Neurosurgery Commons^™

Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, José Alberto Israel Romero Rangel, Manuel Eduardo Soto García, Sergio Soriano Solís, Carlos Raúl Rangel Morales, Gerson Reyes Rodríguez, José Antonio Soriano Sánchez

Archives of Neurosurgery

BACKGROUND: Chiari's Malformation surgical treatment has significantly changed since the "classical" technique description by Gardner (1950). It is probably the most commonly performed approach, even when multiple techniques are available because no substantial changes nor any clear surgical objectives have been made. OBJECTIVE: To demonstrate a new cutting-edge surgical technique mastering the advantage of each surgical procedure ever described in the history of Chiari's Malformation establishing three critical points in surgical technique: clear patient-specific surgical goals, dynamic posterior fossa reconstruction, and extradural occipitoatlantal dense-adhesions release. METHODS: A comprehensive review of historically described approaches, proof of concept of surgical technique in …

Traumatic Injuries Of The Common Peroneal Nerve And Current Surgical Strategies For Improving Foot Drop. A Clinical Series And Literature Review., Carlos Alberto Rodríguez Aceves, María Elena Córdoba Mosqueda, Racob Alberto García Velazco, Humberto González Ugalde, Héctor Antonio Soriano Solís, Fabiola Estela Elizabeth Ortega Ponce, Kartik G. Krishnan

Archives of Neurosurgery

Background: Common peroneal nerve injuries are the most frequent nerve injuries in the lower extremity. They may produce severe gait deficits because of weakness or absence in ankle dorsiflexion. Functional improvement after injury, despite any intervention, remains unpredictable. There are various surgical strategies aimed to restore foot drop, but no consensus exists regarding the best surgical treatment.

Objective: In this article, we report our experience and reviewing general aspects of common peroneal nerve anatomy and lesions, current surgical strategies to restore functionality, and the overall outcomes previously published in the literature.

Methods: Retrospective review of patients with foot drop secondary …

Validation Of The Distress Thermometer In A Mexican Population With Brain Tumors: A Diagnostic Accuracy Study, Dan Morgenstern-Kaplan, Sergio Moreno-Jiménez, Fernanda Páez-Plascencia, Angel Ruiz-Chow, Fabiola Flores-Vázquez

Archives of Neurosurgery

Objective: Mental health in cancer patients must be addressed. This study's main objective was to evaluate the sensitivity and specificity of the DT in a population of patients with brain tumors and determine the optimal cut-off point for the DT. Methods: We performed a cross-sectional study at the National Institute of Neurology and Neurosurgery in Mexico City, in a cohort of 110 patients. Results: Of the 108 participants with brain tumors that were included in the analysis (2 patients excluded by incomplete DT), 40 had gliomas, 31 had pituitary adenomas, 21 had meningiomas, and 16 had other types of tumors. …

Suprameatal Tubercle Classification; Its Implementation On Clinical Cases, Humberto Reyna Mendez, Jose Alfredo Espinosa Mora, Laura Ubaldo Reyes, Alberto Angeles Castellanos, Ignacio Mora Magaña, Mauro Alberto Segura Lozano, Rachel Blue, John Yk Lee, Diego Mendez Rosito

Archives of Neurosurgery

Abstract:

Background: The suprameatal tubercle (SMT) is a variable prominence of the petrosal surface of the temporal bone that lies above the internal acoustic meatus. An enlarged SMT may present an obstacle during surgeries of the posterior fossa, including microvascular decompression or by itself cause trigeminal neuralgia.

Methods: Based on our prior study of 200 temporal bones, its data collection and establishing a classification of the SMT this extension study exemplifies its clinical application.

Results: According to the classification of the SMT four selected cases are clinically and anatomically correlated to exemplify the utility of this classification.

