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Corpus callosum The corpus callosum (from Latin: “tough body”), also known as the colossal commissure, is a wide, flat bundle of neural fibers beneath the cortex in the eutherian brain at the longitudinal fissure. It connects the left and right cerebral hemispheres and facilitates interhemispheric communication. It is the largest white matter structure in the brain, consisting of 200–250 … Read more

Microvascular Decompression Complications Latest Pubmed Related Articles Commentary: Facial Nerve Massage for the Treatment of Hemifacial Spasm Refractory to Microvascular Decompression: Outcomes and Complications Microvascular decompression for young onset primary trigeminal neuralgia: a single-center experience Outcomes after microvascular decompression for sole arterial versus venous compression in trigeminal neuralgia Effective Control of Postoperative Cerebrospinal Fluid Leakage … Read more

Neurosurgical Residency Away Rotation Neurosurgical Residency Away Rotation is an important component in the education of a neurosurgical resident. Subspecialization of physicians and regional centers concentrate the volume of certain rare cases into fewer hospitals. Consequently, the primary institution of a Neurosurgical Resident Training Program may not have sufficient case volume to meet the current Residency Review Committee case minimum requirements in some areas. To ensure the competency of graduating residents through comprehensive neurosurgical education, programs may need residents … Read more

Neurosurgical Training in Germany There has been a fivefold increase in neurosurgeons over the last three decades in Germany, despite a lesser increase in operations. Currently, there are approximately 1000 neurosurgical residents employed at training hospitals. Neurosurgery remains an attractive specialty in Germany, but there are two concerns that may impede its appeal in the near future. The administrative burden … Read more

Olfactory groove meningioma Olfactory groove meningiomas (OGMs) are arachnoid cell neoplasms of the frontoethmoidal suture and lamina cribrosa, 1) and may involve any part of the area from the crista galli to the planum sphenoidale 2) 3) 4). Epidemiology Olfactory groove meningioma epidemiology Classification Olfactory groove meningioma classification Clinical features Olfactory groove meningioma clinical features Diagnosis Olfactory groove meningioma diagnosis. Differential diagnosis Tuberculum sellae meningioma Planum sphenoidale meningioma Treatment … Read more

3D Exoscope for Vascular neurosurgery Neurovascular microsurgical experience through 3D exoscopy. Case report and literature review Microvascular anastomosis in a challenging setting using a 4 K three-dimensional exoscope compared with a conventional microscope: An <em>in vivo</em> animal study 3D Exoscopes are Noninferior to Operating Microscopes in Aneurysm Surgery: Comparative Single-Surgeon Series of 52 Consecutive Cases Case … Read more

Parkinson’s disease Mechanisms of 1Hz inhibitory and 5Hz excitatory repetitive transcranial magnetic stimulations in Parkinson’s Disease- An fMRI study Neurotrophin mimetics and tropomyosin kinase receptors: a futuristic pharmacological tool for Parkinson’s Inner retinal layers’ alterations of the microvasculature in early stages of Parkinson’s disease: a cross sectional study Distinct phenotypes of stimulation-induced dysarthria represent different … Read more

Norwegian Registry for Spine Surgery (NORspine) https://helsedata.no/en/forvaltere/university-hospital-of-north-norway/norwegian-registry-for-spine-surgery/ Latest Pubmed Related Articles Characteristics and outcomes of patients who did not respond to a national spine surgery registry Postoperative Dural Sac Cross-sectional Area as an Association for Outcome after Surgery for Lumbar Spinal Stenosis. Clinical and Radiological Results from the Nordsten-spinal Stenosis Trial Return to work after … Read more

Condoliase for lumbar disc herniation Latest Pubmed Related Articles Short-term clinical and radiographic outcomes of chemonucleolysis with condoliase for painful lumbar disc herniation and analysis regarding intradiscal injection area Cost-effectiveness analysis of intradiscal condoliase injection vs. surgical or conservative treatment for lumbar disc herniation Predictive Factors for Poor Outcome following Chemonucleolysis with Condoliase in Lumbar … Read more

Degenerative cervical myelopathy J.Sales-Llopis Neurosurgery Service, Alicante University General Hospital, Alicante, Spain. The assessment, diagnosis, operative and nonoperative management of degenerative cervical myelopathy (DCM) have evolved rapidly over the last 20 years. A clearer understanding of the pathobiology of DCM has led to attempts to develop objective measurements of the severity of myelopathy, including technology … Read more

Deep brain stimulation of the nucleus accumbens for alcohol use disorder Deep brain stimulation of the nucleus accumbens in treatment-resistant alcohol use disorder: a double-blind randomized controlled multi-center trial Deep brain stimulation of the nucleus accumbens in the treatment of severe alcohol use disorder: a phase I pilot trial Deep Brain Stimulation in Drug Addiction … Read more

SMAD6 (SMAD Family Member 6) is a Protein Coding gene. It belongs to the SMAD family of signaling molecules. It acts as an inhibitory SMAD, meaning that it negatively regulates signaling pathways activated by transforming growth factor-beta (TGF-beta) and bone morphogenetic proteins (BMPs). SMAD6 plays a role in various biological processes such as cell proliferation, … Read more

