【期刊速览】World Neurosurgery | Online 2024年8月速览（十）

1. The New Alternative Technique Outcomes: Atlas Lateral Mass Screw and C2-3 Transfacet Screw Fixation for Complex Atlantoaxial Instability in patients with Thin C2 Pedicle or High-Riding Vertebral Artery

新的替代技术结果: Atlas侧块螺钉和C2-3跨关节螺钉固定治疗C2椎弓根或高位骑行椎动脉患者的复杂寰枢椎不稳

The study aimed to evaluate the safety, feasibility, effect on fusion, and clinical efficacy of atlas lateral mass and C2-3 transfacet screw fixation technique, serves as an alternative method to traditional posterior atlantoaxial fixation. The atlas lateral mass and C2-3 transfacet screw fixation technique, an alternative to conventional posterior fixation, has been demonstrated tobe an efficacious method for providing adequate stabilization and fusion in patients with atlantoaxial instability, even in the cases of thin C2 pedicle, high-riding vertebral artery, previous failed surgeries or reoperation.

Severe traumatic brain injury (TBI) is a condition burdened by high morbidity and mortality. Prevention of secondary insults is one of the main goals of management and intracranial pressure monitoring is a cornerstone in management of TBI. The relationship between intracranial pressure and optic nerve sheath is known from the literature. Optic nerve sheath ultrasonography could represent a method added to our armamentarium for monitoring intracranial pressure. We propose the use of ONSD ultrasound as a screening investigation for post-traumatic intracranial hypertension in the context of an emergency department, especially in contexts where there is limited availability of intracranial pressure monitors.

REF: Lioi F, Ramm-Pettersen J, Fratini A, Riva C, Colella N, Missori P. Ultrasonographic assessment of optic nerve sheath diameter as a screening tool for intracranial hypertension in traumatic brain injury. World Neurosurg. Published online August 27, 2024. doi:10.1016/j.wneu.2024.08.111 PMID: 39209251

Almost all postoperative assessments for pituitary patients are performed in clinical settings under the supervision of medical providers. With the emergence of telemedicine, however, there are opportunities to monitor these patients remotely. The potential for use of such technologies is inconsistently described in the brain tumor literature, especially for patients with pituitary adenomas. Due to advancing capabilities of smartphone apps, the potential of telemedicine may extend beyond patient appointments. We show that by integrating novel advances in medical technologies from a variety of specialties, it is possible to develop smartphone-based protocols for remote monitoring of patients after pituitary surgery.

REF: Sarikonda A, Rafi R, Schuessler C, et al. Smartphone Applications for Remote Monitoring of Patients after Transsphenoidal Pituitary Surgery: A Narrative Review of Emerging Technologies. World Neurosurg. Published online August 28, 2024. doi:10.1016/j.wneu.2024.08.123 PMID: 39214293

We describe a novel yet simple training exercise for residents who are being introduced to endoscopic spine surgery. One of the lessons learned with this exercise that we will consider in future courses would be to place a radiodense "lesion" that could be visualized on fluoroscopy, and serve as a radiologic target to find. This can help guide the trainee in knowing where to search if the "lesion" is more difficult to find.

REF: De Biase G, Akinduro OO, Pirris SM. Enhancing Cadaver Labs for Endoscopic Spine Surgery: the glove as the "lesion". World Neurosurg. Published online August 28, 2024. doi:10.1016/j.wneu.2024.08.125 PMID: 39214294

Glioblastoma represents the most common aggressive primary brain tumour in adults. Changes in cognition, personality and in behaviour of patient as well as side effects of treatments cause unique challenges for providing care and may impact caregiver burden in different ways. The end-of-life phases of glioblastoma patient may represent a critical factor that significantly affects not only the patient but also caregiver burden, caregiving tasks, and caregiver time. A urgent multidisciplinary support program is needed to face and improve caregivers burden.

REF: Gulino V, Brunasso L, Avallone C, et al. Caregivers' Perspective and Burden of The End-of-Life Phase of Patients With Glioblastoma: A Multicenter Retrospective Study. World Neurosurg. Published online August 28, 2024. doi:10.1016/j.wneu.2024.08.114 PMID: 39214291

This historical account reviews the life and times of Mildred Codding (1902-1991) in neurosurgery and medical illustration. This article provides glimpses into the personality and marked influence of Mildred Codding on neurosurgery and medical education and adds to the growing literature on her person.

Rhinosinusitis and intracranial hemorrhage are prevalent conditions within their respective medical specialties. While rhinosinusitis is predominantly an inflammatory disease confined to the paranasal sinuses, it can, in exceedingly rare circumstances, lead to intracranial hemorrhage with potentially fatal outcomes. Despite the gravity of this rare association, the literature remains sparse regarding its pathophysiological mechanisms, natural history, management principles, and clinical outcomes. Intracranial hemorrhagic complications, primarily EDH and SDH, are rare and potentially fatal consequences of rhinosinusitis. It should be cognizant of the potential existence of such a possibility during clinical practice.

REF: Fu Y, Fang X, Li Y, Li Z, Zhao X, Sha J. Intracranial Hemorrhagic Complications of Rhinosinusitis: A Systematic Literature Review and Case Illustration. World Neurosurg. Published online August 28, 2024. doi:10.1016/j.wneu.2024.08.127 PMID: 39214292

Most patients with microprolactinomas have to take dopamine agonist for a lifetime. Many of them in our center have consulted endoscopic transsphenoidal surgery as an alternative therapy. According to our findings, endoscopic transsphenoidal surgery performed on patients with microprolactinomas at advanced pituitary tumor centers could be an option with high success rates and low complications. Moreover, improving MRI imaging techniques and/or multidisciplinary team discussion before surgery for microprolactinoma could improve tumor remission after surgery.

REF: Zhu Z, Li Z, Luo L, et al. The Role of Endoscopic Transsphenoidal Surgery in Microprolactinomas: A Retrospective Study. World Neurosurg. Published online August 29, 2024. doi:10.1016/j.wneu.2024.08.124 PMID: 39216725

Because of the complexity of the brain and its structures, anatomical knowledge is fundamental in neurosurgery. Anatomical dissection, body preservation, and vascular injection remain essential for training, teaching, and refining surgical techniques. This article explores the historical development of these practices and provides the contextual background of modern neurosurgical cadaveric brain models. These advancements laid the foundation for modern neurosurgical cadaveric studies, many remaining relevant today.

REF: On TJ, Xu Y, Meybodi AT, et al. Historical roots of modern neurosurgical cadaveric research practices: dissection, preservation, and vascular injection techniques. World Neurosurg. Published online August 29, 2024. doi:10.1016/j.wneu.2024.08.120 PMID: 39216723