Conclusion: The SMT …

The Pipeline Endovascular Device Versus The Flow Re-Direction Endoluminal Device For Cerebral Aneurysm. A One-Year Follow-Up In A Single-Center Experience, Omar Pichardo, Alan Picazo, Omar Castillon, Jonathan Zuniga, Gustavo Alan Juarez Jimenez

Archives of Neurosurgery

Background: The Flow Diverters are devices derived from brain stents, made up of a network of microfilaments of various materials that allow the vessel remodeling. The Pipeline Embolization Device and The Flow Re-Direction Endoluminal Device are the two devices with more global clinical experience. Our objective is to compare the 1-year results using these devices in a cohort of patients assessing their occlusion rate and their clinical outcome as by the modified Rankin Score (mRS).

Methods: In this retrospective nested case-control cohort study, we reviewed the medical records of patients undergoing treatment with a Flow Diverter stent for brain aneurysms …

Chiari Formation And Atlantoaxial Instability. Commentary On Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, Atul Goel

Archives of Neurosurgery

The authors have reviewed Chiari formation treatment and have put-forth their personal experience with minimally invasive techniques to perform foramen magnum decompression surgery. Based on the historical review of the subject, the authors have discussed the historical validity of only bone decompression, extra-arachnoidal decompression, and tonsillectomy. The article falls in line with the current minimally invasive surgery wave, a slightly larger cousin of the buttonhole surgery trend. It may be pertinent that I review my understanding of the subject based on the ongoing experience of nearly four decades. In the year 1998, we identified that the posterior fossa volume in …

Archives Of Neurosurgery: The Scientific Home Of Neurosurgery. The Creation Of The Unique Diamond-Open Access Journal In Neurosurgery With An Author-Friendly Advisory Peer-Reviewing And Publishing Policy Within Reach Of Everyone In The World… Born From The Ashes Of A World-Chaos., José Alberto Israel Romero Rangel, Fiacro Jiménez Ponce, José Antonio Soriano Sánchez

Archives of Neurosurgery

This is an editorial article.

Microendoscopic Versus Open Discectomy For The Treatment Of Extruded Lumbar Disc Herniation: A Comparative Cohort Study, Juan Guapo Mendoza, Antonio Guapo Mendoza, Juan Arturo Muciño Mercado, Sonia Melisa Juarez, Arturo Gonzalez, Vianney Guapo Ortiz

Archives of Neurosurgery

Background: Lumbosciatica syndrome affects millions of people worldwide, usually caused by a herniated disc. Most patients with extruded herniated discs are highly symptomatic, and they respond better to surgical treatment. Several studies have tried to compare the efficacy and benefits of microendoscopic discectomy (MED) and open discectomy (OD).

Objective: The objective of this study was to compare the results and complications of our MED experience versus standard OD in patients with lumbar disc extrusion.

Material and methods: We included patients from 18 to 60 years with radicular pain syndrome and single-level extruded disc herniation between January 2015 and December 2020. …

Hypothalamic Hamartoma Related To Pallister-Hall Syndrome In An Adolescent Patient: Illustrative Case., Victor Ramzes Chavez-Herrera, Roberto Casarrubias-Islas, Karen A Leal-Tapia, Rosa L Margarita Flores-Salgado, Juan C Huicochea-Montiel, Bayron A Sandoval-Bonilla

Archives of Neurosurgery

Background: Hypothalamic hamartomas in relationship to Pallister-Hall syndrome are extremely rare; just over 100 cases have been reported. Most hypothalamic hamartomas are sporadic.

Observation(s): A 17-year-old boy presented with a 3-year history of gelastic seizures and a suprasellar mass. The complete physical examination, blood work, and study images resulted in bilateral mesial-polydactyl, metacarpal syndactyly, glandular hypospadias, and hypoplastic nails. There were no hormone or neurological manifestations. MRI studies demonstrated a large non-enhancing suprasellar mass adjacent to the hypothalamus and displaced normal structures. An open biopsy of the mass and genetic studies were carried out to confirm the presumptive diagnosis. After …

Congress Proceedings Of The Xxviii Meeting Of The Mexican Society Of Neurological Surgery

Archives of Neurosurgery

No Abstract for this article.

