Article
Clinical Neurology
James Mooney, Nicholas Erickson, Adeel Ilyas, Ethan Tabibian, Barton L. Guthrie
Summary: The majority of North American neurosurgeons prioritize clinical symptomatic presentation over imaging evidence of neurovascular compression when deciding to perform microvascular decompression for trigeminal neuralgia. High-volume surgeons tend to consider imaging findings of vascular compression more heavily in their decision-making process compared to low-volume surgeons.
WORLD NEUROSURGERY
(2021)
Article
Surgery
Juan Li, Min Zhou, Yuhai Wang, Sze Chai Kwok, Jia Yin
Summary: Neurapraxia using aneurysm clip is a safe and effective treatment option for patients with classic trigeminal neuralgia who do not have identifiable neurovascular conflict during microvascular decompression (MVD). It provides immediate pain relief and has a relatively low rate of recurrence.
Article
Clinical Neurology
Tobias Greve, Joerg-Christian Tonn, Jan-Hinnerk Mehrkens
Summary: Despite a higher prevalence of comorbidities in elderly patients, complication rates and neurological deficits after MVD were comparable to younger patients. Rates of immediate and long-term pain relief compared favorably to previous studies and were similar between elderly and younger patients.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Richard Loayza, Johan Wikstrom, Anna Grabowska, Robert Semnic, Hans Ericson, Sami Abu Hamdeh
Summary: This study aimed to investigate the outcome after microvascular decompression (MVD) surgery in trigeminal neuralgia (TN) patients and whether it is affected by neurovascular conflict (NVC) severity and sex. The results showed that the success rate of MVD was 80% in TN patients with severe NVC, and 56% in TN patients with mild NVC. No significant sex difference was observed in the outcome.
ACTA NEUROCHIRURGICA
(2023)
Article
Clinical Neurology
Raymond J. J. So, Anita L. L. Kalluri, Stanley Zhu, Joshua Materi, Sumil K. K. Nair, Michael Lim, Judy Huang, Chetan Bettegowda, Risheng Xu
Summary: The presence of multiple compressive vessels in trigeminal neuralgia (TN) patients is associated with higher pain scores preoperatively and an increased risk for pain recurrence after microvascular decompression (MVD), compared to patients with a single compressive vessel.
Article
Clinical Neurology
Yang Zhang, Dengbin Sun, Yunjie Xie, Rui Li, Hang Zhao, Zhaoping Wang, Lei Feng
Summary: This study aimed to explore the predictive value of preoperative MRI indices of the SpTV on the results of MVD in TN patients. Logistic regression analysis and ROC curves were used to identify independent risk factors and evaluate their predictive value. The results showed that RD of SpTV and NVC were associated with poor results after MVD surgery. Combining RD and NVC may achieve a relatively high predictive value for poor outcomes.
Article
Clinical Neurology
Silvia Baroni, Alessandro Rapisarda, Vanessa Gentili, Benedetta Burattini, Giacomo Moretti, Francesca Sarlo, Alessandro Izzo, Manuela D'Ercole, Alessandro Olivi, Andrea Urbani, Nicola Montano
Summary: This study measured the levels of neuron-specific enolase (NSE) in the serum and cerebrospinal fluid (CSF) of 20 patients undergoing microvascular decompression (MVD) and correlated these findings with the type of neurovascular conflict (NVC). Results showed that NSE levels were related to the etiopathology and severity of NVC. A significant reduction in serum NSE levels was associated with the resolution of NVC and clinical improvement in trigeminal neuralgia (TN).
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Risheng Xu, Sumil K. Nair, Joshua Materi, Divyaansh Raj, Giho Park, Ravi Medikonda, Safwan Alomari, Timothy Kim, Yuanxuan Xia, Judy Huang, Michael Lim, Chetan Bettegowda
Summary: Microvascular decompression (MVD) is an effective surgical intervention for severe facial pain, and discharging carefully selected patients within 1 day post-operation can lead to cost savings without compromising patient outcomes.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Risheng Xu, Sumil K. Nair, Joshua Materi, Divyaansh Raj, Giho Park, Ravi Medikonda, Safwan Alomari, Timothy Kim, Yuanxuan Xia, Judy Huang, Michael Lim, Chetan Bettegowda
Summary: This study examined the safety and cost-benefits of discharging patients with microvascular decompression (MVD) within 1 day of admission for severe facial pain. The results showed that discharging carefully selected patients within 1 day of admission was safe and resulted in reduced hospital admissions, complications, and total hospital costs.
