Publications by authors named "Pavlina Lenga"

Introduction: Tumorous growths in the sellar region pose significant clinical challenges due to their proximity to critical visual structures such as the optic chiasm and optic nerves. Given their proximity to the optic system, these tumors are often diagnosed due to a progressive decrease in visual acuity. Thus, surgical intervention is crucial to prevent irreversible damage, as timely decompression can halt the progression of edema and subsequent optic atrophy.

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  • This study investigates the relationship between motor deficits (MD) in patients after glioma surgery and the proximity of the tumor to key motor pathways, specifically the corticospinal tract (CST).
  • It compares two imaging techniques—conventional Diffusion Tensor Imaging Fiber Tracking (DTI-FT) and q-ball Imaging Fiber Tracking (QBI-FT)—to determine which better predicts postoperative motor impairment.
  • Preliminary results indicate that patients with more severe MD have lesions significantly closer to the CST when analyzed using QBI-FT, suggesting this method could improve neurosurgical planning, although more extensive research is needed to validate these findings.
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Introduction: The treatment of spinal chordomas presents a significant challenge due to their resistance to both radiotherapy and chemotherapy as well as the complexity of the surgical procedures required. This study presents a series of cases of primary spinal chordomas, focusing on the development of a personalized therapeutic strategy that is tailored to each patient's unique clinical status. This approach aims to ensure that treatments are optimally aligned with the patient's overall prognosis and surgical eligibility.

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Introduction: Spinal tumors (ST) often result in dire prognosis, carrying risks such as permanent paralysis, sensory loss, and sphincter dysfunction. Data on their incidence and etiology in pediatric populations are markedly scant. Our study investigates the etiology, clinical manifestation, treatment, and outcomes of pediatric ST.

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  • The study investigates the management of primary spinal sarcomas, highlighting the significance of a multidisciplinary approach centered on surgical intervention due to the tumors' complexity and high recurrence rates.
  • A retrospective analysis of 14 patients revealed chondrosarcoma as the most common type, and surgical strategies included en-bloc resection, intra-lesional excision, and tumor debulking, showing significant post-surgery improvements in neurological conditions and functional status.
  • Overall, the findings underscore the effectiveness of surgical approaches, particularly en-bloc resection, in treating spinal sarcomas while noting the importance of careful management to mitigate risks of complications.
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Objective: Otitis media and sinusitis are common childhood infections, typically mild with good outcomes. Recent studies show a rise in intracranial abscess cases in children, raising concerns about a link to COVID-19. This study compares a decade of data on these cases before and after the pandemic.

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Study Design: Prospective case series.

Objectives: Drawing from prospective data, this study delves into the frequency and nature of adverse events (AEs) following spinal surgery specifically in octogenarians, shedding light on the challenges and implications of treating this specific cohort as well as on risk factors for their occurrence.

Methods: Octogenarians who received spinal surgery and were discharged between January 2019 and December 2022 were proactively included in our study.

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Introduction: In light of an aging global population, understanding adverse events (AEs) in surgeries for older adults is crucial for optimal outcomes and patient safety.

Research Question: Our study compares surgical outcomes and AEs in patients aged 65-79 with those aged ≥80, focusing on clinical outcomes, morbidity and mortality rates, and age-related risk factors for AEs.

Material And Methods: Our study, from January 2019 to December 2022, involved patients aged 65-79 and ≥ 80 undergoing spinal surgery.

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Introduction: Brain tumor surgery represents a critical and high-risk area within the field of neurosurgery. Our study aims to offer a comprehensive analysis of adverse events (AEs) from a prospectively maintained database at a leading neurosurgical tertiary center, with a specific focus on different types of tumor entities.

Methods: From January 2022 to September 2023, our study focused on adult patients, who underwent surgery for intracranial tumors.

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Background: We aimed to compare the clinical course of patients aged 18-65 years and ≥65years who underwent anterior cervical discectomy and fusion (ACDF) or corpectomy for ventrally located CSEA.

Methods: Clinical and imaging data were retrospectively collected from the institutional database between September 2005 and December 2021.

Results: A total of 35 and 26 patients aged 18-64 and ≥ 65 years, respectively who were diagnosed with ventrally located CSEA were included.

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  • Visual field deficits (VFDs) are often seen in patients with brain lesions, particularly in the temporal and occipital lobes; this study assesses how two imaging techniques—Diffusion Tensor Fiber Tractography (DTI-FT) and Q-ball High-Resolution Fiber Tractography (QBI-HRFT)—help in planning surgeries to minimize VFDs.
  • The research involved eight patients with gliomas near the optic radiation (OR), revealing that those with VFDs had a closer proximity of their lesions to the OR, indicating that smaller distances could correlate with a higher likelihood of vision loss.
  • The findings suggest that QBI-HRFT offers a more precise reconstruction of OR compared to DTI-
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  • Quantitative pupillometry (QP) is gaining traction in neurocritical care as a reliable tool for assessing the pupillary light reflex (PLR) in brain death (BD) determinations.
  • In a study of 17 adults with confirmed BD, the NPi®-200 Pupillometer was used to evaluate PLR, revealing consistent findings of a 0 NPi, indicating loss of brain function.
  • Results suggest that using QP for BD certification could enhance organ donation opportunities and calls for more research on its effectiveness and application in clinical settings.
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Introduction: Cervical stenosis and concurrent Cervical Spondylotic Myelopathy (CSM) are prevalent in the elderly. Treatment options include Anterior Cervical Discectomy Fusion (ACDF) and Posterior Decompression and Fusion (PDF).