High-Grade Avm. Educational Vignette And Clinical Cases, Marcos Devanir Silva Da Costa, Marcelo Augusto Acosta Goiri, Daniela Coelho, Juan Alberto Paz Archila, Talita Helena Martins Sarti, Feres Chaddad-Neto

Archives of Neurosurgery

The arteriovenous malformation (AVM) is a vascular malformation characterized by fistulas between arteries and veins forming a nidus, without interposition of capillary vessels and of which early draining vein is identified at the digital angiography. Potential reports of its existence date from the second century AD. Spetzler and Martin (S-M) proposed a classification considering three features and Lawton then added new predictors. A maximum of 10 score can be achieved by applying the modified S-M grade system. This classification guides decision-making and the possible choice of the multimodal treatment (surgery, radiosurgery and embolization). We discuss historical, pathological, clinical and therapeutic …

“Primum Non Nocere”, The Role Of Research In Meeting This Primary Objective In Neurosurgical Praxis., José Antonio Soriano Sánchez, Fiacro Jiménez Ponce, José Alberto Israel Romero Rangel

Archives of Neurosurgery

The present editorial object is to make us aware of the role that scientific production has in patient safety. Our goal shall be to provide the best neurosurgical praxis parameters supported by the best scientific evidence, developed in strict alignment to current research and publishing ethics, to warrant patient safety in every process of neurosurgical care. Once this has been said, be the worldwide neurosurgical scientific community welcome to publish in Archives of Neurosurgery, a new journal that will make publishing possible for every neurosurgeon around the world, to become the scientific home of Neurosurgery.

Endoscopic–Assisted Surgery For Cerebello Pontine Angle Pathology: Technical Note And Surgical Results In A Series Of Patients, Jaime Jesus Martinez Anda, Pablo David Guerrero Suarez, Diego Pineda Martínez, Rafael Avendaño Pradel, Ernesto Javier Jurado Delgado, Ricardo Santiago Villlagrana Sánchez, Juan Carlos Cisneros Lesser, Carolina De La Llata Segura, Rogelio Revuelta Gutiérrez

Archives of Neurosurgery

Objectives: Endoscopic–assisted surgery combined with the operating microscope has been described for several surgical techniques and pathologies of the cerebellopontine angle (CPA). The use of an endoscope allows for a panoramic view of the CPA cistern and a high degree of maneuverability in narrow cisternal spaces that enable the surgeon to deal with most CPA lesions safely. We performed an observational study to describe the surgical anatomy and technique for endoscopic-assisted CPA surgery, describing our experience in a case series of patients with CPA pathology. Methods: Anatomical and surgical technique description of endoscopic-assisted surgery for CPA pathology, based on observations …

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

Archives Of Neurosurgery Volume 1 Issue 1 - Full Issue

Archives of Neurosurgery

Archives of Neurosurgery Volume 1 Issue 1 - Full Issue

Misdiagnosis Between Coccygeal Dislocation Fracture And Lumbosacral Disc Herniation, Gilberto Gardea-Loera, Gilberto Gardea-Ramírez, Ylián Ramírez-Tapia

Archives of Neurosurgery

INTRODUCTION: Coccydynia is the condition of disabling pain in the coccyx that occurs when sitting or moving to a standing position. Due to a lack of knowledge by spine specialists, many patients suffer for years without adequate treatment. We highlight the relevance of diagnosing and treating coccygodynia correctly to avoid lumbosacral pathology overestimation. METHODS: We present a series of patients with painful coccygeal segment syndrome associated with different lumbar alterations who underwent coccygectomy from 1996 to 2021 in our spine clinic. We describe VAS and MacNab scores and complication rates. We used Student-T-Test for statistical analysis. RESULTS: We included 40 …

