Review
Medicine, General & Internal
Martin Reincke, Maria Fleseriu
Summary: Cushing syndrome is a condition characterized by prolonged increase in plasma cortisol levels. It can be caused by both exogenous steroid use and endogenous overproduction of cortisol. It presents with skin changes such as facial redness, bruising, and purple striae, as well as metabolic manifestations like hyperglycemia and hypertension.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Clinical Neurology
Penelope Trimpou, Erika Backlund, Oskar Ragnarsson, Thomas Skoglund, Tobias Hallen, Gunnhildur Gudnadottir, Jeanette Carlqvist, Dan Farahmand
Summary: This study compared the outcomes of endoscopic and microscopic surgery for Cushing's disease over a 15-year period, finding no significant differences in remission, recurrence, and complication rates between the two techniques. However, the endoscopic group had a shorter postoperative hospital stay.
WORLD NEUROSURGERY
(2022)
Article
Endocrinology & Metabolism
Wentai Zhang, Mengke Sun, Yanghua Fan, He Wang, Ming Feng, Shaohua Zhou, Renzhi Wang
Summary: An ML-based model was developed to predict immediate remission after TSS in CD patients, with the best performance achieving an AUC of 0.743, mainly relying on factors such as first operation, cavernous sinus invasion on preoperative MRI, tumour size, and preoperative ACTH level.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Health Care Sciences & Services
Natalia Kuritsyna, Uliana A. Tsoy, Vladislav Y. Cherebillo, Artem A. Paltsev, Anton Ryzhkov, Pavel A. Ryazanov, Vladimir K. Ryzhkov, Elena N. Grineva
Summary: This study aimed to find a combination of predictors to forecast Cushing's disease (CD) remission after transsphenoidal endoscopic surgery (TSS). The results showed that adenoma size, high-dose dexamethasone suppression test (HDDST) serum cortisol suppression rate, and morning serum cortisol level 24 hours after surgery were predictors of CD remission one year after TSS.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Endocrinology & Metabolism
Regin Jay Mallari, Jai Deep Thakur, Garni Barkhoudarian, Amy Eisenberg, Amanda Rodriguez, Sarah Rettinger, Pejman Cohan, Lynnette Nieman, Daniel F. Kelly
Summary: This study describes the predictive performance of preoperative biochemical and imaging data on postoperative remission and clinical characteristics in patients with presumed Cushing's disease. The use of strict biochemical thresholds can improve surgical remission rates and avoid recommending surgery to patients with equivocal biochemical data.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Review
Clinical Neurology
Emma De Ravin, Hoang Anh T. Phan, Stefan Harmsen, Steve S. Cho, Clare W. Teng, E. James Petersson, Caitlin White, Evelyn M. Galban, Rebecka Hess, John Y. K. Lee
Summary: SSTR5 shows strong expression in human corticotroph adenomas and weak expression in surrounding pituitary parenchyma, a pattern not definitively observed in canine patients. While SSTR2 mRNA expression is similar in human normal pituitary and corticotrophinoma cells, it may be significantly higher in canine normal pituitary tissue than in corticotroph tumoral tissue. Limited data are available on SSTR subtypes 1, 3, and 4.
WORLD NEUROSURGERY
(2021)
Review
Endocrinology & Metabolism
Chan Hee Koh, Danyal Z. Khan, Ronneil Digpal, Hugo Layard Horsfall, Ahmad M. S. Ali, Stephanie E. Baldeweg, Pierre-Marc Bouloux, Neil L. Dorward, William M. Drake, Jane Evanson, Joan Grieve, Danail Stoyanov, Marta Korbonits, Hani J. Marcus
Summary: This study investigated whether advances in imaging improved outcomes for Cushing's disease. By analyzing 166 non-controlled single-arm studies, it was found that despite improvements in radiological detection rates over four decades, there were no changes in clinical outcomes. Therefore, advances in imaging alone may be insufficient to improve surgical outcomes for Cushing's disease.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Clinical Neurology
Marcus A. Zachariah, Santino Cua, Whitney E. Muhlestein, Bradley A. Otto, Ricardo L. Carrau, Lawrence S. Kirschner, Luma M. Ghalib, Russell R. Lonser, Douglas A. Hardesty, Daniel M. Prevedello
Summary: This retrospective cohort study aimed to evaluate whether intraoperative ACTH measurement could predict outcome after surgery for Cushing disease. The results showed that the intraoperative ACTH level could accurately predict outcome and further investigation is warranted.
