Intramedullary schwannomas are a rare form of spinal tumors. Here, we present a case of a 61-year-old woman who was admitted to our hospital with complaints of weakness in both lower extremities, numbness, urinary and defecation disorders, and radiculating back pain. Physical examination revealed sensory and motoric deficits in the lower extremities, as well as autonomical dysfunctions. Radiological imaging revealed a mass at the lower level of thoracic spinal segment, which was confirmed as a schwannoma through histopathological analysis. The patient underwent laminectomy tumor removal and posterior stabilization. She was also diagnosed with type 2 diabetes mellitus and hypertension. Spinal intramedullary schwannoma is a rare condition that requires a thorough history and physical examination for diagnosis, particularly for patients with neurological impairments. Prompt treatment is essential once the diagnosis is made.
{"title":"Lower Thoracic Spinal Myeloradiculopathy with Intramedullary Schwannoma in an Elderly Woman: A Rare Case Report","authors":"Muhammad Reyhan Syawal","doi":"10.31579/2578-8868/268","DOIUrl":"https://doi.org/10.31579/2578-8868/268","url":null,"abstract":"Intramedullary schwannomas are a rare form of spinal tumors. Here, we present a case of a 61-year-old woman who was admitted to our hospital with complaints of weakness in both lower extremities, numbness, urinary and defecation disorders, and radiculating back pain. Physical examination revealed sensory and motoric deficits in the lower extremities, as well as autonomical dysfunctions. Radiological imaging revealed a mass at the lower level of thoracic spinal segment, which was confirmed as a schwannoma through histopathological analysis. The patient underwent laminectomy tumor removal and posterior stabilization. She was also diagnosed with type 2 diabetes mellitus and hypertension. Spinal intramedullary schwannoma is a rare condition that requires a thorough history and physical examination for diagnosis, particularly for patients with neurological impairments. Prompt treatment is essential once the diagnosis is made.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135991890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Endoscopic third ventriculostomy (ETV) has been established as a viable treatment option for obstructive hydrocephalus of children over 8 weeks of age. ETV in pediatric groups may be unsuccessful due to the failure of redirection of cerebrospinal fluid (CSF) flow, re-closure of ventriculostomy opening or due to infection. The exact cause is still debatable. Some issues like failure to eliminate the second membrane during the procedure or formation of the new arachnoid membrane at the stoma are still not clear. This study aims to assess the surgical failure of ETV and its predisposing factors.Methods: Thirty-two pediatric patients with hydrocephalus were analyzed retrospectively to assess efficacy of endoscopic third ventriculostomy in children. The patients’ age limit was between 6 months and 12 years. This is a retrospective study of 32 patients in Fayoum University Hospital in the period between May 2017 and December 2020. Patients having hydrocephalus in pediatric groups more than 8 weeks of age were included in the study.Results: The mean age of all patients was 24 months and the mean follow-up period was six months. Of 32 ETVs, the success rate was 78% in 25 patients and the failure rate was 22% in 7 patients. The study included 24 males (75 %) and 8 females (25%) with a male to female ratio (3:1). Clinical presentations varied from enlarged head (macrocrania), dilated scalp veins, repeated vomiting and poor ocular fixation and following. Complications were divided into failure of procedure, infection, CSF leak and re-exploration.Conclusions: Endoscopic ventriculocisternostomy remains an effective surgical technique in the treatment of obstructive hydrocephalus. It is linked to a very low rate of permanent morbidity and avoids ventriculo- peritoneal shunt-related morbidity and long life shunt dependence. But we should take in consideration good selection of indicated cases especially in pediatric groub.