Extraforaminal Minimally Invasive Lumbar Conjoined Nerve Root Decompression And Segment Fusion: Surgical Technique, Case Report And Literature Review, Manuel Rodríguez García, José Antonio Soriano Sánchez, Sergio Soriano Solis, Oscar Sánchez Escandón, Iris Tatiana Montes González

Archives of Neurosurgery

INTRODUCTION

Associated or conjoined nerve roots are an embryological anomaly presented primarily as bifid nerve roots arising from the dura. They are susceptible to trauma with radicular symptoms and even neurological deterioration of patients presenting them, due to space they occupy and adhesions to adjacent structures. We report a case treat with a minimally invasive technique.

CASE REPORT

A 68-year-old woman with lumbar and radicular pain in the right lower limb, with findings of L4-L5 instability and L4-L5, L5-S1 degenerative disc changes on imaging studies with bilateral L5 and S1 radiculopathy predominantly on the right side on preoperatory neurophysiological studies. …

Dr. Mauro Loyo: Mexican Icon Of World Neurosurgery. Posthumous Tribute, Ramiro Del Valle

Archives of Neurosurgery

Dr. Mauro Loyo Varela was born on November 30th, 1941, in the city of Veracruz. Not only was he an extraordinary surgeon, but he was also an unforgettable teacher. He held several academic positions in and outside the country. He taught 83 Latin American and Caribbean neurosurgeons with patience and devotion, always willing to share his knowledge without reservation. A man of singular talent, his contributions to neurosurgery were outstanding. From 1977 to 1986, he was the Chief of Neurosurgery Services at the IMSS National Medical Center. Between 1982 and 1990, he contributed to the design of numerous instruments and …

Why The Neurosurgeon Should Apply The Concepts Of Neuroethics In Their Daily Clinical Practice, Miguel Antonio Sandoval Balanzario, Lizbeth Itzel Sandoval Olivares, Noe Santiago Ramírez, Noe Santiago Rea

Archives of Neurosurgery

The human being is a community and social being, thus, he was capable to establish rules and humanize he's environment, allowed by the development of he's intelligence, as well as moral behavior. Nevertheless, morals and ethics have also evolved along the history, allowing the birth of neuroethics in 2002 with the objective to study ethical behavior of neurological research procedures and study ethics from the neuroscientific point.

Using Intersurgeon Variation To Inform Cost-Reduction Strategies In Anterior Cervical Discectomy And Fusion (Acdf), Ken Porche, Sasha Vaziri, Alan Stein, Omar Awan, Brandon Lucke-Wold, Paul S. Kubilis, Paul Lipori, Daniel J Hoh, Adam Polifka, W. Christopher Fox

Archives of Neurosurgery

Background: Inter-surgeon variability is a potential driver of variation in bundled care costs associated with cervical spine surgery.

Objective: This study aims to determine modifiable inter-surgeon factors that predict hospital cost variations associated with anterior cervical discectomy and fusions (ACDF).

Methods: This is a retrospective review of ACDF cases performed at a single institution by 15 surgeons from 2011 to 2017. Univariate analyses and mixed linear regression models were then used with the surgeon as a random effects variable to determine which factors were associated with surgical episode costs and surgical time. Signs and symptoms of cervical myelopathy were collected …

Intrasellar Neurocytoma. A Case Report & Literature Review, Gabriel Carrillo-Marhx, Mariana Flores-Núñez Dr., Basilio Fernández-Alvarado Dr., Pedro Pablo De Juambelz-Cisneros Dr., Fernando Pazos-Gómez Dr.

Archives of Neurosurgery

Background: Neurocytoma is an unusual intracranial neoplasm; it represents 0.1-0.5% of brain neoplasms. The first report of an extraventricular neurocytoma (EVN) was published in 1989. Suprasellar neurocytomas are classified as EVN, representing a scarce variant of neurocytoma. There are only 22 cases of sellar neurocytomas reported in the literature, including the present one.

