microsurgical-creation-giant-bifurcation-aneurysms-rabbits-for

Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices

Giant aneurysms are dangerous lesions requiring endovascular treatment, with high rates of aneurysm recanalization and re-rupture. Reliable in vivo models ...

Karl Landsteiner University of Health Sciences

University Hospital St. Pölten

Incomplete neurosurgical resection of brain metastases (BM) due to insufficient intraoperative visualization of tumor tissue is a major clinical challenge and might result in local recurrence. Recently, visible 5-aminolevulinic acid (5-ALA) induced fluorescence was first reported in patients with BM. The aim of this study was thus to investigate, for the first time systematically, the value of 5-ALA fluorescence for intraoperative visualization of BM in a large patient cohort.

Detailed analysis of 5-aminolevulinic acid induced fluorescence in different brain metastases at two specialized neurosurgical centers: experience in 157 cases.

Bone infiltration of the tumour is common in meningioma surgery. This may also affect patients without indicative signs of bone infiltration on preoperative imaging. Unrecognized bone invasion may lead to higher recurrence rates. 5-ALA fluorescence-guided resection (5-ALA-fg) could be a promising tool to help recognize possible bone invasion and/or tumour remnants. However, there is still little data about 5-ALA-fg resection in bone and soft tissue infiltrating meningiomas.

Fluorescence-guided resection in bone and soft tissue infiltrating meningiomas.

Corticosteroid therapy (CST) prior to biopsy may hinder histopathological diagnosis in primary central nervous system lymphoma (PCNSL). Therefore, preoperative CST in patients with suspected PCNSL should be avoided if clinically possible. The aim of this study was thus to analyze the difference in the rate of diagnostic surgeries in PCNSL patients with and without preoperative CST.

Influence of preoperative corticosteroid treatment on rate of diagnostic surgeries in primary central nervous system lymphoma: a multicenter retrospective study.

An incidental dural tear is a well-known complication during spine surgery. A rare consequence is a postoperative nerve root herniation. The purpose of this report is to describe a case of such a herniation with entrapment in the facet gap joint and to present the first MR images of this rare surgical complication.

Nerve root herniation with entrapment in the facet joint gap after lumbar decompression surgery: a case presentation.

Atypical and anaplastic meningiomas account for 20% of all meningiomas. An irregular tumor shape on preoperative MRI has been associated with WHO grade II-III histology. However, this subjective allocation does not allow quantification or comparison. An objective parameter of irregularity could substantially influence resection strategy toward a more aggressive approach. Therefore, the aim of this study was to objectively quantify the level of irregularity on preoperative MRI and predict histology based on WHO grade using this novel approach.

The meningioma surface factor: a novel approach to quantify shape irregularity on preoperative imaging and its correlation with WHO grade.

Spontaneous spinal epidural hematoma (SSEDH) is a rare condition with potentially devastating consequences. Known prognostic factors are short time to surgery, preoperative neurologic condition, and age. The aim of this study was to investigate the impact of the transversal hematoma extent with its subsequent spinal canal obliteration on outcome in patients with SSEDH.

Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study.

The clinical impact of 5-aminolevulinic acid (5-ALA) fluorescence during resection of brain metastases is not yet clear.. Recent data demonstrated significantly lower incidence of visible fluorescence in cerebral melanoma metastases (CMM) compared to other brain metastases (BM). The aim of this study was to investigate if characteristic melanoma features such as pigmentation, intratumoural hemosiderin and bleeding have an influence on visible fluorescence in CMM.

Does pigmentation, hemosiderin and blood effect visible 5-ALA fluorescence in cerebral melanoma metastasis?

Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients.

An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients.

In seizure-naive brain tumor patients, the efficacy of perioperative prophylactic antiepileptic drug treatment remains controversial. In case of administration, the common preferred drug is levetiracetam (LEV) because of its favorable pharmacological profile. Research to date has not sufficiently determined how LEV affects cognition in the short term, as is the case in the perioperative period. The objective of this prospective study was to examine the neurocognitive functioning of seizure-naive brain tumor patients after receiving LEV perioperatively.

Perioperative levetiracetam for seizure prophylaxis in seizure-naive brain tumor patients with focus on neurocognitive functioning.

Penetrating brain injury (PBI) is a heterogeneous condition with many variables. Few data exist on civilian PBI. In some publications, PBI differentiation between low-velocity injury (LVI) and high-velocity injury (HVI) is made, but exact definitions are not given yet. The incidence of PBI depends heavily on the country of origin. Furthermore, captive bolt pistol (CBP) injuries represent a rare type of LVI and almost no reports exist in the human medical literature. Treatment of PBI has been controversially discussed due to high morbidity and mortality with results varying considerably between series. Prognostic factors are of utmost importance to identify patients who presumably benefit from treatment.

Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria.

Epidural hematomas (EDH) occur in up to 8.2% of all traumatic brain injury patients, with more than half needing surgical treatment. In most patients suffering from this perilous disease, good recovery with an excellent clinical course is possible. However, the clinical course is mainly dependent on the presence of additional intracerebral injuries. Few studies comparing isolated and combined EDH in detail exist.

The importance of additional intracranial injuries in epidural hematomas: detailed clinical analysis, long-term outcome, and literature review in surgically managed epidural hematomas.

Article	Year
Detailed analysis of 5-aminolevulinic acid induced fluorescence in different brain metastases at two specialized neurosurgical centers: experience in 157 cases. Journal of neurosurgery\| PubMed ID: 31561223	2019
Fluorescence-guided resection in bone and soft tissue infiltrating meningiomas. Acta neurochirurgica\| PubMed ID: 31873793	2020
Influence of preoperative corticosteroid treatment on rate of diagnostic surgeries in primary central nervous system lymphoma: a multicenter retrospective study. BMC cancer\| PubMed ID: 34187419	2021
Nerve root herniation with entrapment in the facet joint gap after lumbar decompression surgery: a case presentation. BMC musculoskeletal disorders\| PubMed ID: 34452602	2021
The meningioma surface factor: a novel approach to quantify shape irregularity on preoperative imaging and its correlation with WHO grade. Journal of neurosurgery\| PubMed ID: 34624861	2022
Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study. Acta neurochirurgica\| PubMed ID: 34633546	2021
Does pigmentation, hemosiderin and blood effect visible 5-ALA fluorescence in cerebral melanoma metastasis? Photodiagnosis and photodynamic therapy\| PubMed ID: 35430323	2022
An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients. Frontiers in oncology\| PubMed ID: 35515113	2022
Perioperative levetiracetam for seizure prophylaxis in seizure-naive brain tumor patients with focus on neurocognitive functioning. BMC neurology\| PubMed ID: 35804291	2022
Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria. Frontiers in surgery\| PubMed ID: 35836601	2022
The importance of additional intracranial injuries in epidural hematomas: detailed clinical analysis, long-term outcome, and literature review in surgically managed epidural hematomas. Frontiers in surgery\| PubMed ID: 37592941	2023

Florian Scheichel

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