALs) or surface fiducial markers (FMs) for their match points during registration to define an alignment of the head in the physical and radiographic image space. In this study, we sought to determine the concordance among a point-merged FM registration, a point-merged AL registration, and a combined point-merged anatomic/surface-merged (SM) registration, i.e.

Fluorescent in situ hybridization and ex vivo 1H magnetic resonance spectroscopic examinations of meningioma tumor tissue: is it possible to identify a clinically-aggressive subset of benign meningiomas?

Objective: Although histologically benign, Grade I meningiomas can sometimes behave aggressively. The clinically-aggressive subset of Grade I meningiomas is typically indistinguishable from clinically-benign Grade I meningiomas in vivo. We compared molecular genetic and biochemical findings to clinical, pathological, and immunohistochemical information in a series of clinically-aggressive Grade I meningiomas with a series of clinically-benign meningiomas to identify characteristics that may be used to distinguish between these two groups.

Implicating chromosomal aberrations with meningioma growth and recurrence: results from FISH and MIB-I analysis of grades I and II meningioma tissue.

The fluorescence in situ hybridization (FISH) technique was used in 111 WHO grades I and II meningioma patients. Clinical, radiological, pathological, and immunohistochemical data were compared to aberrations of chromosomes 1p, 14q, and 22q determined by FISH. Significant differences for MIB-1 labeling were found between grades I and II tumors (p < 0.

Continuous intraventricular pressure monitoring for diagnosis of normal-pressure hydrocephalus.

Objectives: Normal-pressure hydrocephalus (NPH) syndrome is treatable by implantation of a cerebrospinal fluid (CSF) shunt. However, diagnosis of NPH by clinical and radiological findings alone is unreliable, and co-existing structural dementia can contribute to low success rates after shunt implantation. The aim of our study was to investigate whether long-term results after shunt implantation in NPH improve when surgical candidates are selected by continuous intraventricular pressure monitoring (CIPM).

Minimally invasive retroperitoneal approach for lumbar corpectomy and reconstruction. Technical note.

Anterior decompressive surgery with spinal fusion is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgical approach-related trauma. The purpose of this study was to show that lumbar corpectomy and spinal reconstruction can be performed via a minimally invasive retroperitoneal (MIR) approach and therefore, the surgical approach-related trauma can be reduced.

Diagnostic and prognostic significance of genetic regional heterogeneity in meningiomas.

We analyzed the frequency and regional distribution of cells with genetic abnormalities of chromosomes 1, 14, and 22 in meningiomas. This data was evaluated for correlation to the clinical outcome of the patients. Eight defined areas of each of 77 paraffin-embedded meningioma samples (59 grade I, 13 grade II, and 5 grade III) were analyzed by fluorescent in situ hybridization using bacterial artificial chromosome probes localized to chromosomes 1p36.

Frequency and risk factors for meningioma in clinically healthy 75-year-old patients: results of the Transdanube Ageing Study (VITA).

Background: The prevalence of clinically silent intracranial tumors in specific populations is poorly researched. It is known that, in advanced age groups, the number of clinically manifest meningiomas constitute a small proportion of the actual number of cases. The goals of the current study were to determine the frequency of asymptomatic patients with meningioma in advanced age and to identify risk factors for meningiomas in this population.

Early diagnosis of external ventricular drainage infection: results of a prospective study.

Objectives: The aim of this study was to evaluate the influence of total drainage time on the risk of catheter infection, and the predictive value of standard laboratory examinations for the diagnosis of bacteriologically recorded cerebrospinal fluid (CSF) infection during external ventricular drainage.

Methods: During a three year period, all patients of the neurosurgical intensive care unit (ICU), who received an external ventricular drain, were prospectivly studied. Daily CSF samples were obtained and examined for cell count, glucose and protein content.

Microsurgery for glioblastoma preserves short-term quality of life both in functionally impaired and independent patients.

Objective: Considering the short remaining life expectancy with glioblastoma multiforme, numerous patients and their referring physicians are hesitant to use aggressive surgical treatment for fear of greater risk of neurological deterioration. The aim of our study was to determine whether surgical treatment of glioblastoma, utilizing modern microsurgical dissection techniques and tools, interferes with short-term quality of life.

Methods: The functional status before and after 67 microsurgical operations in 65 patients with glioblastomas was studied retrospectively.

Penetration failure and misdiagnosis of stereotactic biopsy caused by the uncommonly firm tissue of a gliomyosarcoma.

Objective And Importance: We report the very rare case of a gliomyosarcoma that caused penetration failure in stereotactic biopsy and therefore led to misdiagnosis. This complication should be considered as a potential reason for diagnostic failure with uncommonly firm tumors in frame-based stereotactic biopsy.

Clinical Presentation: An 83-year-old women presented with a 4-week history of right hemiparesis.

Noncontiguous spinal metastases and plasmocytomas should be operated on through a single posterior midline approach, and circumferential decompression should be performed with individualized reconstruction.

Background: In noncontiguous spinal metastatic disease, anterior or combined anterior-posterior surgery is an effective treatment. The objective of this study is to investigate whether circumferential decompression through a single-stage posterior midline approach with individualized spinal reconstruction can still achieve comparable results for functional improvement and for maintenance of spinal alignment in the absence of the risks associated with the more invasive transcavitary or combined approaches.

Method: Seventeen patients with noncontiguous spinal metastases and plasmocytomas at one or two adjacent levels were included in this series.

Gamma knife radiosurgery of skull base meningiomas.

Background: The standard surgical treatment of meningiomas is total resection of the tumour. The complete removal of skull base meningiomas can be difficult because of the proximity of cranial nerves. Stereotactic radiosurgery (SRS) is an effective therapy, either for adjuvant treatment in case of subtotal or partial tumour resection, or as solitary treatment in asymptomatic meningiomas.

Minimally invasive retroperitoneal approach for lumbar corpectomy and anterior reconstruction. Technical note.

The anterior decompressive procedure in which spinal fusion is performed is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgery-related trauma. The purpose of this study was to show that lumbar corpectomy and anterior reconstruction can be performed via a minimally invasive retroperitoneal approach (MIRA) and therefore the surgical approach-related trauma can be reduced.

[Behavior of cerebral blood flow velocity in conventional ventilation and superimposed high frequency jet ventilation].

Objective: Patients with increased intracranial pressure or vasospasm after subarachnoidal haemorrhage with decreased cerebral perfusion present a special problem on developing respiratory insufficiency, since kinetic therapy or extracorporal life support are contraindicated. Superimposed High Frequency Jet Ventilation (SHFJV) has been shown to be of benefit in ventilating patients with pulmonary insufficiency. The aim of this study was to evaluate if SHFJV could be safely applied in patients with critical cerebral blood flow; if so, SHFJV might be beneficial when pulmonary insufficiency occurs concomitantly.