Free Article with CME: SEEG in Children and Adolescents With Difficult-to-Localize Refractory Focal Epilepsy
Background: Although stereoelectroencephalography (SEEG) has been shown to be a valuable tool for preoperative decision making in focal epilepsy, there are few reports addressing the utility and safety of SEEG methodology applied to children and adolescents.
Objective: To present the results of our early experience using SEEG in pediatric patients with difficult-to-localize epilepsy who were not considered candidates for subdural grid evaluation.
Methods: Thirty children and adolescents with the diagnosis of medically refractory focal epilepsy (not considered ideal candidates for subdural grids and strip placement) underwent SEEG implantation. Demographics, electrophysiological localization of the hypothetical epileptogenic zone, complications, and seizure outcome after resections were analyzed.
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Background: Trigeminal neuralgia is a relatively common neurosurgical pathology with multiple management options. Microvascular decompression (MVD) is nonablative and is considered the gold standard. However, stereotaxic radiosurgery (SRS) and percutaneous stereotaxic rhizotomy (PSR) are 2 noninvasive but ablative options that have rapidly gained support.
Objective: To use Medicare claims data in conjunction with a literature review to assess the usage, effectiveness, and cost-effectiveness of the 3 different invasive treatments for trigeminal neuralgia.
Methods: All of the claims of trigeminal neuralgia treatment were extracted from the 2011 5% Inpatient and Outpatient Limited Data Set. Current Procedural Terminology, 4th Edition/International Classification of Diseases, Ninth Revision codes for the 3 different surgical treatment modalities were used to further classify these claims. Kaplan-Meier survival curves in key articles were used to calculate quality-adjusted life years and cost-effectiveness for each procedure.
Free Editor Choice with CME: Solitaire AB Stent-Assisted Coiling of Wide-Necked Intracranial Aneurysms
Background: Endovascular treatment of intracranial aneurysms can be technically difficult when the neck is wide. The Solitaire AB stent (Covidien, Irvine, California), the only fully retrieved stent, assists in the coiling of wide-neck intracranial aneurysms.
Objective: To evaluate the mid-term angiographic follow-up of wide-necked aneurysms treated with the Solitaire AB stent.
Methods: SOLARE (SOLitaire Aneurysm Remodeling) is a consecutive, prospective study conducted in 7 European centers. A core laboratory evaluated the postoperative and mid-term (6 month ± 15 days) angiographic results by using the Raymond classification Scale. Recanalization was defined as worsening, and progressive thrombosis was defined as improvement in the Raymond scale score.
An interview with Monica S. Vavilala M.D., the senior author of August’s Journal Club target article, is available for download. Additional episodes have also been added to the Russian, Korean and Japanese Neurosurgery International Podcasts on iTunes. Each podcast episode is the scientific abstract from a published article translated into a foreign language and read by a native speaker. Use iTunes to download new and existing podcasts in your preferred language.
Free Editor Choice with CME: Outcomes After Surgery and Radiotherapy for Spinal Myxopapillary Ependymoma
Background: The role of radiotherapy after surgery for myxopapillary ependymoma (MPE) is unclear.
Objective: To review long-term outcomes after surgery, with or without radiation, for spinal MPE.
Methods: Fifty-one patients with spinal MPE treated from 1968 to 2007 were included. Associations between clinical variables and overall survival (OS), progression-free survival (PFS), and local control (LC) were tested with Cox regression analysis.