WORLD NEUROSURGERY
(2022)
Article
Neurosciences
Grazia Menna, Alessandro Rapisarda, Alessandro Izzo, Manuela D'Ercole, Quintino Giorgio D'Alessandris, Alessandro Olivi, Nicola Montano
Summary: Microvascular decompression (MVD) is a safe and effective surgical procedure for elderly patients with trigeminal neuralgia (TN), with no significant differences in surgical outcomes compared to non-elderly patients.
Article
Clinical Neurology
Imran Noorani, Amanda Lodge, Andrew Durnford, Girish Vajramani, Owen Sparrow
Summary: The study found that MVD provides better initial pain relief and longer durability of relief compared to percutaneous surgery. Balloon compression offers the most durable pain relief among percutaneous procedures. Post-operative numbness and age are predictors of good outcome for percutaneous surgery.
ACTA NEUROCHIRURGICA
(2021)
Article
Clinical Neurology
Shaani Singhal, R. Andrew Danks
Summary: The study revealed significant discrepancies in diagnosing neurovascular conflict causing trigeminal neuralgia between neurosurgeons and radiologists, with neurosurgeons showing higher accuracy. Underreporting of the condition by radiologists on preoperative MRI scans was common, highlighting the importance of neurosurgeons in accurately diagnosing and treating trigeminal neuralgia.
WORLD NEUROSURGERY
(2022)
Review
Clinical Neurology
Liwu Jiao, Hao Ye, Jibo Lv, Yong Xie, Wei Sun, Guolin Ding, Simin Cui
Summary: This study analyzed literature regarding the feasibility of repeat MVD for recurrent or persistent trigeminal neuralgia. It found that the effective rate of repeat MVD was 91.66% with a postoperative complication rate of 37.31%, mainly related to postoperative adhesions around the nerve and nerve injury caused by partial sensory rhizotomy.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Chunran Zhu, Chengrong Jiang, Wu Xu, Jing Wang, Yulong Chong, Weibang Liang
Summary: This study aimed to investigate the causes and clinical outcomes of primary young onset trigeminal neuralgia (TN). The study retrospectively analyzed the clinical characteristics, surgical outcomes, and postoperative complications of 19 primary TN patients who underwent microvascular decompression (MVD) at Nanjing Drum Tower Hospital. The results showed that neurovascular compression, especially by the superior cerebellar artery, was the main cause of primary young onset TN. MVD was a safe and effective treatment for these patients.
NEUROSURGICAL REVIEW
(2023)
Article
Clinical Neurology
Changik Lee, Jin-gyu Choi, Byung-chul Son
Summary: This study aimed to estimate the morphological changes in the trigeminal nerve after microvascular decompression (MVD). Results showed that the trigeminal nerve cross-sectional area (CSA) increased significantly in patients with favorable outcomes after MVD, while there was no significant change in patients with unfavorable outcomes. Kaplan-Meier survival analysis demonstrated that an increase in trigeminal nerve CSA predicted favorable outcomes.
Article
Clinical Neurology
Emanuele La Corte, Morgan Broggi, Alberto Raggi, Silvia Schiavolin, Francesco Acerbi, Giovanni Danesi, Mariangela Farinotti, Giovanni Felisati, Alberto Maccari, Bianca Pollo, Marco Saini, Claudia Toppo, Francesca Valvo, Riccardo Ghidoni, Maria Grazia Bruzzone, Francesco DiMeco, Paolo Ferroli
Summary: Skull base chordomas are rare malignant tumors with few reliable markers for clinical decision making and survival prediction. This study identified preoperative clinical symptoms, surgical features, postoperative complications, KPS decline, and degree of MR contrast enhancement as significant prognostic factors. The authors also developed the Peri-Operative Chordoma Scale (POCS) as a personalized grading scale for potential adjuvant therapies in SBC patients.