Stroke guidelines There are multiple stroke guidelines globally. To synthesize these and summarize what existing stroke guidelines recommend about the management of people with stroke, the World Stroke Organization (WSO) Guideline committee, under the auspices of the WSO, reviewed available guidelines. They identified areas of strong agreement across guidelines, and their global coverage. To systematically review the literature to identify stroke guidelines (excluding primary stroke prevention and subarachnoid … Read more

Idiopathic normal pressure hydrocephalus Magnetic resonance imaging Latest Pubmed Related Articles Resting-state functional-MRI in iNPH: can default mode and motor networks changes improve patient selection and outcome? Preliminary report Association of right precuneus compression with apathy in idiopathic normal pressure hydrocephalus: a pilot study Patients with heterozygous HTRA1-related cerebral small vessel disease misdiagnosed with other … Read more

Pregnant neurosurgical resident It is possible for a neurosurgical resident to be pregnant, as there are no specific restrictions on pregnant individuals becoming or remaining neurosurgical residents. However, pregnant residents may need to make accommodations for their pregnancy, such as modifying their work schedule or duties, in order to ensure the safety of both the resident and the patient. It is important … Read more

Central nervous system tumor guidelines NCCN Guidelines The NCCN Guidelines for Central nervous system tumor focus on the management of the following adult CNS cancers: glioma (WHO grade 1, WHO grade 2-3 Oligodendroglioma IDH-mutant and 1p/19q-codeleted, WHO grade 2-4 Astrocytoma IDH-mutants, WHO grade 4 glioblastoma), intracranial and spinal ependymomas, medulloblastoma, limited and extensive brain metastases, leptomeningeal metastases, non-AIDS-related Primary central nervous system lymphomas, metastatic spine tumors, meningiomas, and primary spinal cord tumors. … Read more

Brain metastases Investigating the role of delayed contrast magnetic resonance imaging (MRI) to differentiate radiation necrosis from tumour recurrence in brain metastases after stereotactic radiosurgery The Effects of Supportive Caring on Symptoms Distress, Nursing Needs, and Depression in Patients With Brain Tumor After Surgery: A Preliminary Study Efficacy and safety comparison of PD-1 inhibitors <em>vs.</em> … Read more

Cerebellar mutism Clinical characteristics and prognosis of Glioblastoma patients with infratentorial recurrence The importance of olivary hypertrophic degeneration as a differential diagnosis in cerebellar mutism syndrome Cerebellar mutism syndrome: From pathophysiology to rehabilitation A presurgical voxel-wise predictive model for cerebellar mutism syndrome in children with posterior fossa tumors Postoperative MRI features of cerebellar mutism syndrome: … Read more

Chronic subdural hematoma J.Sales-Llopis Neurosurgery Department, University General Hospital of Alicante, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Alicante, Spain Latest articles Helical coils augment embolization of the middle meningeal artery for treatment of chronic subdural hematoma: A technical note Persistent facial nerve palsy after middle meningeal artery … Read more

Tranexamic acid for intracranial meningioma Latest Pubmed Articles A systematic review and meta-analysis of the effects of tranexamic acid in surgical procedure for intracranial meningioma Myocardial infarction after craniotomy for asymptomatic meningioma Safety of intravenous tranexamic acid in patients undergoing supratentorial meningiomas resection: protocol for a randomised, parallel-group, placebo control, non-inferiority trial Effect of tranexamic … Read more

Radiation necrosis diagnosis Latest Pubmed Related Articles Radiation necrosis or tumor progression? A review of the radiographic modalities used in the diagnosis of cerebral radiation necrosis A phase III, multicenter, randomized controlled trial of preoperative versus postoperative stereotactic radiosurgery for patients with surgically resectable brain metastases VEGFR-TKI treatment for radiation-induced brain injury after gamma knife … Read more

NFTI-QOL The NFTI-QOL is a robustly constructed disease-specific QOL questionnaire for neurofibromatosis type 2. It correlates strongly and significantly with EuroQOL and all SF-36 domains (p < 0.01). It is straightforward and quick (≤3 minutes) for patients to complete and easy to score. It is suitable as a quantitative method of assessing QOL in NF2 both in a clinical setting and as an outcome measure … Read more

Intracranial Aneurysm (IA) Natural history see Intracranial Aneurysm Natural history History see Intracranial Aneurysm History. Epidemiology see Intracranial Aneurysm Epidemiology. Classification see Intracranial Aneurysm classification. Pathogenesis see Intracranial aneurysm pathogenesis. Computational fluid dynamics see Computational fluid dynamics for intracranial aneurysm Risk Factors Intracranial aneurysm risk factors. Clinical features The clinical presentation is varied, ranging from asymptomatic lesions to those presenting with … Read more

The role of major journals publishing the results of randomized controlled trials (RCTs) is crucial. This is because, when results are published in a major journal, the study receives “…the journal’s stamp of approval”, the published results carry a kind of professional approbation, and the paper becomes more attractive to both the readers and media, who may amplify the real value … Read more

Anterior sacral meningocele Anterior sacral meningoceles are congenital lesions that consist of a spinal fluid-filled sac in the pelvis communicating by a small neck with the spinal subarachnoid space through a defect in the sacrum. They protrude into retroperitoneal and presacral space. 1) 2). The wall of the sac consists of two layers, an inner arachnoid membrane … Read more

