Carotid artery stenting with intravascular lithotripsy for calcific carotid stenosis: A systematic literature review.

BackgroundEndovascular techniques such as stenting, endarterectomy, and transcarotid arterial revascularization are common therapeutic options in the management of carotid artery stenosis; however, they involve a risk of major complications (e.g. in-hospital transient ischemic attack or ischemic stroke).

Spinal Idiopathic Hypertrophic Pachymeningitis: A Systematic Review of Diagnostic Features, Clinical Management, and Surgical Outcomes.

Objective: To comprehensively review the diagnostic features, clinical management, and surgical outcomes of spinal idiopathic hypertrophic pachymeningitis (sIHP) through a systematic analysis of existing literature.

Methods: A systematic review was conducted using PubMed, EMBASE, Web of Science, and Cochrane databases from inception to October 31, 2024. Studies reporting on adult patients with sIHP, including clinical, treatment, outcome, and follow-up data, were included.

Adult Cerebellopontine Angle Medulloblastoma: A Systematic Review of Clinical Features, Management Approaches, and Patient Outcomes.

Objective: The aim of this study was to systematically review the existing individual patient data in the literature on adult cerebellopontine angle (CPA) medulloblastoma (MB) and characterize the patient presentation, management strategies used, and oncological outcomes of this rare entity to guide future clinical practice.

Methods: Following PRISMA guidelines, a systematic review was conducted by searching PubMed, EMBASE, Web of Science, and Cochrane databases from inception to 19 June 2024. Studies regarding adult patients with histologically confirmed MB radiographically confirmed to be located in the CPA were included.

Primary Extradural Meningioma: A Systematic Review of Diagnostic Features, Clinical Management, and Surgical Outcomes.

This systematic review consolidates the literature on primary extradural meningiomas (PEMs), a rare subset of meningiomas. We describe the clinical features, management strategies used, and treatment outcomes for published cases. A systematic review was conducted using PRISMA guidelines across multiple databases to 29 July 2024.

Intravascular lithotripsy prior to transcarotid arterial revascularization: A technical tale of two cases.

calcific carotid stenosis is becoming more common as the advanced-age population grows, requiring new therapeutic approaches. As such, transcarotid arterial revascularization is gaining significant popularity in the management of carotid stenosis due to low rates of perioperative complications and optimal clinical outcomes. In addition, intravascular lithotripsy has shown promise in safely facilitating the success of endovascular procedures in the context of calcified lesions.

Mixed Gangliocytoma-Pituitary Adenoma: A Systematic Review of Diagnostic Features, Clinical Management, and Surgical Outcomes.

Objective: Mixed gangliocytoma-pituitary adenomas (MGPAs) are very rare sellar neoplasms. Contemporary understanding of their natural history, clinical characteristics, optimal management strategies, and prototypical outcomes remains poorly understood.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Embase, Web of Science, and Cochrane were searched to include studies of patients with histologically confirmed mixed gangliocytomas.

Safety and efficacy of antibiotic-impregnated absorbable calcium sulfate beads (Stimulan) in cranioplasty.

Cranioplasty is a common neurosurgical procedure that follows hemicraniectomy in the setting of neoplasm resection or increased intracranial pressure. Although standardized practices aim at minimizing infection risk, infection of the surgical site has been reported in 6.6%-8.

Transradial stenting of left subclavian artery origin using shockwave intravascular lithotripsy balloon plasty: Technical report and literature review.

Lesions of the subclavian artery often involve pathologic stenosis due to high degrees of calcification within the vessel wall. While endovascular angioplasty and stenting is generally the preferred method for obtaining flow reconstitution, calcification of the vessel wall has proven to significantly impair the efficacy of successful stent deployment. Shockwave intravascular lithotripsy (IVL) is a technology that has been very successful in addressing this challenge in other vascular territories, however its use has yet to be approved for supra-aortic vessels such as the subclavian artery.

Prognostic and morphological factors in pediatric cerebellar contusions.

Background: Although uncommon, cerebellar contusions are associated with significant morbidity and mortality. Literature is lacking in the prognostic and morphological factors relating to their clinical picture and outcomes, especially within children. The objective of this study is to evaluate prognostic and anatomic factors in the clinical picture of cerebellar contusions, including effacement of the 4 ventricle and cisterna magna.

Impact of timing of decompressive craniectomy on outcomes in pediatric traumatic brain injury.

Background: Decompressive craniectomy (DC) can be utilized in the management of severe traumatic brain injury (TBI). It remains unclear if timing of DC affects pediatric patient outcomes. Further, the literature is limited in the risk assessment and prevention of complications that can occur post DC.

A Morphometric Study Analyzing the Anterior Epidural Space Volume Throughout Childhood.

Background: Following disc herniations, fragments migrate into the anterior epidural space within the lumbar spine. Although the volume of this area has been previously described in the adult population, the volume is relatively unknown within children.

Objectives: Investigate the relative volume in the lumbar anterior epidural space within the growing spine by using imaging studies.

Analysis of the timing and the usage of drains following cranioplasty on outcomes and the incidence of bone resorption.

Background: Pediatric cranioplasty is associated with a high rate of complications, including bone resorption (BR) in 20-50% of cases. We aimed to evaluate factors contributing to BR, including the effect of the timing of cranioplasty and the use of post-surgical drains.

Methods: This is a dual institution retrospective review of all patients under 18 years old who underwent a cranioplasty following a decompressive craniectomy (DC) for the treatment of traumatic brain injury between 2011 and 2021.