OPERATIVE NEUROSURGERY
(2023)
Article
Clinical Neurology
Yuichi Fujita, Yoichi Uozumi, Takashi Sasayama
Summary: Purely intrasellar chordoma is a rare condition that originates from an ectopic embryological notochord in the sella turcica. Due to its rarity and nonspecific symptoms, intrasellar chordoma may be misdiagnosed as pituitary adenoma based on preoperative radiographic images. This report presents a case of intrasellar chordoma mimicking pituitary macroadenoma, which was successfully resected by endoscopic endonasal trans-sphenoidal surgery. The radiographic features, such as enlarged sellar with thinned remodelled bone and high signal on T2-weighted images with heterogeneous enhancement, are characteristic of chordoma and should raise suspicion in sellar lesions.
WORLD NEUROSURGERY
(2023)
Article
Medicine, General & Internal
Ach Taieb, Saad Ghada, Gorchene Asma, Ben Abdelkrim Asma, Kacem Maha, Ach Koussay
Summary: This case report describes a patient with ACTH-dependent Cushing's syndrome, who had hypercortisolism confirmed and normal ACTH levels. Transsphenoidal surgery was performed to remove a pituitary microadenoma. However, after surgery, the patient still exhibited persistent hypercortisolism. CT scan revealed surgically removed adrenal adenomas and improved the patient's condition.
CLINICAL CASE REPORTS
(2022)
Article
Neurosciences
Chuan Shao, Junwei Wang, Pan Wang, Nan Wu
Summary: Retrospective analysis was conducted on patients with Cushing's disease (CD) who underwent endoscopic transsphenoidal surgery (ETS) with a layered peel strategy. The study found a low rate of surgical complications postoperatively and no recurrence events during follow-up. However, further studies are needed to confirm the effectiveness and safety of this approach due to the limited number of cases.
Article
Endocrinology & Metabolism
Christina Tatsi, Megan Neely, Chelsi Flippo, Maria-Eleni Bompou, Meg Keil, Constantine A. Stratakis
Summary: The recovery of adrenal function in pediatric patients with CD after TSS may not be influenced by most clinical and biochemical factors, except for an increase in urinary free cortisol which may prolong the recovery time. Patients who recover adrenal function earlier are at a higher risk for CD recurrence, highlighting the importance of close follow-up and counseling for these patients.
CLINICAL ENDOCRINOLOGY
(2021)
Article
Clinical Neurology
Ryan Delport, James King, Mendel Castle-Kirszbaum, Tony Goldschlager, Carmela Caputo, Yi Yuen Wang
Summary: This study aimed to determine if resection of pituitary adenomas via the endoscopic endo-nasal approach (EEA) improves headaches and investigate factors that may be associated with headaches in patients with pituitary adenoma. The results showed that surgery using this method can significantly improve headaches and patients with cavernous sinus invasion are more likely to experience improvement in headaches.
WORLD NEUROSURGERY
(2023)
Article
Multidisciplinary Sciences
Xing Huang, Ni Fan, Hai-jun Wang, Yan Zhou, Xudong Li, Xiao-Bing Jiang
Summary: The study illustrates the application of 3D printing in planning endoscopic endonasal transsphenoidal surgery, showing that printing models of intracranial skull base diseases can effectively assist neurosurgeons in surgical planning and improve outcomes.
SCIENTIFIC REPORTS
(2021)
Article
Medicine, General & Internal
Chao Tao, Gang Cheng, Yunxiang Chen, Peiyuan Gu, Weixing Hu
Summary: This study retrospectively reviewed the tumor characteristics and surgical outcomes of a consecutive series of endoscopic endonasal approach pituitary adenomas resection mainly performed by a single author between March 2018 and June 2019. The results demonstrated that EEA is an effective and safe approach for resecting pituitary adenomas with satisfactory gross total resection rate, near-total resection rate, and endocrinological remission rate, while maintaining minimal nasal injury.