Observations: A 48-year-old woman arrived at the emergency department (ED) with a previously made MRI, which reported a sellar neoplasm. Due to the clinical presentation, location, and image characteristics, the lesion was managed as a pituitary neuroendocrine tumor. The final pathology report established the final diagnosis of …

A Combination Of Glossopharyngeal And Trigeminal Neuralgia Secondary To Covid-19: Case Report., Mauro Alberto Segura-Lozano, Adriana Fernanda Segura-Zenón, Alejandro González-Silva, Octavio Carranza-Rentería, Yael Rodrigo Torres-Torres, Aarón Giovanni Munguía-Rodríguez

Archives of Neurosurgery

Background: During the COVID-19 pandemic, a wide variety of neurological symptoms have appeared as part of SARS-CoV-2 infection, including cranial nerve impairments. Case Description: We describe a 33-year-old woman who developed glossopharyngeal neuralgia (GPN) and trigeminal neuralgia (TN) immediately after the curse of COVID-19. MRI demonstrated two vascular structures contacting the right trigeminal nerve and possible vascular contact on the ipsilateral glossopharyngeal nerve. Severe arachnoiditis was identified during microvascular decompression of the right glossopharyngeal and trigeminal nerves. After the intervention and during the last follow-up, the patient remains without neuropathic pain. Conclusions: SARS-CoV-2 is a possible etiology of …

Issues To Publish In Latin America, Fiacro Jiménez Ponce, José Antonio Soriano Sánchez, José Alberto Israel Romero Rangel

Archives of Neurosurgery

Scientific knowledge is essential to the development of civilization, particularly in our case for anatomy and physiology of the central nervous system and neurosurgical practice. In this editorial, we are reviewing three critical aspects of scientific publications: The scientific training of physicians, the impact of publications, and the ethical aspects related to elaborating a paper.

Aneurysmal Subarachnoid Hemorrhage And Acute Subdural Hematoma, Neurosurgical And Endovascular Rescue. Case Report., José Omar Santellan Resident, José Ramón Aguilar Dr., Abraham Ibarra Dr., Ulises García Dr.

Archives of Neurosurgery

Introduction: Acute subdural hemorrhage (aSDH) in association with aneurismal subarachnoid hemorrhage (SAH) is a severe disease with an incidence of 0.5% to 7.9% of all SAH. Due to the rarity of aneurysmal aSDH, it remains difficult to define a comprehensive management protocol. In this case review, following the CARE guidelines, we show the hybrid management of this pathology to know the importance of using different types of neurosurgical treatments in case of two severe diseases in critical patients.

We present two patients who developed sudden onset cephalea and neurological impairment secondary to aneurysmal subarachnoid hemorrhage associated with acute subdural hematoma. …

The Scientific Divulgation In Neurosurgery., Rodrigo Ramos-Zuñiga, Sergio Manuel Ibarra-Navarro

Archives of Neurosurgery

The communication of scientific findings in a young discipline in the evolution of knowledge about the human nervous system, has had a consistent and significant advance. This interdisciplinary and multidisciplinary vision has been a fundamental educational axis in the development of neurosurgery in terms of innovation, scientific progress, technological development and quality of patient care. It is therefore essential that scientific writing and communication channels continue to preserve these quality standards, to validate without bias and with certainty, the value and strength of the advances of neurosurgery as a science.

Passive Functional Mapping Using Infrared Thermography In Epilepsy Awake Surgery: Case Report, Enrique De Font-Réaulx, Javier Terrazo-Lluch, Paul Shkurovich-Bialik, Miguel Ángel Collado-Corona, Ernesto Ramírez-Navarrete, Luis Díaz-López Md, Alma Rosa Martínez-Rosas Msc, Adalberto González-Astiazarán