ACTA NEUROCHIRURGICA
(2021)
Correction
Biochemistry & Molecular Biology
Francesca Luisa Sciacca, Ambra Rizzo, Gloria Bedini, Fioravante Capone, Vincenzo Di Lazzaro, Sara Nava, Francesco Acerbi, Davide Rossi Sebastiano, Simona Binelli, Giuseppe Farago, Andrea Gioppo, Marina Grisoli, Maria Grazia Bruzzone, Paolo Ferroli, Chiara Pantaleoni, Luigi Caputi, Jesus Vela Gomez, Eugenio Agostino Parati, Anna Bersano
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2020)
Letter
Oncology
Alessandro Perin, Franco Servadei, Francesco DiMeco
JOURNAL OF NEURO-ONCOLOGY
(2020)
Review
Clinical Neurology
Silvia Schiavolin, Alberto Raggi, Chiara Scaratti, Claudia Toppo, Fabiola Silvaggi, Davide Sattin, Morgan Broggi, Paolo Ferroli, Matilde Leonardi
Summary: The study reviewed data on preoperative nonmedical factors predictive of outcome in brain tumor surgery, finding that individual characteristics beyond clinical factors can influence postoperative course. This highlights the importance of considering socio-demographic, cognitive, and psychological factors in predicting surgical outcomes.
NEUROSURGICAL REVIEW
(2021)
Article
Clinical Neurology
Victor E. Staartjes, Morgan Broggi, Costanza Maria Zattra, Flavio Vasella, Julia Velz, Silvia Schiavolin, Carlo Serra, Jiri Bartek, Alexander Fletcher-Sandersjoo, Petter Forander, Darius Kalasauskas, Mirjam Renovanz, Florian Ringel, Konstantin R. Brawanski, Johannes Kerschbaumer, Christian F. Freyschlag, Asgeir S. Jakola, Kristin Sjavik, Ole Solheim, Bawarjan Schatlo, Alexandra Sachkova, Hans Christoph Bock, Abdelhalim Hussein, Veit Rohde, Marike L. D. Broekman, Claudine O. Nogarede, Cynthia M. C. Lemmens, Julius M. Kernbach, Georg Neuloh, Oliver Bozinov, Niklaus Krayenbuhl, Johannes Sarnthein, Paolo Ferroli, Luca Regli, Martin N. Stienen
Summary: Decision-making for intracranial tumor surgery involves balancing oncological benefits with risks, and predicting functional impairment post-surgery remains challenging. A prediction model has been developed to help assess surgical risk and support case-by-case discussions with patients.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Marco Cenzato, Davide Colistra, Giorgia Iacopino, Christian Raftopoulos, Ulrich Sure, Marcos Tatagiba, Robert F. Spetzler, Alexander N. Konovalov, Andriy Smolanka, Volodymir Smolanka, Roberto Stefini, Carlo Bortolotti, Paolo Ferroli, Giampietro Pinna, Angelo Franzini, Philipp Dammann, Georgios Naros, Davide Boeris, Paolo Mantovani, Domenico Lizio, Mariangela Piano, Enrica Fava
Summary: The study illustrates that despite strict adherence to safe entry zones, Holmes tremor can still occur as a delayed complication after brainstem cavernoma resection. It was found that cavernoma location in the midbrain significantly increases the risk of developing HT. Further research is needed to prevent this severe neurological disorder.
JOURNAL OF NEUROSURGERY
(2021)
Editorial Material
Clinical Neurology
Morgan Broggi, Costanza M. Zattra, Paolo Ferroli
OPERATIVE NEUROSURGERY
(2021)
Article
Neurosciences
Silvia Schiavolin, Arianna Mariniello, Morgan Broggi, Francesco Acerbi, Marco Schiariti, Angelo Franzini, Francesco Di Meco, Paolo Ferroli, Matilde Leonardi
Summary: The study found that patients returning to work after brain tumor surgery were mainly those with meningioma and glioma, who reported lower postoperative disability and shorter home-to-work travel time. Additionally, patients with better preoperative and postoperative attention and executive functions were more likely to return to work.