Editorial Material
Clinical Neurology
Yi-Hsuan Kuo, Jau-Ching Wu
JOURNAL OF NEUROSURGERY-SPINE
(2022)
Article
Clinical Neurology
Hsuan-Kan Chang, Tun-Wei Hsu, Johnson Ku, Jason Ku, Jau-Ching Wu, Jiing-Feng Lirng, Shih-Ming Hsu
Summary: The study found that PD and T1 intensity values generated with synthetic MRI are significantly correlated with T-score. PD has excellent predictive ability for osteoporosis and osteopenia.
JOURNAL OF NEUROSURGERY-SPINE
(2022)
Editorial Material
Radiology, Nuclear Medicine & Medical Imaging
Chao-Hung Kuo, Tsung-Hsi Tu
Article
Clinical Neurology
Yi-Hsuan Kuo, Chao-Hung Kuo, Hsuan-Kan Chang, Chin-Chu Ko, Tsung-Hsi Tu, Chih-Chang Chang, Henrich Cheng, Jiing-Feng Lirng, Wen-Cheng Huang, Jau-Ching Wu
Summary: This study compared the clinical outcomes of CBT-based Dynesys dynamic stabilization (CBT-DDS) with standard minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). The results showed that CBT-DDS had similar clinical and radiological outcomes to MI-TLIF in patients with L4-L5 or L3-L5 spondylosis and spondylolisthesis, making it a viable and effective alternative with a shorter operation time and similarly limited segmental motility.
WORLD NEUROSURGERY
(2022)
Article
Surgery
Chao-Hung Kuo, Yi-Hsuan Kuo, Chih-Chang Chang, Hsuan-Kan Chang, Li-Yu Fay, Jau-Ching Wu, Wen-Cheng Huang, Henrich Cheng, Tsung-Hsi Tu
Summary: This study evaluated the outcomes of patients with cervical myelopathy caused by OPLL who underwent a combined anterior and posterior approach. The results showed that simultaneous circumferential decompression and fixation was an effective surgical option, with high fusion rates and low reoperation rates, and minimal post-operative complications.
FRONTIERS IN SURGERY
(2022)
Review
Clinical Neurology
Tsung-Hsi Tu, Ching-Ying Wang, Yu -Chun Chen, Jau-Ching Wu
Summary: Cervical disc arthroplasty (CDA) is a popular surgical option for cervical radiculopathy or myelopathy caused by disc problems. A bibliometric analysis of CDA literature reveals a trend towards multilevel CDA and fewer studies comparing CDA to anterior cervical discectomy and fusion (ACDF). CDA has proven to be effective in maintaining segmental mobility and neurologic improvement with low complication rates, especially for 1- and 2-level disc diseases.
JOURNAL OF NEUROSURGERY-SPINE
(2023)
Article
Nursing
Xin-Yi Cai, Jiann-Her Lin, Wen-Cheng Huang, Jau-Ching Wu, Pin-Yuan Chen, Hsiao-Yean Chiu
Summary: This study explores the changing patterns of sensory symptoms and their impact on health-related quality of life in patients undergoing lumbar spine surgery. The study finds that sensory symptoms gradually decline after surgery, except for itching. Moderate-to-severe pain is the only symptom that has a long-term influence on patients' quality of life.
PAIN MANAGEMENT NURSING
(2023)
Article
Medicine, General & Internal
Yu-Wen Cheng, Yang-Yi Chen, Chao-Hung Kuo, Wei-Chuan Liao, Aij-Lie Kwan
Summary: The atypical spindle cell/pleomorphic lipomatous tumor (ASPLT) was classified as a new tumor by the World Health Organization (WHO) in 2020. It is a benign tumor commonly found in the limbs, with rare occurrence in the paraspinal region. This case study reports a 38-year-old male with ASPLT located in the left psoas muscle, presenting with sudden onset back pain. Surgical excision was performed successfully, leading to improved symptoms and no postsurgical neurological deficit. The risk of metastasis was minimal, but there is a nonnegligible risk of local recurrence.