Preoperative Embolization for Brain Arteriovenous Malformation Latest Pubmed Related Articles Head-Mounted Augmented Reality in the Planning of Cerebrovascular Neurosurgical Procedures: A Single-Center Initial Experience Microsurgery versus Microsurgery With Preoperative Embolization for Brain Arteriovenous Malformation Treatment: A Systematic Review and Meta-analysis Treatment of high-grade brain arteriovenous malformations using a hybrid operating room: A prospective single-arm study … Read more

1p/19q co-deletion Latest Pubmed Related Articles The Role of Neuro-Inflammation and Innate Immunity in Pathophysiology of Brain and Spinal Cord Tumors Immunological profiles of human oligodendrogliomas define two distinct molecular subtypes A Patient With Epilepsy, Ganglioglioma, and Oligodendroglioma With Anaplastic Foci in the Same Left Frontoparietal Lesion: A Case Report Clinical Benefit of Bevacizumab and … Read more

Cervical Sympathetic Nerve Block for cerebral vasospasm Sympathetic perivascular nerve fibers originate from the superior cervical ganglion (SCG) to innervate the cerebral vasculature, with activation resulting in vasoconstriction. Sympathetic pathways are thought to be a significant contributor to cerebral vasospasm 1). A simple treatment such as a cervical sympathetic nerve block may be an effective therapy but is not routinely performed as cerebral vasospasm treatment/DCI. … Read more

Delirium Diagnosis Quality Improvement in Delirium Health Literacy in Older Adult Patients and Their Caregivers Attending a Geriatric Clinic The Effect of Consultation-Liaison Psychiatry on Postoperative Delirium in Elderly Hip Fracture Patients in the General Hospital Pulsatile Femoral Vein Doppler and Congestive Delirium, What Is the Relationship?: A Case Report General Anesthesia in a Patient … Read more

Spinal cord injury epidemiology Latest The Importance of Prospective Registries and Clinical Research Networks in the Evolution of Spinal Cord Injury Care Pediatric Cervical Spine Injuries Molecular and cellular changes in the post-traumatic spinal cord remodeling after autoinfusion of a genetically-enriched leucoconcentrate in a mini-pig model Traumatic Thoracic and Lumbar Spine Injury in Adult Population … Read more

Brain abscess J.Sales-Llopis Neurosurgery Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL – FISABIO Foundation), Alicante, Spain. A brain abscess is a focal area of necrosis starting in an area of cerebritis surrounded by a membrane. Brain abscesses are suppurative infections of the brain parenchyma surrounded by a vascularized capsule. see also Intracranial abscess. It is a potentially life-threatening condition requiring … Read more

Trigone ventricular meningioma Prophylactic Intraventricular Piping Method Prevents Entrapped Temporal Horn After Removal of Ventricle Trigone Meningioma: Technical Note Risk Factors of Postoperative Meningitis in Lateral Ventricular Trigone Meningiomas: A Clinical Analysis of 64 Patients Massive intracranial hemorrhage caused by intraventricular meningioma: case report Quiescent and Activated Fibroblasts in Lateral Ventricular Meningioma With a Dura-like … Read more

 Table of Contents  Linezolid in Neurosurgery Latest articles Case series References Linezolid in Neurosurgery Latest articles Diagnosis and Treatment to a Post-Craniotomy Intracranial Infection Caused by Corynebacterium Nocardia farcinica pituitary abscess in an immunocompetent patient: illustrative case Experience with enterococcal meningitis/ventriculitis in children Analysis of the management of ventriculitis cases at a UK neurosurgery centre … Read more

Frontal sinus cranialization Algorithms for the management of frontal sinus fractures: A retrospective study A Clinical Case of Delayed Posttraumatic Frontal Sinus Cerebrospinal Fluid Leakage Management Via External Surgical Approach Management of Frontal Bone Fracture in a Tertiary Neurosurgical Care Center-A Retrospective Study Frontal Sinus Fractures: A Contemporary Approach in the Endoscopic Era Frontal Cranioplasty … Read more

Cerebellar pilocytic astrocytoma Latest news Key concepts ● Often cystic, half of these have a mural nodule. ● Usually presents during the second decade of life (ages 10–20 yrs). ● A subtype of pilocytic astrocytoma. Formerly referred to by the nonspecific and confusing term cystic cerebellar astrocytoma. Epidemiology Cerebellar pilocytic astrocytoma epidemiology. Classification Children see Cerebellar pilocytic astrocytoma in children. … Read more

Microvascular decompression for hemifacial spasm Routine postoperative admission to the neurocritical intensive care unit after microvascular decompression: necessary or can it be abandoned? Correction to: The value of intraoperative indocyanine green angiography in microvascular decompression for hemifacial spasm to avoid brainstem ischemia Hemifacial Spasm Caused by Distal Neurovascular Compression Confirmed by Lateral Spread Response Monitoring … Read more

Pediatric traumatic brain injury outcome see also Traumatic brain injury outcome. Latest articles Withdrawal of life sustaining therapies in children with severe traumatic brain injury Prediction Models for Neurocognitive Outcome of Mild Traumatic Brain Injury in Children: a Systematic Review Low morbidity and mortality in children with severe traumatic brain injury treated according to the Lund … Read more

Rongeur A rongeur is a strongly constructed instrument with a sharp-edged, scoop-shaped tip, used for gouging out bone. Rongeur is a French word that means rodent or ‘gnawer’. A rongeur can be used to open a window in bone, often in the skull. It is used in neurosurgery, podiatric surgery, and orthopedic surgery to expose areas for … Read more

