Activity

01; 95% CI, 0.64-1.59; P= 0.95; I

= 0%). MIS was associated with less blood loss (mean difference,-690.00 mL; 95% CI,-888.31 to-491.69; P < 0.001; I

= 56%), and lower transfusion rate compared with COS (OR, 0.27; 95% CI, 0.11-0.66; P= 0.004; I

= 50%). Length of surgery was similar in both groups (mean difference,-12.49 minutes; 95% CI,-45.93 to 20.95; P= 0.46; I

= 86%). MIS resulted in shorter length of stay compared with COS (mean difference-3.58 days; 95% CI,-6.90 to-0.26; P= 0.03; I

= 89%).

MIS was associated with lower complications, blood loss, transfusion rate, and shorter length of stay with a similar rate of neurologic improvement and length of surgery compared with COS.

MIS was associated with lower complications, blood loss, transfusion rate, and shorter length of stay with a similar rate of neurologic improvement and length of surgery compared with COS.

Animal brain tumor models can be useful educational tools for the training of neurosurgical residents in risk-free environments. Magnetic resonance imaging (MRI) technologies have not used these models to quantitate tumor, normal gray and white matter, and total tissue removal during complex neurosurgical procedures. This pilot study was carried out as a proof of concept to show the feasibility of using brain tumor models combined with 7-T MRI technology to quantitatively assess tissue removal during subpial tumor resection.

Seven exvivo calf brain hemispheres were used to develop the 7-T MRI segmentation methodology. Three brains were used to quantitate brain tissue removal using 7-T MRI segmentation methodology. Alginate artificial brain tumor was created in 4 calf brains to assess the ability of 7-T MRI segmentation methodology to quantitate tumor and gray and white matter along with total tissue volumes removal during a subpial tumor resection procedure.

Quantitative studies showed a correlation between removed brain tissue weights and volumes determined from segmented 7-T MRIs. Analysis of baseline and postresection alginate brain tumor segmented 7-T MRIs allowed quantification of tumor and gray and white matter along with total tissue volumes removed and detection of alterations in surrounding gray and white matter.

This pilot study showed that the use of animal tumor models in combination with 7-T MRI technology provides an opportunity to increase the granularity of data obtained from operative procedures and to improve the assessment and training of learners.

This pilot study showed that the use of animal tumor models in combination with 7-T MRI technology provides an opportunity to increase the granularity of data obtained from operative procedures and to improve the assessment and training of learners.

The cause of surfer myelopathy remains enigmatic and long-term follow-up outcomes are not well documented. In the present study, the mechanisms underlying surfer myelopathy in children are analyzed and the long-term follow-up outcomes are reported.

Clinical data from 3 institutions were retrospectively analyzed. Patients were assessed using the American Spinal Injury Association Impairment Scale (AIS) on admission and at follow-up. The mechanisms were studied by analyzing patients’ medical history, magnetic resonance imaging, and magnetic resonance angiography. The prognosis of long-term follow-up was summarized.

Thirty-one children were diagnosed with surfer myelopathy. Intramedullary high-intensity T2 signal from mid to lower thoracic level to conus was found during the acute stage. Follow-up magnetic resonance imaging in the subacute stage showed cranial progression of the T2 hyperintensity up to 1-10 vertebral segments, and no neurologic deterioration was found. Intramedullary lesion length between the complete and incomplete injury was significantly different (P < 0.01) in the subacute phase. Flow voids around nerve roots and in the epidural space were detected in 18 patients and 15 patients, respectively, on axial T2-weighted imaging. Enlarged tortuous veins were found in 3 of 6 patients who underwent spinal magnetic resonance angiography, which were discontinuous around nerve root. During long-term follow-up, no patients with AIS grade A recovered, and atrophic cord was observed in the later stage in 14 patients. Patients with incomplete injury had different recoveries.

Surfer myelopathy in children is caused by spinal venous hypertension. TBK1/IKKε-IN-5 The AIS grade on admission is a predictor of prognosis.

Surfer myelopathy in children is caused by spinal venous hypertension. The AIS grade on admission is a predictor of prognosis.

A combined transcranial and transfacial approach has long been the gold standard for surgical management of large tumors with sinonasal and skull base involvement. The extended endoscopic endonasal approach for such pathologies has its advantages, but it has flaws as well, such as anatomic limitations and more ponderous skull base reconstruction and thus higher risk of postoperative complications. Our primary technique for surgical treatment of these pathologies has been a combination of transfacial and minimally invasive transciliary supraorbital keyhole approaches. With the aim to further minimize invasiveness, potential complications, and unsatisfactory aesthetic outcomes during surgical treatment of large tumors invading both the sinonasal area and the skull base, we abandoned the transfacial approach and simultaneously combined the transciliary supraorbital keyhole approach with the endoscopic endonasal approach.

The well-known microscope-assisted minimally invasive approach via a transciliary supraorbital keyhole craniotomy was combined with the endoscopic endonasal approach.

Six patients with different histologic types of tumors affecting the sinonasal area and the skull base were operated on. The mean operative time was 3 hours, there were no unexpected intraoperative or postoperative complications, and total tumor removal was achieved in each patient. None of the patients experienced complications associated with the surgery during follow-up.

Our combined simultaneous multiportal approach enables total tumor eradication with reduced operative time and is associated with minimal intraoperative and postoperative complications, low mortality rate, and excellent cosmetic results.

Our combined simultaneous multiportal approach enables total tumor eradication with reduced operative time and is associated with minimal intraoperative and postoperative complications, low mortality rate, and excellent cosmetic results.