Lumbar Drain Infection Rates: A Comprehensive Risk Factor Analysis From a Multicenter Retrospective Study of 1000+ Cases.

Background And Objectives: Lumbar drain (LD) insertion is a common cerebrospinal fluid (CSF) diversion method in neurosurgery; however, infection remains a major complication with significant morbidity. We evaluated the incidence, etiology, and associated risk factors of LD infection across 4 neurosurgical units over 15 years.

Methods: This retrospective multicenter cohort study included all adults requiring a LD between January 2009 and February 2024.

Evolution of Spinal Cord Swelling in Acute Traumatic Spinal Cord Injury.

We hypothesized that the Monro-Kellie doctrine, a key principle in traumatic brain injury (TBI), also applies in traumatic spinal cord injury (TSCI). By analyzing 9986 h of intraspinal pressure (ISP) monitoring data from 79 TSCI patients, we show that concepts developed to quantify compensatory reserve in TBI may be analogously defined in TSCI, termed ISP pulse amplitude (sAMP), spinal compensatory reserve index (sRAP), and ISP waveform shape. As ISP increases beyond 15 mmHg, compensatory reserve becomes impaired (sAMP rises and sRAP becomes positive).

Spinal cord perfusion pressure correlates with breathing function in patients with acute, cervical traumatic spinal cord injuries: an observational study.

Objective: This study aims to determine the relationship between spinal cord perfusion pressure (SCPP) and breathing function in patients with acute cervical traumatic spinal cord injuries.

Methods: We included 8 participants without cervical TSCI plus 13 patients with cervical traumatic spinal cord injuries, American Spinal Injury Association Impairment Scale grades A-C. In the TSCI patients, we monitored intraspinal pressure from the injury site for up to a week and computed the SCPP as mean arterial pressure minus intraspinal pressure.

Duroplasty for injured cervical spinal cord with uncontrolled swelling: protocol of the DISCUS randomized controlled trial.

Background: Cervical traumatic spinal cord injury is a devastating condition. Current management (bony decompression) may be inadequate as after acute severe TSCI, the swollen spinal cord may become compressed against the surrounding tough membrane, the dura. DISCUS will test the hypothesis that, after acute, severe traumatic cervical spinal cord injury, the addition of dural decompression to bony decompression improves muscle strength in the limbs at 6 months, compared with bony decompression alone.

Adverse Effect of Neurogenic, Infective, and Inflammatory Fever on Acutely Injured Human Spinal Cord.

This study aims to determine the effect of neurogenic, inflammatory, and infective fevers on acutely injured human spinal cord. In 86 patients with acute, severe traumatic spinal cord injuries (TSCIs; American Spinal Injury Association Impairment Scale (AIS), grades A-C) we monitored (starting within 72 h of injury, for up to 1 week) axillary temperature as well as injury site cord pressure, microdialysis (MD), and oxygen. High fever (temperature ≥38°C) was classified as neurogenic, infective, or inflammatory.

Fat in the Fossa and the Sphenoid Sinus: A Simple and Effective Solution to CSF Leaks in Transsphenoidal Surgery. Cohort Study and Systematic Review.

 Cerebrospinal fluid (CSF) leak following endoscopic transsphenoidal surgery (TSS) remains a challenge and is associated with high morbidity. We perform a primary repair with f at in the pituitary f ossa and further fat in the s phenoid sinus (FFS). We compare the efficacy of this FFS technique with other repair methods and perform a systematic review.

Removal or retention of minimally invasive screws in thoracolumbar fractures? Systematic review and case-control study.

Background: There is uncertainty regarding delayed removal versus retention of minimally invasive screws following percutaneous fixation for thoracolumbar fractures. We conducted a systematic review and case-control study to test the hypothesis that delayed metalwork removal following percutaneous fixation for thoracolumbar fractures improves outcome.

Methods: A systematic review was performed in accordance with the PRISMA guidelines.

Spinal myxomas: review of a rare entity.

Intramuscular myxomas are rare, benign mesenchymal tumours, occurring predominantly in large skeletal muscles as large, slow-growing and painless masses. Spinal occurrence is rare, and may present incidentally, or diagnosed via localized symptoms secondary to local infiltration of surrounding structures. Differential diagnosis based on imaging includes sarcomas, meningiomas and lipomas.

Monitoring Spinal Cord Tissue Oxygen in Patients With Acute, Severe Traumatic Spinal Cord Injuries.