Hemorrhagic transformation Large areas of hemorrhagic transformation within an ischemic infarct may be more indicative of cardiogenic brain embolism (CBE) due to thrombolysis of the clot and reperfusion of infarcted brain with the subsequent hemorrhagic conversion. Hemorrhagic transformation most often occurs within 48 hrs of a CBE stroke, and is more common with larger strokes. Intraarterial thrombolysis within 6 hours of stroke onset may increase recanalization rates to … Read more

Glioblastoma J.Sales-Llopis Neurosurgery Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL – FISABIO Foundation), Alicante, Spain. Definition While glioblastoma was historically classified as isocitrate dehydrogenase (IDH)-wildtype and IDH-mutant groups, the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) and the World Health Organization Classification of Tumors of the Central Nervous System 2021 clearly updated … Read more

Mechanical thrombectomy outcome Clinical trials have shown that mechanical thrombectomy (MT) is associated with improved functional outcomes for patients with acute ischemic stroke presenting with proximal anterior circulation, large vessel occlusion, and salvageable brain tissue 1) 2) 3) 4) 5). Stroke patients who underwent successful thrombectomy with general anesthesia achieved higher rates of functional independence when procedural ETCO2 exceeded 35 mmHg. Further studies to confirm this effect and investigate optimal ETCO2 parameters should … Read more

Deep Brain Stimulation for Post-Traumatic Stress Disorder In 2018 the application of DBS for PTSD was still strictly investigational and animal models suggest that stimulation of the amygdala, ventral striatum, hippocampus, and prefrontal cortex may be effective in fear extinction and anxiety-like behavior 1). Neuroimaging, preclinical, and preliminary clinical data suggested that the use of DBS for the treatment of PTSD may … Read more

TachoSil TachoSil is a collagen sponge coated with the human coagulation factors fibrinogen and thrombin. The sponge is manufactured from horse tendons. TachoSil reacts upon contact with blood, other body fluids, or saline to form a clot that glues it to the tissue surface. Hemostasis is reached in a few minutes, and the sponge is absorbed by the body within several weeks. Corza has acquired … Read more

ShuntScope Autoclavable reusable SHUNTSCOPE® is designed to facilitate the endoscopic ventricular drainage placement during shunt surgery. Case series A retrospective analysis of all pediatric patients undergoing ventricular catheter placement using the ShuntScope from 01/2012 to 01/2022 in the Department of Neurosurgery, Saarland University Medical Center, Homburg was performed. Demographic, clinical, and radiological data were evaluated. The visualization quality of the intraoperative endoscopy was stratified into the categories of excellent, … Read more

Serum Biomarkers for Traumatic Brain Injury Traumatic brain injury (TBI) is frequently associated with abnormal blood-brain barrier function, resulting in the release of factors that can be used as molecular biomarkers of TBI, among them GFAP, UCH-L1, S100B, and NSE. Although many experimental studies have been conducted, clinical consolidation of these biomarkers is still needed to increase the predictive power and reduce the poor … Read more

Charlson comorbidity index (CCI) http://touchcalc.com/calculators/cci_js https://www.mdcalc.com/charlson-comorbidity-index-cci The purpose of the study was to assess whether the Charlson Comorbidity Index (CCI) was associated with in-hospital death and short-term functional outcome in elderly patients (age ≥ 70) with intracerebral hemorrhage (ICH). This was a retrospective cohort of aged ICH patients (≥70 years old) admitted within 24 hours of ICH onset. The CCI was derived using hospital discharge ICD-9 CM codes and … Read more

Glioblastoma targeted therapy Latest articles Dual EGFR- and TfR-targeted gene transfer for sodium iodide symporter gene therapy of glioblastoma MicroRNA-588 regulates the invasive, migratory and vasculogenic mimicry-forming abilities of hypoxic glioma cells by targeting ROBO1 Efficiently targeted therapy of glioblastoma xenograft via multifunctional biomimetic nanodrugs Glioma stem cells activate platelets by plasma-independent thrombin production to … Read more

Subgaleal hematoma Subgaleal hematoma is a type of cephalhematoma in the potential space between the periosteum and the galea aponeurosis. They dont calcify. Its occurrence beyond the neonatal period is rare and is often associated with head trauma involving tangential or radial forces applied to the scalp causing emissary veins traversing the subgaleal space to be ruptured 1). Epidemiology In patients with traumatic intracranial hemorrhage or skull fractures, the … Read more

Chronic subdural hematoma recurrence prevention Systematic reviews and meta-analyses In total, 402 studies were included in this analysis and 32 potential risk factors were evaluated. Among these, 21 were significantly associated with the postoperative recurrence of CSDH. Three risk factors (male, bilateral hematoma, and no drainage) had convincing evidence 1). Subdural drain The single most important … Read more

Moyamoya disease Moyamoya disease is a chronic, occlusive cerebrovascular disease, characterized by bilateral steno-occlusive changes at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. These diagnostic criteria of the moyamoya disease, stated by the Research Committee on Spontaneous Occlusion of the Circle of Willis (moyamoya disease) in Japan, are … Read more