FRONTIERS IN HUMAN NEUROSCIENCE
(2021)
Review
Clinical Neurology
Emanuele La Corte, Daniela Eldahaby, Elena Greco, Domenico Aquino, Giacomo Bertolini, Vincenzo Levi, Malte Ottenhausen, Greta Demichelis, Luigi Michele Romito, Francesco Acerbi, Morgan Broggi, Marco Paolo Schiariti, Paolo Ferroli, Maria Grazia Bruzzone, Graziano Serrao
Summary: The frontal aslant tract (FAT) is a recently identified white matter tract that plays a role in speech and language functions, working memory, social tasks, and music processing. Microstructural alterations of the FAT are associated with various neurological disorders, making pre-operative, intra-operative, and post-operative assessments crucial for patients with brain tumors in proximity to the FAT.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Alexis Paul Romain Terrapon, Costanza Maria Zattra, Stefanos Voglis, Julia Velz, Flavio Vasella, Kevin Akeret, Ulrike Held, Silvia Schiavolin, Oliver Bozinov, Paolo Ferroli, Morgan Broggi, Johannes Sarnthein, Luca Regli, Marian Christoph Neidert
Summary: The study proposes a novel multidimensional and patient-centered classification system for adverse events (AE) in neurosurgery, called the Therapy-Disability-Neurology (TDN) grading system. Results from a retrospective observational study on 6071 interventions show positive correlations between the severity of AE and length of stay (LOS), treatment cost, and deterioration of Karnofsky Performance Status Scale (KPS). External validation further strengthens the correlations between AE grades, LOS, and KPS at discharge.
Article
Oncology
Paolo Ferroli, Ignazio Gaspare Vetrano, Silvia Schiavolin, Francesco Acerbi, Costanza Maria Zattra, Marco Schiariti, Matilde Leonardi, Morgan Broggi
Summary: In elderly patients undergoing brain tumor surgery, postoperative complications and preoperative surgical complexity significantly influence the early outcome. Postoperative complications are the only factor with an impact on the 3-month follow-up.
Editorial Material
Clinical Neurology
Morgan Broggi, Costanza M. Zattra, Paolo Ferroli
OPERATIVE NEUROSURGERY
(2021)
Article
Clinical Neurology
Costanza Maria Zattra, Morgan Broggi, Silvia Schiavolin, Marco Schiariti, Francesco Acerbi, Silvia Esposito, Camilla de Laurentis, Giovanni Broggi, Paolo Ferroli
Summary: This study analyzed neurosurgical outcomes in pediatric intra-axial thalamic and posterior fossa tumors and found that surgical complexity was associated with a higher risk of postoperative worsening. The Milan Complexity Scale appeared to be a useful tool for estimating this risk and facilitating parental informed consent.
INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT
(2021)
Article
Clinical Neurology
Francesco Acerbi, Francesco Restelli, Camilla de Laurentis, Jacopo Falco, Claudio Cavallo, Morgan Broggi, Julius Hoehne, Karl-Michael Schebesch, Marco Schiariti, Paolo Ferroli
Summary: The study evaluated the current practice of fluorescence-guided techniques in neuro-oncological surgery in Europe and found that 5-ALA is still the preferred fluorescent dye for resection of high-grade gliomas, while SF is gaining attention as a cheaper and more ductile alternative.
JOURNAL OF NEUROSURGICAL SCIENCES
(2021)
Article
Clinical Neurology
Laura Valentini, Francesca Chiaffarino, Nicoletta Bonfanti, Marilou Pannacci, Paolo Cortellazzi, Caterina Uberti-Foppa, Marika Furlanetto, Francesco Di Meco, Luca Massimi
Summary: The study revealed that the overall rate of SSI was 1.7% for patients and 1.5% for procedures. Factors such as surgeries lasting longer than 3 hours, undergoing two or more surgeries, and having prosthetic implants were positively associated with SSI risk. Prolonging antibiotic prophylaxis showed limited efficacy in high-risk conditions and wound complications.
JOURNAL OF NEUROSURGICAL SCIENCES
(2021)