Objectives: To determine the feasibility of monitoring tissue oxygen tension from the injury site (pscto2) in patients with acute, severe traumatic spinal cord injuries.

Design: We inserted at the injury site a pressure probe, a microdialysis catheter, and an oxygen electrode to monitor for up to a week intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), tissue glucose, lactate/pyruvate ratio (LPR), and pscto2. We analyzed 2,213 hours of such data.

Recurrent terminal ventricle cyst: a case report.

The terminal ventricle (TV) of Krause is a rare cystic dilation of the conus' central canal. Due to limited understanding surrounding its pathophysiology, optimal management remains controversial. We report a 25-year-old female presenting with acute paraparesis.

Low-Grade Glioma Case Series: Lessons Learned from an Evolving 10-Year Single-Institution Multidisciplinary Team Practice.

Background: Low-grade gliomas are a heterogeneous group with significant changes in their management during the last decade.

Objective: To assess how our multidisciplinary team approach to the management of low-grade glioma has evolved over the past 10 years and its implications for outcomes.

Methods: Retrospective single-center cohort study of adult patients with a pathologically confirmed diagnosis of World Health Organization grade II glioma between 2009 and 2018.

Systematic Review Comparing Open versus Endoscopic Surgery in Clival Chordomas and a 10-Year Single-Center Experience.

 Chordomas are rare, slow-growing, and osteo-destructive tumors of the primitive notochord. There is still contention in the literature as to the optimal management of chordoma. We conducted a systematic review of the surgical management of chordoma along with our 10-year institutional experience.

Spinal Cord Compression Caused by Fibroblastic Reticular Cell Tumor (FRCT) Originating from Thoracic Spine.

Background: The authors present the first reported case of a fibroblastic reticular cell tumor (FRCT) presenting with spinal cord compression. FRCTs are the rarest subset of dendritic cell tumors, a specific group of hematologic malignancies. FRCTs reportedly behave similar to low-grade sarcomas as opposed to malignant tumors.

Is There a Difference in Hospital Stay between Patients undergoing Translabyrinthine or Retrosigmoid Surgery for Vestibular Schwannoma Stratified by Tumor Size?

 To date, no European study has compared approach-specific outcome data in vestibular schwannoma (VS) surgery stratified by tumor size. We analyzed hospital length of stay (LOS), intensive therapy/high-dependency unit (ITU/HDU) LOS, and complications in patients undergoing VS surgery via the translabyrinthine (TL) versus retrosigmoid (RS) approaches, stratifying for tumor size.  Prospective database undergoing retrospective review.

Drug-induced paraspinal myositis mimicking acute bilateral sciatica.

Although cocaine induced myopathy and myotoxicity are described in the literature, we report a rare case of cocaine induced paraspinal myositis presenting with acute sciatic symptoms. A 35-year-old man presented with acute left-sided sciatica and was discharged from the emergency department (ED). He subsequently attended ED the following day in severe pain and bilateral sciatic symptoms, but denied symptoms of neurogenic bowel/bladder disturbance.

Subclinical meningoventriculitis as a cause of obstructive hydrocephalus.

Communicating hydrocephalus may complicate infantile bacterial meningitis, typically presenting with systemic features of infection. We report a rare case of 'subclinical meningoventriculitis' causing obstructive hydrocephalus and its challenging management. A healthy 10-week-old immunocompetent male patient presented with failure to thrive and vomiting, secondary to presumed gastro-oesophageal reflux.

Joseph Buford Pennybacker, C.B.E., M.D., F.R.C.S. (1907-1983): Continuing Sir Hugh Cairns' Oxford Legacy and Pioneer of the Modern Management of Cerebral Abscesses.

The authors examine the life and contribution of Joseph Buford Pennybacker to British neurosurgery and the modern management of cerebral abscesses. Pennybacker's inspirational journey began with him aspiring to follow in the footsteps of the pioneering surgeon, Ephraim McDowell. It saw him cross the Atlantic, learn medicine at Edinburgh, train in neurology at Queen Square in London, and study neurosurgery under Sir Hugh Cairns in Oxford.

Trigeminal neuralgia in a paediatric patient caused by arachnoid cyst.

Trigeminal neuralgia (TGN) in the paediatric population is seldom reported and often not considered in the differential diagnosis of paediatric craniofacial pain. Even less common are cerebellopontine angle (CPA) lesions causing TGN in paediatric patients. To the best of our knowledge, this is the first report of a CPA arachnoid cyst causing TGN in a paediatric case.