Cardiac Complications After Subarachnoid Hemorrhage Subarachnoid hemorrhage (SAH) is a serious condition, and a myocardial injury or dysfunction could contribute to the outcome. Acute cardiac complications frequently occur after subarachnoid hemorrhage (SAH). These complications include electrocardiogram (ECG) abnormalities, the release of cardiac biomarkers, and the development of acute stress-induced heart failure resembling Takotsubo cardiomyopathy 1) 2) 3) 4) 5) 6) non-ST elevation myocardial infarction, ST-elevation myocardial infarction and cardiac arrest, … Read more

Somatostatin analogs in meningioma Meningiomas are associated with several sex hormones-related risk factors and demonstrate a predominance in females. These associations led to investigations of the role that hormones may have on meningioma growth and development. While it is now accepted that most meningiomas express progesterone and somatostatin receptors, the conclusion for other receptors has been less definitive. Miyagishima et al. performed a review of what is known … Read more

Foramen magnum meningioma Foramen magnum meningiomas (FMMs) are slow growing, posterior fossa meningiomas most often intradural and extramedullar. They are those arising anteriorly from the inferior third of the clivus to the superior edge of the C2 body, laterally from the jugular tubercle to the C2 laminae, and posteriorly from the anterior border of the occipital squama to the spinous process of C2 1) 2) 3). Epidemiology They represent 2% of all meningiomas 4). … Read more

Pediatric Emergency Care Applied Research Network (PECARN) see PECARN traumatic brain injury algorithm. The overuse of CT leads to inefficient care. Therefore, to maximize precision and minimize the overuse of CT, the Pediatric Emergency Care Applied Research Network (PECARN) previously derived clinical prediction rules for identifying children at high risk and very low risk for intra-abdominal trauma undergoing acute intervention and clinically important traumatic brain injury after blunt trauma in large cohorts of children who are … Read more

Pituitary adenoma recurrence Tumor recurrence or residual regrowth are poor prognosis for pituitary adenoma. A comprehensive review of the literature quantified the pituitary adenoma recurrence rates for commonly observed pituitary adenomas after transsphenoidal surgical resection with curative intent. Findings suggest that surveillance within 1 year may be of low yield. Further, clinical trials and cohort studies investigating the cost-effectiveness of surveillance schedules and their impact on the quality of life of patients under surveillance will provide further insight … Read more

Brain metastases treatment guidelines ASCO-SNO-ASTRO Guideline 2022 https://ascopubs.org/doi/10.1200/JCO.21.02314?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed EANO–ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours 2021 https://www.annalsofoncology.org/article/S0923-7534(21)02214-6/fulltext Published:August 05, 2021 Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Role of Surgery in the Management of Adults With Metastatic Brain Tumors 2019 Please see … Read more

Anaplastic meningioma Anaplastic meningioma (also known as malignant meningiomas) is defined by several criteria including: 1) Invasion of adjacent brain parenchyma or skull. (see invasive meningioma) 2) Numerous mitosis (> 5/high-powered field) 3) Elevated proliferative index (>3%) as assessed by either 5-bromodeoxyuridine or KI-67 staining 4) Necrosis 5) Increased cellularity 6) Nuclear pleomorphism 7) metastases Epidemiology Anaplastic meningiomas are uncommon, accounting for only ~1% of … Read more

Glioblastoma recurrence treatment There is no consensus as to the standard of care as no therapeutic options have produced substantial survival benefit for Glioblastoma recurrences (Glioblastomas) 1) 2). A purely radiological diagnosis of recurrence or progression can be hampered by flaws induced by pseudoprogression, pseudoresponse, or radionecrosis There is sufficient uncertainty and equipoise regarding the question of reoperation for patients with Glioblastoma recurrence to support the need for a randomized controlled trial 3). … Read more

Nucleus accumbens The nucleus accumbens (NAcc), also known as the accumbens nucleus or as the nucleus accumbens septi (Latin for nucleus adjacent to the septum) is a region in the basal forebrain rostral to the preoptic area of the hypothalamus. The nucleus accumbens and the olfactory tubercle collectively form the ventral striatum, which is part of the basal ganglia. Each cerebral hemisphere has its … Read more

Chronic Subdural Hematoma Surgical Technique (1) Twist drill craniostomy for chronic subdural hematoma is a relatively safe technique that can be employed under local anesthesia and thus can be considered as first-line treatment in high-risk surgical candidates. (2) Single and double burr hole craniotomies have shown comparable results. (3) Intraoperative irrigation during burr-hole craniostomy doesn’t affect the outcome. (4) Drain insertion after hematoma evacuation lowers … Read more

Temporal lobe epilepsy Mesial temporal sclerosis (MTS) is the most common cause of intractable temporal lobe epilepsy. Clinical features Temporal lobe epilepsy (TLE) is a chronic neurological condition characterized by recurrent seizures (epilepsy) which originate in the temporal lobe with progressive neurological disabilities, including cognitive deficit, anxiety and depression. The seizures involve sensory changes, for example smelling an unusual odour that is not there, and disturbance … Read more

Subarachnoid hemorrhage scales see also Poor grade aneurysmal subarachnoid hemorrhage Hijdra sum score Hunt and Hess Stroke Scale World Federation of Neurological Surgeons Grading System Modified Fisher scale VASOGRADE Graeb Score or LeRoux scores improve the prediction of shunt dependency and in parts of case fatality rate (CFR) in aneurysmal SAH patients therefore confirming the … Read more

