0000000000459982
AUTHOR
Ludovica Leone
Maximizing the Extent of Resection in High-Grade Glioma.
High-grade gliomas (HGGs) are devastating tumors associated with one of the worst prognoses in oncology. Glioblastoma multiforme (GBM) is the most frequently reported histologic type, with a median survival after surgery and combined treatment with chemotherapy and radiotherapy of 12–16 months. Several studies have shown that the extent of resection (EOR) of the contrast-enhancing part of the tumor improves survival in patients with HGGs, although the quest to achieve optimal oncologic outcomes must be tempered with the neurologic result following radical resection. To date, limited evidence exists on the relationship between EOR and level of clinical benefit for patients with HGGs. Brown e…
Management of Odontoid Cervical Fracture
Fractures of the cervical odontoid process are the most common fractures of the cervical tract, accounting for one third of all cervical spine fractures. They are more frequent in elderly patients, and with the aging of the world population, their incidence and clinical and social relevance are expected to increase in the near future. The mechanisms underlying odontoid fractures differ according to patient age, with high-energy mechanisms being the causative factor frequently encountered in younger patients and low-energy trauma commonly occurring in elderly patients. Despite rising incidence and costs, there is considerable uncertainty regarding the optimal management for these fractures, …
Dysphagia Prevention in Anterior Cervical Discectomy Surgery: Results from a Prospective Clinical Study
Background: Dysphagia is a common complication after anterior cervical discectomy surgery (ACDS). Recent studies have shown that reducing the endotracheal tube cuff pressure, local irrigation with methylprednisolone, and minimizing the pharynx/esophagus retraction can decrease the incidence of postoperative dysphagia after ACDS. This is the first study assessing the efficacy of all these 3 measures simultaneously. Methods: This prospective study included 35 patients (group 1) who underwent ACDS with the adoption of all the 3 preventive measures. Group 1 was compared with a homogenous group of 35 patients who underwent regular ACDS (group 2). Postoperative dysphagia and odynophagia were eval…
Long-Term Efficacy of Shunt Therapy in Idiopathic Normal Pressure Hydrocephalus.
Background: Idiopathic normal pressure hydrocephalus (iNPH) is one of the very few treatable types of dementia. Shunt therapy has been shown to be effective in improving symptoms. However, the long-term results of cerebrospinal fluid diversion are variable. The aim of this retrospective study was to investigate long-term outcomes of patients with idiopathic normal pressure hydrocephalus treated with ventriculoperitoneal shunt by using programmable valves. Methods: Symptoms before treatment were recorded. Clinical symptoms and outcome after ventriculoperitoneal shunt were assessed based on changes in gait, urinary incontinence, and cognitive dysfunction at yearly follow-up spanning at least …