Archives of Neurosurgery

Background: Active Functional Mapping (AFM) is the gold standard method for localizing cortical and subcortical brain functional areas and tracts. By definition, it requires direct application of controlled electrical stimuli under established protocols. Nevertheless, it entails inherent risks, such as causing intraoperative seizures. On the other hand, Passive Functional Mapping (PFM) doesn´t require electrical stimulation of the nervous system. PFM is based on the knowledge that brain metabolism generates different electromagnetic radiation patterns depending on its metabolism, that are invisible to the human eye, but infrared thermographic cameras can show those changes related to brain activity without the use of …

The Many Worlds Of Neurosurgery And The Labyrinth Of Borges, Juan F. Villalonga, Giulia Guizzardi, Domenico Solari

Archives of Neurosurgery

Nowadays, an apprentice of neurosurgery has to complete long and different pathways of education.The encounter between the schools of Napoli and Tucuman, make us identify a common strategy of neurosurgical education. In attempt of defining the philosophy behind it we attempt a comparison in between the life and training of a modern neurosurgeon and the character of a tale of Borges (i.e. Ts'ui Pên). As neurosurgeons of the 21st century we must be like the inextricable Ts'ui Pên.

L5-S1 Collapsed Space Is Not A Contraindication For Elif. Technical Note And Preliminary Clinical Results, Iris Tatiana Montes González, Sergio Soriano Solis, Manuel Eduardo Soto García, Manuel Rodríguez García, Gerson Reyes Rodríguez., Víctor David López García, José Antonio Soriano Sánchez

Archives of Neurosurgery

INTRODUCTION: Extraforaminal lumbar interbody fusion (ELIF) avoids vascular, neural, and genitourinary risks of anterior and lateral techniques. However, many authors consider ELIF to be contraindicated in L5-S1, especially in the case of a collapsed space. Therefore, we aim to provide a technical note for ELIF in the context of an L5-S1 collapsed space and present our experience and the postoperative clinical results of our patients. MATERIALS AND METHODS: We collected data from the records of patients with ELIF L5-S1 level collapsed between March 2020 to June 2021, using for this study sex, age, clinical symptoms, diagnosis, L5-S1 height space, EVA, …

Innocuous Expectoration Of An Anterior C3 Loosened Screw—Case Report And Literature Review About A Benevolent Evolution With No Esophageal Injury, Gerson Reyes Rodriguez, José Alberto Israel Romero Rangel, Manuel Soto García, Manuel Rodriguez Garcia, Victor David Lopez Garcia, Iris Tatiana Montes González, José Antonio Soriano Sánchez

Archives of Neurosurgery

The anterior cervical discectomy and fusion (ACDF) technique is the gold-standard treatment for myeloradiculopathy. We present the case of a seventy-five years old female who came to revision because of worsening solids dysphagia, dry cough, and foreign body sensation in the past two weeks; we had practiced her an ACDF procedure four years ago. She denied presenting neurological deficit or neck pain. The physical examination was normal. Cephalic migration of the left C3 screw was evident on cervical plain and dynamic films and CT-Scan. She was admitted to the hospital for an upper gastrointestinal endoscopy that visualized retropharyngeal ulceration. Thirty …

Clinical Applications Of Direct Cortical Stimulation During Awake Craniotomies. Commentary On Passive Functional Mapping Using Infrared Thermography In Epilepsy Awake Surgery., Ramiro Antonio Perez De La Torre, Ramanathan Siddarth, Pérez Ramírez Pedro, Santiago Noé

Archives of Neurosurgery

As clinicians, we rely on various imaging methods to identify abnormal brain lesions. We can distinguish this myriad of neurological disorders by using imaging alone or together with either or both electrophysiological monitoring and direct cortical stimulation. This last alternative is the most frequently used approach to diagnosing brain lesions requiring awake craniotomies for adequate management. Awake craniotomies have become the standard of care for focal lesions, including vascular malformations like cavernous angiomas, intrinsic brain tumors, gliomas, vasculitic brain lesions, postinfectious brain lesions, brain metastasis, and also for epilepsy surgery. Surgery for epileptic patients requires multidisciplinary team interactions and a …