Posts Tagged ‘tumor’
Background: Navigated transcranial magnetic stimulation (nTMS) is increasingly used in presurgical brain mapping. Preoperative nTMS results correlate well with direct cortical stimulation (DCS) data in the identification of the primary motor cortex. Repetitive nTMS can also be used for mapping of speech-sensitive cortical areas.
Objective: The current cohort study compares the safety and effectiveness of preoperative nTMS with DCS mapping during awake surgery for the identification of language areas in patients with left-sided cerebral lesions.
Methods: Twenty patients with tumors in or close to left-sided language eloquent regions were examined by repetitive nTMS before surgery. During awake surgery, language-eloquent cortex was identified by DCS. nTMS results were compared for accuracy and reliability with regard to DCS by projecting both results into the cortical parcellation system.
Background: Jugular foramen tumors are rare and challenging lesions for skull base surgeons due to their difficult operative accessibility. Various surgical approaches to the jugular foramen have been described to overcome the morbidity of standard petrosectomy.
Objective: To describe the surgical anatomy of a novel route to the jugular foramen without opening the fallopian canal: the navigated tailored presigmoidal suprabulbar infralabyrinthine approach.
Methods: Ten cadaver heads were dissected under navigational guidance on both sides to examine the advantages and limitations of the presigmoidal suprabulbar infralabyrinthine approach without opening the fallopian canal. Mastoidectomy was performed using a high-speed drill. Under navigation guidance, the sigmoid sinus, jugular bulb, posterior semicircular canal, and fallopian canal were located and preserved. The jugular foramen with the extradural part of the IXth, Xth, and XIth nerve were identified.
Background: The evidence of or against the presence of a July phenomenon in resident teaching hospitals has been inconsistent. Moreover, there are limited data on the “July phenomenon” in the field of neurosurgery.
Objective: To determine whether a “July phenomenon” exists for neurosurgical mortality or complications.
Methods: A search of the National Inpatient Sample database from 1998 to 2008 was performed for all admissions for International Classification of Diseases, 9th Revision codes corresponding to nontraumatic hemorrhage, central nervous system (CNS) trauma, CNS tumor, and hydrocephalus. Generalized linear mixed-model analysis was performed, adjusted for patient demographics and hospital characteristics, for the outcomes of mortality and complications for the month of July compared with all other months in teaching hospitals.