{"title":"Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus in Children; Challenges and Clinical Outcomes","authors":"Ahmed Hosameldin","doi":"10.31579/2578-8868/274","DOIUrl":"https://doi.org/10.31579/2578-8868/274","url":null,"abstract":"Background: Endoscopic third ventriculostomy (ETV) has been established as a viable treatment option for obstructive hydrocephalus of children over 8 weeks of age. ETV in pediatric groups may be unsuccessful due to the failure of redirection of cerebrospinal fluid (CSF) flow, re-closure of ventriculostomy opening or due to infection. The exact cause is still debatable. Some issues like failure to eliminate the second membrane during the procedure or formation of the new arachnoid membrane at the stoma are still not clear. This study aims to assess the surgical failure of ETV and its predisposing factors.Methods: Thirty-two pediatric patients with hydrocephalus were analyzed retrospectively to assess efficacy of endoscopic third ventriculostomy in children. The patients’ age limit was between 6 months and 12 years. This is a retrospective study of 32 patients in Fayoum University Hospital in the period between May 2017 and December 2020. Patients having hydrocephalus in pediatric groups more than 8 weeks of age were included in the study.Results: The mean age of all patients was 24 months and the mean follow-up period was six months. Of 32 ETVs, the success rate was 78% in 25 patients and the failure rate was 22% in 7 patients. The study included 24 males (75 %) and 8 females (25%) with a male to female ratio (3:1). Clinical presentations varied from enlarged head (macrocrania), dilated scalp veins, repeated vomiting and poor ocular fixation and following. Complications were divided into failure of procedure, infection, CSF leak and re-exploration.Conclusions: Endoscopic ventriculocisternostomy remains an effective surgical technique in the treatment of obstructive hydrocephalus. It is linked to a very low rate of permanent morbidity and avoids ventriculo- peritoneal shunt-related morbidity and long life shunt dependence. But we should take in consideration good selection of indicated cases especially in pediatric groub.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135992202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines the impact of kindergarten children's dietary preferences on their cognitive performance and social relationships, with a focus on traditional foods versus processed foods. The research demonstrates that a child's choice of breakfast can significantly affect their cognitive abilities, including memory and concentration, as well as their interpersonal relationships. Traditional foods like salads and olive oil are found to increase cognitive abilities, while processed foods like hot dogs and chocolate sandwiches can be detrimental to academic performance and social behavior. The study utilized puzzle games and card games to evaluate cognitive abilities and found that a processed diet can lead to decreased focus, hyperactivity, and impaired social relationships. QEEG analysis contributes to the existing body of evidence indicating that a traditional diet can enhance academic performance. The study highlights the importance of educating parents about the advantages of a traditional diet and encourages them to prepare breakfast together with their children using traditional foods like olive oil and salad to enhance academic performance and social relationships. The findings offer valuable insights into the importance of a traditional diet for young children's education and highlight the need for greater attention to be given to diet as an important factor in children's academic success.
{"title":"The Effect of Dietary Preferences on Academic Performance Among Kindergarten-Aged Children","authors":"Raed Mualem","doi":"10.31579/2578-8868/277","DOIUrl":"https://doi.org/10.31579/2578-8868/277","url":null,"abstract":"This study examines the impact of kindergarten children's dietary preferences on their cognitive performance and social relationships, with a focus on traditional foods versus processed foods. The research demonstrates that a child's choice of breakfast can significantly affect their cognitive abilities, including memory and concentration, as well as their interpersonal relationships. Traditional foods like salads and olive oil are found to increase cognitive abilities, while processed foods like hot dogs and chocolate sandwiches can be detrimental to academic performance and social behavior. The study utilized puzzle games and card games to evaluate cognitive abilities and found that a processed diet can lead to decreased focus, hyperactivity, and impaired social relationships. QEEG analysis contributes to the existing body of evidence indicating that a traditional diet can enhance academic performance. The study highlights the importance of educating parents about the advantages of a traditional diet and encourages them to prepare breakfast together with their children using traditional foods like olive oil and salad to enhance academic performance and social relationships. The findings offer valuable insights into the importance of a traditional diet for young children's education and highlight the need for greater attention to be given to diet as an important factor in children's academic success.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135992201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sickle cell disease is one of the most common hemoglobinopathy worldwide. It is an autosomal recessive genetic disorder caused by replacement of adenine to thymine nucleotide in the beta chain of hemoglobin results in replacement of valine for glutamic acid at 6th position. This substitution results in formation of sickle hemoglobin (HbS) which in turn leads to a reduced lifespan of red blood cells (RBC). In hypoxic conditions, HbS has a tendency to aggregate and form fibrillar structure called tactoid within the red cells
{"title":"Endothelial Dysfunction in Adult Patients of Sickle Cell Disease","authors":"E Khandelwal","doi":"10.31579/2578-8868/272","DOIUrl":"https://doi.org/10.31579/2578-8868/272","url":null,"abstract":"Sickle cell disease is one of the most common hemoglobinopathy worldwide. It is an autosomal recessive genetic disorder caused by replacement of adenine to thymine nucleotide in the beta chain of hemoglobin results in replacement of valine for glutamic acid at 6th position. This substitution results in formation of sickle hemoglobin (HbS) which in turn leads to a reduced lifespan of red blood cells (RBC). In hypoxic conditions, HbS has a tendency to aggregate and form fibrillar structure called tactoid within the red cells","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135991582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peripheral sensory stimulation (PSS) represents a new area of therapy for patients with neurological disorders. Grounded in strong basic science research, PSS carries potential promise in the management of multiple diseases. We reviewed the literature regarding those conditions that represent reasonable targets for treatment with PSS including stroke, Parkinson’s disease, traumatic brain injury, and auto-immune, inflammatory illness. Potential mechanisms of action are discussed, and future avenues of investigation are described.