Moyamoya Disease Diagnosis Diagnosis of Moyamoya disease requires bilateral symmetrical stenosis or occlusion of the terminal portion of the internal carotid arterys (ICA)s as well as the presence of dilated collateral vessels at the base of the brain 1). (If unilateral, the diagnosis is considered questionable, 2) and these cases may progress to bilateral involvement). Other characteristic findings include: stenosis/occlusion starting at … Read more

Middle meningeal artery embolization for chronic subdural hematoma trials Several randomized controlled trials are planned or ongoing. In most of these trials, conventional neurosurgical treatment with or without adjunctive endovascular embolization is compared. Given the encouraging results with a 91% long-term success rate in the series of Link et al., a large scale clinical trial is warranted 1). https://clinicaltrials.gov/ct2/show/NCT03307395 A proposed … Read more

Insula functions The insula serves as an integration cortex for multimodal convergence of distributed neural networks such as the somesthetic-limbic, insulo-limbic, insulo-orbito-temporal and the prefrontal-striato-pallidal-basal forebrain 1). Histologically, the insula is a part of the paralimbic cortex, as it bears in its antero-inferior part an allo and mesocortical area. The insula is functionally involved in cardiac rhythm and arterial blood pressure control, as well as … Read more

Spontaneous intracranial hypotension diagnosis Spontaneous intracranial hypotension diagnosis have evolved due to improved understanding of spontaneous intracranial hypotension pathophysiology and implementation of advanced myelography techniques. Farnsworth et al. synthesized recent updates and contextualize them in an algorithm for diagnosis and treatment of SIH, highlighting basic principles and points of practice variability or continued debate. This … Read more

Spontaneous intracerebral hemorrhage expansion prediction Signs Black hole sign. Blend sign, Spot sign. NAG scale A fluid level within intraparenchymal hemorrhage on head CT scan is associated with higher likelihood of intracerebral hemorrhage progression. However, this only applies to true fluid levels, with mimics having a lower likelihood of progression. A careful analysis of potential … Read more

Temozolomide adverse effects Check with your doctor immediately if any of the following side effects occur: Less common or rare Amnesia black, tarry stools blood in the urine or stools convulsions cough or hoarseness fever or chills lower back or side pain muscle weakness or paralysis on one or both sides of the body painful … Read more

Axonova Medical https://axonovamed.com/ Functional restoration following major peripheral nerve injury (PNI) is challenging, given slow axon growth rates and eventual regenerative pathway degradation in the absence of axons. Smith et al. from the Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, Axonova Medical are developing tissue-engineered nerve grafts (TENGs) to simultaneously “bridge” missing nerve segments and “babysit” regenerative capacity by providing living axons to guide host axons and … Read more

Ventriculoperitoneal Shunt Complications see External ventricular drainage complications see also Cerebrospinal fluid shunt complications. Ventriculoperitoneal shunt is the most common treatment to manage hydrocephalus; It is unfortunately burdened by up to 25% of complications. The peritoneal approach may expose patients to many complications. Patients with a ventriculoperitoneal shunt tend to develop epidural fluid accumulation after … Read more

Bilateral anterior cingulotomy Bilateral anterior cingulotomy is a form of psychosurgery, introduced in 1948 as an alternative to lobotomy. Lesioning of the target area is typically performed using bilateral stereotactic electrode placement and target ablation, which involves transparenchymal access through both hemispheres. Lauri Laitinen was a pioneer of stereotactic psychosurgery in the 1950s to 1970s, especially by introducing the subgenual cingulotomy. Indications Bilateral anterior cingulotomy has … Read more

Deep brain stimulation (DBS) General information Deep brain stimulation (DBS): Neurosurgical procedure that uses electrical stimulation through surgically implanted electrodes to produce neuromodulation of electrical signals for the purpose of symptom improvement. For many indications, DBS has supplanted ablative procedures in the brain. Deep brain stimulation (DBS) is a neurosurgical procedure introduced in 1987, involving the implantation of a medical device called a neurostimulator (sometimes referred to as a ‘brain pacemaker’), which sends … Read more

Tourette’s syndrome A disorder characterized by random, repeated, and stereotyped motor tic or vocal tics for over > 1 year, 1) usually in several “bouts” per day. Onset is before age 18 years (mean age: 5 years). Male: female ratio is 4:1. The tics may be socially inappropriate, as such, are disabling. TS is often associated with OCD, ADHD & … Read more

Epilepsy diagnosis The accurate diagnosis of seizures is essential as some patients will be misdiagnosed with epilepsy, whereas others will receive an incorrect diagnosis. Indeed, errors in diagnosis are common, and many patients fail to receive the correct treatment, which often has severe consequences Imaging Imaging is pivotal in the evaluation and management of patients with … Read more

Korle-Bu Neuroscience Foundation https://kbnf.org/ Korle-Bu Neuroscience Foundation (KBNF) is a Canada based charity enhancing the delivery of quality brain and spinal medical care in West Africa and beyond. The vision is to alleviate the suffering of West Africans with a special focus on those affected by diseases of the brain and spine, and to address related health care issues. KBNF has been working with … Read more

