Neurosurgical Review最新文献

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Oculomotor nerve palsy recovery following microsurgery vs. endovascular treatment of posterior communicating artery aneurysms: a comparative meta-analysis of short- and long-term outcomes. 后交通动脉瘤显微手术与血管内治疗后眼球运动神经麻痹的恢复:短期和长期疗效的比较荟萃分析。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-18 DOI: 10.1007/s10143-024-03149-7
Rahim Abo Kasem, Conor Cunningham, Sameh Samir Elawady, Mohammad Mahdi Sowlat, Sofia Babool, Saad Hulou, Zachary Hubbard, Atakan Orscelik, Basel Musmar, Alejandro M Spiotta
{"title":"Oculomotor nerve palsy recovery following microsurgery vs. endovascular treatment of posterior communicating artery aneurysms: a comparative meta-analysis of short- and long-term outcomes.","authors":"Rahim Abo Kasem, Conor Cunningham, Sameh Samir Elawady, Mohammad Mahdi Sowlat, Sofia Babool, Saad Hulou, Zachary Hubbard, Atakan Orscelik, Basel Musmar, Alejandro M Spiotta","doi":"10.1007/s10143-024-03149-7","DOIUrl":"https://doi.org/10.1007/s10143-024-03149-7","url":null,"abstract":"<p><p>Recent advancements in endovascular treatment (EVT) and different views on optimal management for posterior communicating artery (PComA) aneurysms with oculomotor nerve palsy (ONP) highlight a need to compare recovery timelines between microsurgery and EVT; heterogeneous outcomes and influencing factors may also affect results. A comprehensive systematic review and meta-analysis were conducted by searching PubMed, Embase, Scopus, and Web of Science databases. The extracted data encompassed patient demographics, details on treatment modalities and timing, and characteristics of PComA aneurysms ONP caused by either unruptured or ruptured aneurysms. The primary outcome was ONP favorable recovery, defined as the resolution of admission symptoms, except for subtle ptosis and mild pupillary asymmetry. We used random effect models to calculate odds ratios (OR) and pool prevalence with their corresponding 95% confidence intervals (CI). A total of 40 studies met the inclusion criteria. Overall, microsurgical clipping of PComA aneurysms demonstrated a significantly higher likelihood of ONP recovery compared to EVT at 1,3,6, and 12 months follow-up. However, recovery rates were comparable in long-term follow-up [18 months: (0.87 vs. 0.64, P-value = 0.36); ≥24 months: (0.86 vs. 0.72 P-Value = 0.26)]. The recovery outcomes for early treatment were similar when assessed during the 6-month follow-up (0.75 vs. 0.56, P-value = 0.07). Our findings suggest microsurgery leads to prompt ONP recovery from PComA aneurysms, while EVT shows potential for delayed favorable recovery; both treatments yield short-term recovery when administered early. A case-by-case approach is recommended, emphasizing a comprehensive understanding of patient factors in relation to the immediate and sustained effects of each treatment.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"904"},"PeriodicalIF":2.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anterior choroidal artery aneurysm case series: a clinical decision algorithm for endovascular and surgical treatment using a novel classification system. 脉络膜前动脉瘤病例系列:使用新型分类系统的血管内治疗和手术治疗临床决策算法。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-18 DOI: 10.1007/s10143-024-03152-y
Patrick S Barhouse, Felipe Ramirez-Velandia, Michael Young, Philipp Taussky, Christopher S Ogilvy
{"title":"Anterior choroidal artery aneurysm case series: a clinical decision algorithm for endovascular and surgical treatment using a novel classification system.","authors":"Patrick S Barhouse, Felipe Ramirez-Velandia, Michael Young, Philipp Taussky, Christopher S Ogilvy","doi":"10.1007/s10143-024-03152-y","DOIUrl":"https://doi.org/10.1007/s10143-024-03152-y","url":null,"abstract":"<p><p>Anterior choroidal artery (AChA) aneurysms represent 2-5% of intracranial aneurysms. The proximity of the origin of the AChA to the aneurysm neck poses a risk of thromboembolic complications following treatment. AChA occlusion can result in significant neurological deficits. We present a case-series of patients with AChA aneurysms and their treatment outcomes. We describe how treatment was chosen based on aneurysm and patient-specific factors to minimize risks, enhance efficacy of treatment, and improve patient outcomes. We retrospectively reviewed 27 patients who underwent treatment for AChA aneurysms at a single institution from 2015-2024. Clinical presentation, aneurysm characteristics, procedural details, and follow-up data were collected. Twenty-seven AChA aneurysms (median diameter 2.94 mm), were treated in 29 procedures. Treatments included clipping (11 aneurysms), flow diversion (13), or coiling (5). The five coiled aneurysms were ruptured at presentation. Three patients experienced permanent infarction (10.3%), two in the setting of vasospasm after coiling and one after flow diversion in a patient who proved to have resistance to clopidogrel. At a median follow-up of 4.73 months (IQR = 1.23-14.03), 25 patients (93%) had favorable functional recovery (mRS 0-2). Patients treated for AChA aneurysms experienced favorable functional outcomes by utilizing surgical and endovascular techniques carefully chosen based on aneurysm and patient-specific factors. Two patients did not achieve independence post-coiling due to disability from their initial subarachnoid hemorrhage. There were no treatment related causes of unfavorable functional outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"905"},"PeriodicalIF":2.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minimally invasive neurosurgery: application of burr-hole technique across a spectrum of brain lesions.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-18 DOI: 10.1007/s10143-024-03151-z