{"title":"Peripheral Sensory Stimulation for Neurological Disorders. A Novel, Non-invasive Therapeutic Option. Review Article","authors":"Eric S. Nussbaum","doi":"10.31579/2578-8868/267","DOIUrl":"https://doi.org/10.31579/2578-8868/267","url":null,"abstract":"Peripheral sensory stimulation (PSS) represents a new area of therapy for patients with neurological disorders. Grounded in strong basic science research, PSS carries potential promise in the management of multiple diseases. We reviewed the literature regarding those conditions that represent reasonable targets for treatment with PSS including stroke, Parkinson’s disease, traumatic brain injury, and auto-immune, inflammatory illness. Potential mechanisms of action are discussed, and future avenues of investigation are described.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135991892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We have recently demonstrated significant general cognitive recovery with delayed improvement of working memory 10 years after stroke in a unique longitudinal cohort.Aim: This study investigated demographic and clinical characteristics relevant to improved cognitive functions 10-year after a first-ever stroke. Materials and Methods: A prospective longitudinal cohort study was carried out in 38 middle-aged (mean age =54 at stroke onset) stroke survivors. Cognition was assessed thrice at one week, seven months, and ten years after the stroke. Working memory and visuospatial function were assessed with the Digit Span and Block Design subtests, respectively. General cognition was evaluated with the Mini-Mental State Examination at the two later time points. Multivariate linear regression was used to identify the variables that may significantly predict improved cognitive functions at 10-year follow-up. Results: We found that having a full-time job prior to the stroke, suffering an ischemic (as opposed to a hemorrhagic) stroke, and having a university education predicted significantly superior general cognitive function 10 years after stroke (R2 of 0.77, p <0.001), while working memory and visuospatial function at 1 week after stroke significantly predicted their respective functions at 10-year follow-up (R2 of 0.41, p = 0.003). Conclusions: Our results indicate that premorbid employment status and higher education as well as having suffered from an ischemic rather than a hemorrhagic stroke might predict superior cognitive recovery among middle-aged individuals 10 years after stroke.
{"title":"Premorbid Employment and Education as Predictors of Recovery in General Cognition ten Years After Stroke Onset - A Longitudinal Cohort Study","authors":"Xiaolei Hu","doi":"10.31579/2578-8868/260","DOIUrl":"https://doi.org/10.31579/2578-8868/260","url":null,"abstract":"Background: We have recently demonstrated significant general cognitive recovery with delayed improvement of working memory 10 years after stroke in a unique longitudinal cohort.Aim: This study investigated demographic and clinical characteristics relevant to improved cognitive functions 10-year after a first-ever stroke. Materials and Methods: A prospective longitudinal cohort study was carried out in 38 middle-aged (mean age =54 at stroke onset) stroke survivors. Cognition was assessed thrice at one week, seven months, and ten years after the stroke. Working memory and visuospatial function were assessed with the Digit Span and Block Design subtests, respectively. General cognition was evaluated with the Mini-Mental State Examination at the two later time points. Multivariate linear regression was used to identify the variables that may significantly predict improved cognitive functions at 10-year follow-up. Results: We found that having a full-time job prior to the stroke, suffering an ischemic (as opposed to a hemorrhagic) stroke, and having a university education predicted significantly superior general cognitive function 10 years after stroke (R2 of 0.77, p <0.001), while working memory and visuospatial function at 1 week after stroke significantly predicted their respective functions at 10-year follow-up (R2 of 0.41, p = 0.003). Conclusions: Our results indicate that premorbid employment status and higher education as well as having suffered from an ischemic rather than a hemorrhagic stroke might predict superior cognitive recovery among middle-aged individuals 10 years after stroke.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"669 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136267793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A comparative analysis of combination therapy regimens was carried out in patients with paranoid schizophrenia with NSAA and identified signs of resistance to ongoing neuroleptic monotherapy. In total, in the period from 2015 to 2022, 155 patients with paranoid schizophrenia with NSAA were studied as part of a multicenter randomized longitudinal study. It has been established that the first-line therapy regimen in this group of patients is a combined regimen of clozapine with haloperidol.Introduction. The increase in the number of therapeutically resistant patients with paranoid schizophrenia with auto aggression remains one of the most pressing problems in psychiatry remains as the most common nosological unit [1,2,3]. At the same time, a large amount of research material has been accumulated on the factors and conditions that affect the formation of the state of resistance in such patients [4,5,6,7]. First of all, these include: a debut at an early age, an "erased" beginning, a continuous course, the dominance of negative symptoms in the structure of the pathological process, and the fading of the affective component. A special place among the clinical predictors of therapeutic resistance is occupied by psychopathic disorders with auto aggressive tendencies, traditionally considered within the framework of heboid states. At the same time, until recently, the main drug from the group of neuroleptics used to overcome resistance was clozapine [8,9,10,11,12,13]. In practice, up to 30% of patients remain intact to its action, which dictates the need for combination therapy [14,15,16]. This predetermines the search for new schemes for the use of medicinal drugs to solve this problem.