CLINICAL CASE REPORTS
(2023)
Article
Clinical Neurology
Chin-Chu Ko, Bo-Kai Feng, Yi-Hsuan Kuo, Chao-Hung Kuo, Tsung-Hsi Tu, Chih-Chang Chang, Henrich Cheng, Wen-Cheng Huang, Jau-Ching Wu
Summary: This study investigated the incidence and risk factors of implant dislocation after cervical disk arthroplasty (CDA) through a retrospective cohort analysis. The results showed a low incidence of implant dislocation, with preoperative kyphosis being a significant risk factor. The study concludes that CDA is a safe and reliable procedure.
Article
Clinical Neurology
Chih-Chang Chang, Hsuan-Kan Chang, Chin-Chu Ko, Ching-Lan Wu, Yi-Hsuan Kuo, Tsung-Hsi Tu, Wen-Cheng Huang, Jau-Ching Wu
Summary: This study compared the outcomes of pedicle-based dynamic stabilization (DS) using plates and cortical bone trajectory (CBT) screws in patients with lumbar degenerative diseases. The CBT method showed advantages in operation time and blood loss compared to the plate method, and had a lower chance of screw loosening.
News Item
Clinical Neurology
Tsung-Hsi Tu, Chih-Chang Chang, Yi-Hsuan Kuo, Chin-Chu Ko, Jau-Ching Wu, Wen-Cheng Huang, Chao-Hung Kuo
WORLD NEUROSURGERY
(2023)
Article
Neurosciences
Ssu-Ju Li, Yu-Chun Lo, Hsin-Yi Tseng, Sheng-Huang Lin, Chao-Hung Kuo, Ting-Chieh Chen, Ching-Wen Chang, Yao-Wen Liang, Yi-Chen Lin, Chih-Yu Wang, Tsai-Yu Cho, Mu-Hua Wang, Ching-Te Chen, You-Yin Chen
Summary: Through experiments on mice models, it was found that NAc-DBS can restore emotional deficits in CSDS-subjected mice, alter functional connectivity and metabolic profile in the dopaminergic pathway, providing a potential strategy for ameliorating emotional processes in individuals with MDD.
NEUROBIOLOGY OF STRESS
(2023)
Article
Biochemistry & Molecular Biology
Li-Yu Fay, Chao-Hung Kuo, Hsuan-Kan Chang, Mei-Yin Yeh, Chih-Chang Chang, Chin-Chu Ko, Tsung-Hsi Tu, Yi-Hsuan Kuo, Wang-Yu Hsu, Chien-Hui Hung, Ching-Jung Chen, Jau-Ching Wu, May-Jywan Tsai, Wen-Cheng Huang, Henrich Cheng, Meng-Jen Lee
Summary: This study analyzed the specimens of patients with or without ossification of the posterior longitudinal ligament (OPLL). The results showed that serum leptin levels were higher in the OPLL group, and angiogenin, osteopontin, and osteopro-tegerin were also higher in OPLL tissue. Additionally, cytokines promoting bone genesis and inhibiting osteoclastogenesis were up-regulated in OPLL tissue, while molecules promoting angiogenesis were abundant in the OPLL tissue.
Article
Clinical Neurology
Ching-Ying Wang, Yi-Lin Chu, Shih-Chieh Lin, Chih-Chun Wu, Wen-Cheng Huang, Chao-Hung Kuo
Summary: This is a case report of a rare cervical sarcoma with osteolytic lesions and intradural extension. The patient presented with numbness and progressive weakness of her limbs. The diagnosis was confirmed through imaging and histopathological examination, and the patient recovered well under multidisciplinary treatment and follow-up.
Article
Clinical Neurology
Guilu He, Jianhao Lin, Jing Ye, Fobao Huang, Changzhi Yan, Zesi Liu, Xiuming Zhou, Qiao Li, Liang Zhang
Summary: This article introduces long tunneled external ventricular drain (LTEVD), which effectively avoids multiple surgeries by connecting an external shunt valve. It allows visual control of drainage flow, prolongs catheter indwelling time, and eliminates the need for multiple surgeries.
