Fresado de la fosa subarcuata para liberar la arteria cerebelosa anteroinferior en una cirugía de un Schwannoma vestibular

Álvaro Campero, Jorge Rasmussen, Julio Diloné, Pablo Ajler, Ramiro López Elizalde

Date of publication: 13-Aug-2018

Introducción:El abordaje suboccipital retrosigmoideo es la vía principal para la resección de los Schwannomas vestibulares (SV). La relación vascular más constante de los nervios del conducto auditivo interno es la arteria cerebelosa anteroinferior (ACAI); pudiendo su recorrido presentarse como un serio obstáculo para la resección completa de la lesión.

Venous air embolisms and sitting position in Helsinki pineal region surgery

Joham Choque-Velasquez, Roberto Colasanti, Julio C. Resendiz-Nieves, Rahul Raj, Ann-Christine Lindroos, Behnam Rezai Jahromi, Juha Hernesniemi

Date of publication: 10-Aug-2018

Background:Nowadays, the sitting position has lost favor among neurosurgeons partly due to assumptions of increased complications, such as venous air embolisms (VAEs) and hemodynamic disturbances. The aim of our study is to describe the importance of some anesthetic considerations and the utility of antigravity trousers as well, together with a skillful neurosurgery and an imperative proper teamwork, in order to prevent the risk of severe VAE during pineal region surgery. We routinely use them for the variant of the sitting position we developed, the “praying position.”

MinION rapid sequencing: Review of potential applications in neurosurgery

Arpan Patel, Evgenii Belykh, Eric J. Miller, Laeth L. George, Nikolay L. Martirosyan, Vadim A. Byvaltsev, Mark C. Preul

Date of publication: 10-Aug-2018

Background:Gene sequencing has played an integral role in the advancement and understanding of disease pathology and treatment. Although historically expensive and time consuming, new sequencing technologies improve our capability to obtain the genetic information in an accurate and timely manner. Within neurosurgery, gene sequencing is routinely used in the diagnosis and treatment of neurosurgical diseases, primarily for brain tumors. This paper reviews nanopore sequencing, an innovation utilized by MinION and outlines its potential use for neurosurgery.

One burr-hole craniotomy: Lateral supraorbital approach in Helsinki Neurosurgery

Joham Choque-Velasquez, Juha Hernesniemi

Date of publication: 10-Aug-2018

Background:In this video abstract, we present a one burr-hole craniotomy for the standard lateral supraorbital approach (LSO) developed by Helsinki Neurosurgery. This is a more aesthetic variant of the classic pterional approach. Presently, the LSO approach is most commonly used at our institution. With the LSO technique, the temporal muscle is just minimally opened close to its superior insertion. Posterior and temporal extension of the craniotomy, furthermore, allows adequate access to the anterior skull base, the sellar and suprasellar regions, the middle cranial fossa, the anterior portion of the Sylvian fissure, and the distal Sylvian fissure. Even though the specific location and size of the lesion may vary, this approach accesses all mentioned structures with a very minimal variation.

Traumatic thoracic spine spondyloptosis treated with spondylectomy and fusion

Arash Fattahi, Abdoulhadi Daneshi

Date of publication: 10-Aug-2018

Background:There are multiple surgical treatment options for traumatic thoracic spine spondyloptosis, a three-column spinal injury typically attributed to high-energy trauma.

Transforaminal epidural steroid injection can result in further neurological injury in a patient with severe foraminal stenosis and nerve impingement

Ramsis F. Ghaly, Thomas Zouki, Aby Pynadath, Kenneth D. Candido, Nebojsa Nick Knezevic

Date of publication: 10-Aug-2018

Background:Chronic low back pain (LBP) is highly prevalent and costly in our society. The use of epidural steroid injections (ESIs) for the treatment of radicular LBP is very widespread and continues to rise. The most popular injection is the lumbar/sacral transforaminal epidural steroid injection (TFESI). Here, we present a serious neurological complication resulting from such a TFESI that was only reversed by timely neurosurgical intervention.

Utility of cerebrospinal fluid lactate in aneurysmal subarachnoid hemorrhage

Jaclyn J. Renfrow, Casey D. Frey, Madison Arnel, Stacey Q. Wolfe, Christopher McLouth, Sudhir Datar

Date of publication: 03-Aug-2018

Background:An external ventricular drain (EVD) treats hydrocephalus in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study examines the utility of cerebrospinal fluid (CSF) lactate collected from an EVD as a proposed biomarker to predict patient outcome and vasospasm/delayed cerebral ischemia.

When and if to stop low-dose aspirin before spine surgery?

Nancy E. Epstein

Date of publication: 03-Aug-2018

Background:Prior to spine surgery (SS), we ask whether and when to stop low-dose aspirin (LD-ASA), particularly in patients with significant cardiovascular disease (CAD). Although platelets typically regenerate in 10 days, it can take longer in older patients.

Effectiveness of modified dural incision to preserve the patency of the occipital sinus in foramen magnum decompression for a patient with Chiari malformation type I

Yasuhiko Hayashi, Issei Fukui, Yasuo Sasagawa, Kouichi Misaki, Masahiro Oishi, Mitsutoshi Nakada

Date of publication: 03-Aug-2018

Background:Foramen magnum decompression (FMD) has been acknowledged as a standard surgical procedure for symptomatic patients with Chiari malformation type I (CM-I). However, even if dural incision is necessary during FMD, the procedure of cutting off the occipital sinus has not been regarded as a safe option.

Definitions and treatments for chiari-1 malformations and its variants: Focused review

Nancy E. Epstein

Date of publication: 27-Jul-2018

Background:Reviewing the neurosurgical literature demonstrated that spinal neurosurgeons rarely (0.78%) diagnose chiari-1 malformation (CM-1) in adults on magnetic resonance (MR) studies defined by tonsillar descent >5 mm below the foramen magnum (FM). Children, averaging 10 years of age, exhibit CM-1 in 96/100,000 cases. According to the literature, fewer spinal neurosurgeons additionally recognize and treat the low lying cerebellar tonsil (LLCT) syndrome.