The impact of traumatic brain injury on economic productivity in the Caribbean.

Introduction: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in the Caribbean as well as globally. Within the Caribbean, the prevalence of TBI is approximately 706 per 100,000 persons - one of the highest rates per capita in the world.

Research Question: We aim to assess the economic productivity lost due to moderate to severe TBI in the Caribbean.

Radiographic Assessment of Bilateral Asymmetry in the Upper Extremities of Living Humans.

Objective Injuries resulting from trauma or tumor resection may cause length alterations in the bones of the upper extremities (UE) requiring reconstruction. Direct contralateral bone is often used to determine the appropriate length for reconstruction but fails to account for potential asymmetry. Given the paucity of data assessing asymmetry in living populations and the need for accurate length approximation, we developed a study evaluating UE long bone asymmetry using radiographic imaging in living subjects.

Avive Soft Tissue Membrane Improves Outcomes of Revision Upper-extremity Nerve Decompression Surgery.

Unlabelled: Revision nerve decompression remains a challenge for surgeons. Avive Soft Tissue Membrane is processed human umbilical cord membrane that may reduce inflammation and scarring, thereby improving tissue gliding. Although synthetic conduits have been reported in revision nerve decompression, the use of Avive has not.

Qualitative and Quantitative Analysis of Pediatric Post Neurosurgical Care in a Lower Middle-Income Country: The Zambian Experience.

Objective: Pediatric postoperative neurosurgical care is an essential component of a child's treatment pathway. It is important to better understand how neurosurgeons in lower middle-income countries (LMICs) have been able to address socioeconomic and systemic factors to improve their patients' access to quality pediatric postoperative neurosurgical care. We aim to characterize the pediatric neurosurgical postoperative system in place in Zambia and to discuss how these efforts have been implemented to improve outcomes and address socioeconomic barriers to accessing health care.

Gabapentin as a Symptomatic Modifier in Median Arcuate Ligament Syndrome: A Case Report and Assessment of Treatment Modalities.

Median arcuate ligament syndrome (MALS) is a rare constellation of neurogenic gastrointestinal (GI) symptoms resulting from compression of the celiac trunk and celiac plexus by the median arcuate ligament. MALS is characterized by nonspecific symptoms including nausea, vomiting, diarrhea, bloating, unintentional weight loss due to food aversion, and postprandial epigastric abdominal pain. We present a case of atypical, chronic MALS that confounded clinicians for over a decade and led to various misdiagnoses, including early-onset Parkinson's disease.

Incidental Detection of Human Herpesvirus-6 in Cerebrospinal Fluid Analysis: To Treat or Not to Treat?

Human herpesvirus-6 (HHV-6) is a ubiquitous beta herpes virus which can result in meningitis/ meningoencephalitis in humans. FilmArray meningitis/encephalitis panel (BioFire Diagnostics, Salt Lake City, UT) is employed in medical centers for the establishment of a central nervous system (CNS) infection, and HHV-6 is often positive. However, establishing HHV-6 as a cause of meningitis or encephalitis is difficult at the present time, as a polymerase chain reaction (PCR) test alone does not establish the etiology of the CNS infection.

A Case of Pediatric Posterior Reversible Encephalopathy Syndrome (PRES) Secondary to Post-streptococcal Glomerulonephritis: A Literature Review and Assessment of Treatment Modalities.

Posterior reversible encephalopathy syndrome (PRES) is a disorder that most commonly affects adults, and is characterized by neurologic symptoms such as encephalopathy, seizures, headaches, and visual disturbances. It usually occurs in the context of other systemic disturbances that result in hypertensive crises, such as renal failure, cytotoxic drugs, and autoimmune conditions. In children, it rarely manifests following chemotherapy induction or hematopoietic stem cell transplantation.

Methicillin-Resistant Staphylococcus aureus Spinal Epidural Abscess: Local and Systemic Case Management.

Spinal epidural abscess (SEA) is a rare condition with complex pathophysiology and highly variable clinical presentation. While it is known to cause focal peripheral nerve symptoms such as muscle weakness, paresthesia, or pain, these are typically accompanied by complaints of back or spine pain and systemic symptoms indicative of infection. In our case, a 53-year-old male initially presented with unilateral pain and swelling in his right hand, with no fever at presentation and no complaints of back pain.

Thoracic spinal extradural arachnoid cyst: A case report and literature review.

Background: Spinal extradural arachnoid cysts (SEDACs) are rare and are variously attributed to congenital, traumatic, or inflammatory etiologies. Here, we report a 70-year-old male who presented with a T11-T12 SEDAC and an incidental craniovertebral junction (CVJ) meningioma.

Case Description: A 70-year-old male presented with progressive bilateral lower limb weakness and paresthesias.

Evaluating the Optimal Management of Inoperable Giant Cell Tumors of the Spine: A Systematic Review and Meta-Analysis.

Background: Surgical resection remains the preferred treatment in spine giant cell tumors (SGCTs), but it is not always feasible. Conservative strategies have been studied for inoperable cases. We systematically reviewed the literature on inoperable SGCTs treated with denosumab, radiotherapy or selective arterial embolization (SAE).

Leptomeningeal Metastases of the Spine: A Systematic Review.

Background/aim: Leptomeningeal metastases (LMs) of the spine have complex management. We reviewed the literature on spine LMs.

Materials And Methods: PubMed, EMBASE, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA guidelines to include studies of spine LMs.