WORLD NEUROSURGERY
(2024)
Article
Clinical Neurology
Vinay Suresh, H. S. Suresh, Bharath Raju, Himanshu Jindal, Ahmad Ozair
Summary: This study investigated the outcomes of postoperative discitis treated with debridement and a novel technique focused on reducing outpatient antibiotic requirement in a low- and middle-income country (LMIC) setting. The results showed that patients with medically refractory postoperative discitis potentially have good outcomes after debridement plus 2-week local antibiotic instillation in LMICs.
WORLD NEUROSURGERY
(2024)
Editorial Material
Clinical Neurology
Beatrice C. Bono, Davide Milani, Fabio Ferreli, Simone Olei, Luca Raspagliesi, Maria Pia Tropeano, Giovanni B. Lasio, Federico Pessina
WORLD NEUROSURGERY
(2024)
Article
Clinical Neurology
Avi A. Gajjar, Shrey Patel, Raj Swaroop Lavadi, Rida Mitha, Rohit Prem Kumar, Tavis Taylor, Galal A. Elsayed, D. Kojo Hamilton, Nitin Agarwal
Summary: Art in neurosurgery has played a crucial role in the discipline for centuries. Medical illustrations help visualize anatomy and surgical procedures, contributing to education, surgical planning, and navigation.
WORLD NEUROSURGERY
(2024)
Article
Clinical Neurology
Joaquin Perez Zabala, Yamila Basilotta Marquez, Romina Arganaraz, Beatriz Mantese
Summary: We present a low-cost and easily accessible adaptation system for stereotactic procedures in infants. By using a headband cast technique, a stereotactic biopsy was successfully performed in a 5-month-old patient, achieving precise targeting, histopathological diagnosis, and no associated complications.
WORLD NEUROSURGERY
(2024)
Editorial Material
Clinical Neurology
Muhammad Kusdiansah, Arnau Benet, Yosuke Suzuki, Kenichi Haraguchi, Nakao Ota, Kosumo Noda, Rokuya Tanikawa
Summary: Fusiform vertebral artery aneurysms are difficult to treat, and endovascular and open microsurgical treatments are used for different situations. This report presents a case with complex anatomy and branch involvement and describes the treatment strategy used.
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Victor M. Lu
Summary: This review emphasizes four essential domains that should be considered when interpreting pediatric neurosurgical SRMAs and provides examples to ensure accurate and effective interpretation of findings in this niche.
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Lapo Bonosi, Angelo Torrente, Filippo Brighina, Cateno Concetto Tito Petralia, Pietro Merlino, Chiara Avallone, Vincenzo Gulino, Roberta Costanzo, Lara Brunasso, Domenico Gerardo Iacopino, Rosario Maugeri
Summary: Corticocortical evoked potentials (CCEPs) have emerged as a valuable intraoperative monitoring technique in eloquent brain tumor surgery, aiding in preserving critical functional areas. Current research shows the potential of CCEPs in guiding surgical decision making, reducing the risk of postoperative neurological deficits, and mapping functional connectivity, but further research and standardization are needed.
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Yuchen Duan, Dagang Feng, Min Zhu, Heng Qiu, Tong Li, Zhen Chen, Leiming Jiang, Yong Huang
Summary: This study aimed to compare the effect of different Modic changes (MC) grades on the cage subsidence rate after spinal interbody fusion surgery. A meta-analysis was conducted on relevant randomized controlled trials and cohort studies. The results showed that MC may be associated with a higher cage subsidence rate. With the increase in MC grades, the incidence of subsidence decreased gradually, but it was always higher than that in the non-Modic changes (NMC). Oblique lumbar interbody fusion may be a better treatment choice for lumbar degenerative disease with MC.
WORLD NEUROSURGERY
(2024)
Editorial Material
Clinical Neurology
Brian F. Saway, Conor M. Cunningham, Mustafa Ismail, Alejandro M. Spiotta
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Joanna M. Roy, Michael M. Covell, Carmelo Venero Jr, Christian A. Bowers
Summary: Early exposure to neurosurgery during medical school is critical for improving recruitment into the specialty. However, about 30% of medical schools in the U.S. lack a neurosurgery program, limiting students' exposure to the field. Virtual education, facilitated by webinars during the pandemic, has advantages such as global outreach and accessibility for international medical students. This review identifies and describes 16 educational resources, serving as a guide for medical students interested in neurosurgery.
WORLD NEUROSURGERY
(2024)