Research Question: This study aims to compare clinical outcomes and complications between ACDF and PDF in patients aged 80 and above.

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This study aimed to compare and assess clinical outcomes of spinal metastasis with epidural spinal cord compression (MESCC) in patients aged 65-79 years and ≥ 80 years with an acute onset of neurological illness who underwent laminectomy. A second goal was to determine morbidity rates and potential risk factors for mortality. This retrospective review of electronic medical records at a single institution was conducted between September 2005 and December 2020.

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Introduction: The prevalence of trauma is increasing in the geriatric population. The optimal therapy for type II odontoid fractures in the elderly is controversial. This study aims to assess the morbidity and mortality associated with odontoid fractures in octogenarians undergoing C1/C2 posterior screw fixation and describe the perioperative and post-operative complications and risk factors associated with mortality.

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Introduction: Endoscopic lung volume reduction (ELVR) with one-way valves produces beneficial outcomes in patients with severe emphysema. Evidence on the efficacy remains unclear in patients with a very low forced expiratory volume in 1 s (FEV) (≤20% predicted). We aim to compare clinical outcomes of ELVR, in relation to the FEV restriction.

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Study Design: Prospective study OBJECTIVES: The occurrence of adverse events (AEs) during surgery is a major cause of increased economic costs, disability, or even death. This study aimed to prospectively identify and quantify AEs in patients undergoing spinal surgery at a neurosurgical tertiary care hospital.

Methods: Patients who underwent spinal surgery and were discharged between January 2019 and December 2022 were enrolled prospectively.

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Objective: The prevalence of degenerative disorders of the spine, such as cervical spinal stenosis with cervical spine myelopathy (CSM) in the geriatric population, has rapidly increased worldwide. To date, there has been no systematic analysis comparing outcomes in older patients suffering from progressive CSM and undergoing surgery depending on their health insurance status. We sought to compare the clinical outcomes and complications after anterior cervical discectomy and fusion (ACDF) or posterior decompression with fusion in patients aged ≥ 65 years with multilevel cervical spinal canal stenosis and concomitant CSM with special focus on their insurance status.

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Background: This study aimed to describe the clinical outcome of metastatic epidural spinal cord compression in octogenarians with an acute onset of neurological illness who undergo laminectomy, further assess morbidity and mortality rates, and determine potential risk factors for a nonambulatory outcome.

Methods: This retrospective review of electronic medical records at a single institution was conducted between September 2005 and December 2020. Patient demographics, surgical characteristics, complications, hospital course, and 90-day mortality were collected.

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Spinal epidural abscess (SEA) with pyogenic vertebral osteomyelitis (PVO) is a rare illness with a steadily increasing incidence. However, comparative analyses of young and older patients with SEA are lacking. We aimed to compare the clinical course of patients aged 18-64 years, 65-79 years, and ≥ 80 years undergoing surgery for SEA.

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Purpose: This study aimed to guide the more efficient management of type 4 and 5 thoracolumbar or lumbar osteoporotic fractures (OF) in patients aged 80 years and older with an acute onset of neurological decline. This aim was achieved by assessing the clinical course and morbidity and mortality rates and identifying potential risk factors for patient mortality METHODS: Electronic medical records were retrieved from a single institution pertaining to the period between September 2005 and December 2020. Data on patient demographics, neurological conditions, surgical characteristics, complications, hospital course, and 90-day mortality were also collected.

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Introduction: Surgical intervention for management of spinal instability after traumatic subaxial fractures in octogenarians requires a clear consensus on optimal treatments. This study aimed to provide a guide for more efficient management through comparison and assessment of clinical outcomes and complications of anterior cervical discectomy and fusion with plate (pACDF) and posterior decompression fusion (PDF) instrumentation alone in patients aged 80 years.

Methods: A single institution retrospective review of electronic medical records was undertaken between September 2005 and December 2021.

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Purpose: Fiber tracking (FT) is used in neurosurgical planning for the resection of lesions in proximity to fiber pathways, as it contributes to a substantial amelioration of postoperative neurological impairments. Currently, diffusion-tensor imaging (DTI)-based FT is the most frequently used technique; however, sophisticated techniques such as Q-ball (QBI) for high-resolution FT (HRFT) have suggested favorable results. Little is known about the reproducibility of both techniques in the clinical setting.

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  • The increase in life expectancy has raised concerns about osteoporotic fractures and spine diseases, leading to the use of cement-augmented pedicle screw fixation in patients with poor bone quality.
  • A study involving 104 patients identified that 64.4% experienced cement leakage during screw placement, with 27 patients developing pulmonary cement embolism (PCE), highlighting a concerning complication.
  • The research concluded that cement-augmented thoracic screws pose a significant risk factor for PCE, suggesting a need for careful monitoring following the procedure.
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Accessory nerve schwannoma is a rare entity in patients presenting with cranial nerve (CN) deficits. Most of these tumours arise from the cisternal segment of the eleventh CN and extend caudally. Herein, we report the third case of an accessory schwannoma extending cranially into the fourth ventricle.

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