CAR-T cell Therapy Chimeric antigen receptor T cells are T cells with genetic engineering to produce an artificial T cell receptor for use in immunotherapy. Therapy based on gene editing technology represents a significant breakthrough in personalized immunotherapy for human cancer. This strategy uses genetic modification to enable T cells to target tumor-specific antigens, attack specific cancer cells, and bypass tumor cell apoptosis avoidance mechanisms to some extent. This method … Read more

Meningioma Systematic Reviews Eight electronic databases/registries were searched to identify eligible meningioma Systematic Reviews with and without meta-analysis published between January 1990 and December 2020. Articles concerning spinal meningioma were excluded. Reporting and methodological quality were assessed against the following tools: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), A Measurement Tool to Assess systematic Reviews (AMSTAR 2), and Risk Of Bias in Systematic reviews (ROBIS). 116 Systematic Reviews were … Read more

Tobacco cigarette smoking as an intracranial aneurysm risk factor Although several studies have suggested that the incidence of intracranial aneurysms (IAs) is higher in smokers, the higher prevalence of subarachnoid hemorrhage (SAH) in smokers remains uncertain. It is unclear whether smoking additionally contributes to the formation of multiple aneurysms and the risk of rupture. The aim … Read more

Stroke in Moyamoya disease Moyamoya disease (MMD) is an idiopathic disease with a progressive nature leading to recurrent stroke due to occlusion of the terminal internal carotid arteries 1). Epidemiology A multi-center, nationwide survey for conservative treatment results was conducted in 2007 in Japan. The authors reported the annual stroke rate as 3.2% from the observation of 34 asymptomatic patients conservatively followed over 44 months. … Read more

Cerebral arteriovenous malformation (AVM) Intracranial arteriovenous malformation in the brain. Epidemiology see Cerebral arteriovenous malformation epidemiology. see Arteriovenous malformation associated aneurysm Classification Cerebral microarteriovenous malformation Parafalcine arteriovenous malformation,…. Ruptured cerebral arteriovenous malformation Unruptured cerebral arteriovenous malformation AVMs that occur in the coverings of the brain are called dural arteriovenous malformation. Deep arteriovenous malformation. Motor area arteriovenous malformation. Pediatric Cerebral arteriovenous … Read more

Vestibular schwannoma treatment Optimal decision making in new diagnosed vestibular schwannoma remains a matter of debate. For small- to medium-sized lesions (Koos grading scale I–III), the options are radiosurgery (RS), microsurgery, or a “wait and-scan” approach 1). This is mainly based on the hospital setting, as well as surgeon’s preference. It is worth noting that comparative studies advocate that GKS compares … Read more

Intraosseous meningioma of the sphenoid bone Some sphenoid wing meningiomas are associated with a significant hyperostosis of the adjacent sphenoid ridge that may even exceed the size of the intradural mass. The decision-making process and surgical planning based on neuroanatomic knowledge are the mainstays of management of this group of lesions. Given their natural history and biologic behavior, many hyperostosing meningiomas at this location require long-term management … Read more

Nicotine replacement therapy in aneurysmal subarachnoid hemorrhage Smoking prevalence is twice as high among patients admitted to hospital because of the acute condition of aneurysmal subarachnoid hemorrhage (aSAH) as in the general population. Despite vasoactive properties, administration of NRT among active smokers with acute SAH appeared to be safe, with similar rates of vasospasm and DCI, and a … Read more

Borden type I intracranial dural arteriovenous fistula Type I dural arteriovenous fistulas are supplied by a meningeal artery or arteries and drain into a meningeal vein or dural venous sinus. The flow within the draining vein or venous sinus is anterograde. Equivalent to Cognard type I and IIa, with a favorable natural history 1) 2). Type Ia – simple dural arteriovenous … Read more

Pituitary adenoma Pituitary adenoma (PA) is a common pituitary tumor that arises from the adenohypophysis, in the pituitary gland. Epidemiology Pituitary adenoma epidemiology. Classification see Pituitary adenoma classification. Risk factors Pituitary tumors have very few known risk factors, and these are related to genetics. There are no known environmental or lifestyle-related risk factors for pituitary tumors. Though science has suggested that … Read more

Glioma Guidelines The Korean Society for Neuro-Oncology (KSNO) published guidelines for managing adult glioma in 2019, and the National Comprehensive Cancer Network and European Association of Neuro-Oncology published guidelines in September 2021 and March 2021, respectively. However, these guidelines have several different recommendations in practice, including tissue management, adjuvant treatment after surgical resection, and salvage treatment for recurrent/progressive gliomas. Currently, the … Read more

Cranioplasty for hydrocephalus prevention after decompressive craniectomy After decompressive craniectomy, the occurrence of hydrocephalus is reported with varying incidences (10–45%) mainly due to differences in diagnostic criteria 1) 2) 3) 4). The management of Hydrocephalus after decompressive craniectomy in need of cranial reconstruction can be challenging and thus is not precisely defined. The debate mainly revolves around the timing of cerebrospinal fluid shunt with respect to the cranioplasty 5). … Read more

Intracranial aneurysm pathogenesis Until now, the exact etiology of intracranial aneurysms formation remains unclear. Time-dependent and site-dependent morphological changes and the level of degradation molecules may be indicative of the vulnerability of aneurysm rupture 1). Miyata et al. proposed the contribution of a structural change in an adventitia, i.e., vasa vasorum formation, to the rupture of IAs 2). Risk Factors Intracranial aneurysm risk … Read more