{"title":"Comparative Analysis of Combination Therapy Regimens in Patients with Paranoid Schizophrenia with Non-Suicidal Auto aggression and Identified Signs of Resistance to Ongoing Neuroleptic Monotherapy","authors":"Kravchenko I.V.","doi":"10.31579/2578-8868/273","DOIUrl":"https://doi.org/10.31579/2578-8868/273","url":null,"abstract":"A comparative analysis of combination therapy regimens was carried out in patients with paranoid schizophrenia with NSAA and identified signs of resistance to ongoing neuroleptic monotherapy. In total, in the period from 2015 to 2022, 155 patients with paranoid schizophrenia with NSAA were studied as part of a multicenter randomized longitudinal study. It has been established that the first-line therapy regimen in this group of patients is a combined regimen of clozapine with haloperidol.Introduction. The increase in the number of therapeutically resistant patients with paranoid schizophrenia with auto aggression remains one of the most pressing problems in psychiatry remains as the most common nosological unit [1,2,3]. At the same time, a large amount of research material has been accumulated on the factors and conditions that affect the formation of the state of resistance in such patients [4,5,6,7]. First of all, these include: a debut at an early age, an \"erased\" beginning, a continuous course, the dominance of negative symptoms in the structure of the pathological process, and the fading of the affective component. A special place among the clinical predictors of therapeutic resistance is occupied by psychopathic disorders with auto aggressive tendencies, traditionally considered within the framework of heboid states. At the same time, until recently, the main drug from the group of neuroleptics used to overcome resistance was clozapine [8,9,10,11,12,13]. In practice, up to 30% of patients remain intact to its action, which dictates the need for combination therapy [14,15,16]. This predetermines the search for new schemes for the use of medicinal drugs to solve this problem.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136267794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Impressive intellect and extrovert nature exhibited by the child spring from both, the supremacy of protective factors during nine months of the gestation period and the favorable genes of the parents. There is no approved allopathic, homeopathic, or ayurvedic medicine for the treatment of autism spectrum disorder or any neurodevelopmental childhood disease for that matter. The challenges faced by the lady during pregnancy and the delivery of the child, therefore need to be delicately addressed so that the birth of an abnormal child does not occur in the first place. The intellectual and physical personality of the unborn child is dependent on the sound health of the pregnant lady during gestation, proper nutrition, and a loving home environment. Thus, the prevention of the birth of an autistic child is the only reasonable option available at present and appears to be simpler than its cure. We believe that the society at large in India and around the world would greatly benefit from this review article.
{"title":"The Prevention of the Birth of an Autistic Child is Simpler than its Cure","authors":"Milind Parle","doi":"10.31579/2578-8868/262","DOIUrl":"https://doi.org/10.31579/2578-8868/262","url":null,"abstract":"Impressive intellect and extrovert nature exhibited by the child spring from both, the supremacy of protective factors during nine months of the gestation period and the favorable genes of the parents. There is no approved allopathic, homeopathic, or ayurvedic medicine for the treatment of autism spectrum disorder or any neurodevelopmental childhood disease for that matter. The challenges faced by the lady during pregnancy and the delivery of the child, therefore need to be delicately addressed so that the birth of an abnormal child does not occur in the first place. The intellectual and physical personality of the unborn child is dependent on the sound health of the pregnant lady during gestation, proper nutrition, and a loving home environment. Thus, the prevention of the birth of an autistic child is the only reasonable option available at present and appears to be simpler than its cure. We believe that the society at large in India and around the world would greatly benefit from this review article.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136267791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Glomus jugulare tumors (GJTs) are benign, slowly growing tumors, highly vascular, with the potential to infiltrate neurovascular structures. Surgical treatment is usually associated with high morbidity and even death. Gamma Knife radiosurgery (GKRS) has been established as an effective treatment option. This retrospective study aims to report and confirm GKRS.'s long-term effectiveness and safety for GJT patients. Methods: A total of 65 patients with GJTs were treated with GKRS, at the authors' center from 2005 to 2020, with a mean follow-up period of 87.7 months. The mean treated GJT volume was 5.4cc with a median prescription dose of 15Gy and a median maximum dose of 42.9Gy. Results: Most patients were females (77%), and the median age at presentation was 48 years. The overall tumor growth control was 93.8% (61 patients) 39% of them achieved tumor size reduction. The overall clinical control was 90.8% (59 patients), and 40.7% achieved clinical improvement. The Actuarial tumor rate free of progression was 100% at 3 years, 91.5% at 5 years, and 86% at 10 years of follow-up. Conclusions: GKRS for GJTs typically results in high long-term tumor control and lower neurological morbidity than those associated with microsurgical resection, therefore should be consider as a dependable effective treatment option.
{"title":"Gamma Knife Radiosurgery as a Dependable, Effective Option for Glomus Jagulare Tumors: A Single Institution Long-Term Experience and Review of the Literature","authors":"Raef F.A. Hafez","doi":"10.31579/2578-8868/258","DOIUrl":"https://doi.org/10.31579/2578-8868/258","url":null,"abstract":"Objective: Glomus jugulare tumors (GJTs) are benign, slowly growing tumors, highly vascular, with the potential to infiltrate neurovascular structures. Surgical treatment is usually associated with high morbidity and even death. Gamma Knife radiosurgery (GKRS) has been established as an effective treatment option. This retrospective study aims to report and confirm GKRS.'s long-term effectiveness and safety for GJT patients. Methods: A total of 65 patients with GJTs were treated with GKRS, at the authors' center from 2005 to 2020, with a mean follow-up period of 87.7 months. The mean treated GJT volume was 5.4cc with a median prescription dose of 15Gy and a median maximum dose of 42.9Gy. Results: Most patients were females (77%), and the median age at presentation was 48 years. The overall tumor growth control was 93.8% (61 patients) 39% of them achieved tumor size reduction. The overall clinical control was 90.8% (59 patients), and 40.7% achieved clinical improvement. The Actuarial tumor rate free of progression was 100% at 3 years, 91.5% at 5 years, and 86% at 10 years of follow-up. Conclusions: GKRS for GJTs typically results in high long-term tumor control and lower neurological morbidity than those associated with microsurgical resection, therefore should be consider as a dependable effective treatment option.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136267795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Transfemoral access is the route of choice for endovascular treatment. However, anatomic variants may be an obstacle, leading to unfavorable outcomes due to difficulty in obtaining access and longer puncture-to-reperfusion times. Alternative routes should be considered in these cases. Objective: To report a case of thrombectomy performed via direct internal carotid artery puncture access. Report: An elderly patient presented with fluctuating neurological deficits (left-sided hemiparesis and dysarthria). Imaging showed ischemia in the right middle cerebral artery territory. The patient was referred for thrombectomy. Due to the tortuosity of the aortic arch, a radial approach was attempted, unsuccessfully. Direct internal carotid artery puncture was performed. The patient was discharged after 7 days with no deficits. Conclusions: Similar cases reported to date have used ultrasound-guided puncture of the common carotid artery. This route was not feasible in the present case, leading to direct puncture of the internal carotid artery. This high-risk maneuver was justified by the adverse clinical picture, and a successful outcome was achieved.
{"title":"Mechanical Thrombectomy Via Direct Internal Carotid Artery Puncture","authors":"Vinicius Moreira Lima","doi":"10.31579/2578-8868/265","DOIUrl":"https://doi.org/10.31579/2578-8868/265","url":null,"abstract":"Introduction: Transfemoral access is the route of choice for endovascular treatment. However, anatomic variants may be an obstacle, leading to unfavorable outcomes due to difficulty in obtaining access and longer puncture-to-reperfusion times. Alternative routes should be considered in these cases. Objective: To report a case of thrombectomy performed via direct internal carotid artery puncture access. Report: An elderly patient presented with fluctuating neurological deficits (left-sided hemiparesis and dysarthria). Imaging showed ischemia in the right middle cerebral artery territory. The patient was referred for thrombectomy. Due to the tortuosity of the aortic arch, a radial approach was attempted, unsuccessfully. Direct internal carotid artery puncture was performed. The patient was discharged after 7 days with no deficits. Conclusions: Similar cases reported to date have used ultrasound-guided puncture of the common carotid artery. This route was not feasible in the present case, leading to direct puncture of the internal carotid artery. This high-risk maneuver was justified by the adverse clinical picture, and a successful outcome was achieved.","PeriodicalId":73865,"journal":{"name":"Journal of neuroscience and neurological surgery","volume":"5 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136267792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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