Basal ganglia hemorrhage Epidemiology Basal ganglia hemorrhage is a common form of intracerebral hemorrhage. Classification Spontaneous basal ganglia hemorrhage. Traumatic basal ganglia hematomas (TBGHs) are uncommon events in patients with closed head injuries. Putaminal hemorrhage. Bilateral basal ganglia hemorrhage. Mechanism Rzepliński et al. injected 40 anatomic specimens of the basal ganglia with a contrast medium, scanned them with a micro-computed tomography … Read more

Stenotrophomonas maltophilia meningitis Treatment Stenotrophomonas maltophilia treatment Case series The clinical characteristics of six Stenotrophomonas maltophilia ABM cases, collected during a study period of nine years (2001-2009) were included. In the related literature, 13 S. maltophilia ABM cases were reported, and their clinical data were also collected. The 19 S. maltophilia ABM cases included 11 men and … Read more

Parkinson’s Disease Treatment Guidelines An update of the Parkinson’s Disease treatment Guidelines was commissioned by the European Academy of Neurology and the European section of the Movement Disorder Society. Although these treatments are initiated usually in specialized centers, the general neurologist should know the therapies and their place in the treatment pathway. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to … Read more

Vancomycin Vancomycin is a glycopeptide antibiotic medication. Blood levels may be measured to determine the correct dose. When taken by mouth it is poorly absorbed. Vancomycin Cerebrospinal Fluid Pharmacokinetics A study described the cerebrospinal fluid (CSF) exposure of vancomycin in 8 children prescribed intravenous vancomycin therapy for cerebral ventricular shunt infection. Vancomycin CSF concentrations ranged from 0.06 to … Read more

Aneurysmal subarachnoid hemorrhage complications Vasospasm is an important cause for mortality following aneurysmal subarachnoid hemorrhage aSAH affecting as many as 70% of patients. It usually occurs between 4th and 21st days of aSAH and is responsible for delayed ischemic neurological deficit (DIND) and cerebral infarction It is one of the factors that can most significantly worsen the prognosis despite different treatments. Transcranial doppler (TCD) … Read more

Cerebral venous sinus thrombosis after Vaccine-induced Immune Thrombotic Thrombocytopenia Health care providers should be familiar with the clinical presentations, pathophysiology, diagnostic criteria, and management consideration of this rare but severe and potentially fatal complication of the SARS-COV2 vaccine Cerebral venous sinus thrombosis (CVT) prior to the COVID pandemic was rare, responsible for 0.5 of all strokes, at the onset of the pandemic on … Read more

Clinically non-functioning pituitary adenoma Clinically non-functioning pituitary adenoma (CNFPA) is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea–galactorrhea in the context of Lactotroph adenomas, acromegaly, Cushing’s disease or hyperthyroidism secondary to TSH secreting pituitary adenoma). Epidemiology see Clinically non-functioning pituitary adenoma epidemiology. Natural history Clinically non-functioning pituitary adenoma natural history. Classification … Read more

Anterior communicating artery aneurysm endovascular treatment complications Intraprocedural aneurysm rupture and thrombus formation are serious complications during coiling of ruptured intracranial aneurysms, and they more often occur in patients with anterior communicating artery aneurysms. It is associated with a high rate of complete angiographic occlusion. However, the procedure-related permanent morbidity and mortality are not negligible for aneurysms in this location 1). Delgado … Read more

Ventriculoperitoneal shunt infection see also Shunt infection. Ventriculoperitoneal shunt infection is the most common ventriculoperitoneal shunt complication, followed by abdominal pseudocyst, abscess, and infected fluid collection 1). Epidemiology see Ventriculoperitoneal Shunt Infection Epidemiology. Types see Methicillin resistant Staphylococcus aureus ventriculoperitoneal shunt infection. see Staphylococcus epidermidis ventriculoperitoneal shunt infection see Cryptococcus neoformans ventriculoperitoneal shunt infection. Risk factors Ventriculoperitoneal shunt infection risk factors. Treatment Ventriculoperitoneal shunt infection treatment … Read more

Er:YAG laser An Er: YAG laser (erbium-doped yttrium aluminium garnet laser, erbium YAG laser) is a solid-state laser whose active laser medium is erbium-doped yttrium aluminium garnet (Er:Y3Al5O12). Er: YAG lasers typically emit light with a wavelength of 2940 nm, which is infrared light. Erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation can effectively resect water-bearing tissues. Application of Er:YAG resection in neurosurgery is complicated by unpredictable bleeding in the surgical field. An integrated theranostics system combining a dual-wavelength laser surgery system using a thulium (Tm) … Read more

http://medical.olympusamerica.com/products/orbeye By displaying the progress of surgical procedures on a large 55-inch monitor, the new model has the potential to both reduce surgeon fatigue by eliminating the need for extensive viewing via microscope eyepieces and to include the entire surgical team in the view of the procedure. Because the use of digital technology has made … Read more

Hiccups A hiccup is an involuntary contraction (myoclonic jerk) of the diaphragm that may repeat several times per minute. It is known as synchronous diaphragmatic flutter (SDF), or singultus, Latin for the act of catching one’s breath while sobbing. The hiccup is an involuntary action involving a reflex arc. Once triggered, the reflex causes a … Read more