Jun-Feng Huo, Jia-Jia Zheng, Mohamed Helmy, Min-Di Liu, Xue-Jun Zhang, Dong-Lei Song, Wei Sun
{"title":"Minimally invasive neurosurgery: application of burr-hole technique across a spectrum of brain lesions.","authors":"Jun-Feng Huo, Jia-Jia Zheng, Mohamed Helmy, Min-Di Liu, Xue-Jun Zhang, Dong-Lei Song, Wei Sun","doi":"10.1007/s10143-024-03151-z","DOIUrl":"https://doi.org/10.1007/s10143-024-03151-z","url":null,"abstract":"<p><strong>Objective: </strong>The burr-hole technique is a minimally invasive transcranial approach designed to minimize the surgical incision size and reduce disruption to brain tissue. We aimed to share our experience with the burr-hole technique for removing brain lesions and to evaluate its effectiveness in treating appropriately sized intra-axial brain lesions.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed the clinical features, radiological characteristics, surgical techniques, and outcomes of patients who underwent burr-hole surgery for intra-axial brain lesions between January 2019 and December 2023.</p><p><strong>Results: </strong>A total of 81 patients were included in the study. Gross total resection was achieved in 74 patients (91.4%), whereas subtotal resection was performed in 7 patients (8.6%). There were no perioperative deaths, cerebrospinal fluid leaks, or wound infections. The median follow-up duration was 40.5 months (range, 4.1-63.7 months). At the end of the follow-up period, 14 patients (17.3%) experienced recurrence, including 6 with glioma and 8 with primary cerebral lymphoma. Among these patients, 10 died due to lesion recurrence.</p><p><strong>Conclusions: </strong>The burr-hole approach using a retractable tubular device is a safe and effective method for the removal of brain lesions. As a novel minimally invasive technique, it significantly facilitates and accelerates the evolution of microsurgical outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"903"},"PeriodicalIF":2.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of microsurgical surgery in patients with proximal vertebral artery stenosis unsuited for endovascular treatment: a single-center retrospective study.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-14 DOI: 10.1007/s10143-024-03153-x
Mingyuan Liu, Peiguang Yan, Mingxin Wang, Jia Guo, Wei Liu, Ganchun Wu, Lufei Wang, Jingjing Liu, Li Li
{"title":"Application of microsurgical surgery in patients with proximal vertebral artery stenosis unsuited for endovascular treatment: a single-center retrospective study.","authors":"Mingyuan Liu, Peiguang Yan, Mingxin Wang, Jia Guo, Wei Liu, Ganchun Wu, Lufei Wang, Jingjing Liu, Li Li","doi":"10.1007/s10143-024-03153-x","DOIUrl":"10.1007/s10143-024-03153-x","url":null,"abstract":"<p><p>To investigate the clinical efficacy and safety of microsurgical surgery in patients with proximal vertebral artery stenosis unsuitable for endovascular treatment. A retrospective analysis was conducted on the clinical data of 34 patients with proximal vertebral artery stenosis who underwent microsurgical surgery at the Department of Cerebrovascular Surgery, Shengli Oilfield Central Hospital, Dongying, Shandong, from March 2020 to April 2023. Preoperative imaging confirmation of proximal vertebral artery stenosis or occlusion was obtained using cervical CT angiography (CTA), CT perfusion imaging (CTP), and magnetic resonance angiography (MRA). Postoperative imaging examinations were utilized to evaluate blood flow patency, and clinical symptoms and complications during hospitalization and follow-up were documented. Postoperative imaging examinations in the 34 patients (Males: 79.4%; Mean age: 66.7 ± 9.6 years) revealed patent vertebral and supplying arteries. No new instances of transient ischemic attacks (TIAs) or other cerebrovascular events were observed during hospitalization, and clinical symptoms were improved. The mean follow-up duration was 10 months (range: 6-39 months). One patient died from septic shock due to abdominal infection, and one patient exhibited moderate ipsilateral vertebral artery stenosis on a follow-up CTA at 6 months postoperatively. The Modified Rankin Scale (mRS) scores decreased for 30 patients after surgery compared to preoperative scores, with all postoperative mRS scores being less than 1. The difference between preoperative and postoperative mRS scores was statistically significant (P < 0.01). Six patients experienced temporary postoperative complications, which resolved after active treatment, and one patient developed permanent Horner's syndrome without affecting the quality of life. Microsurgical surgery for patients with proximal vertebral artery stenosis, when endovascular treatment is unsuitable, demonstrates good clinical efficacy and a low incidence of complications, offering a viable surgical treatment option. Further multicenter studies with larger sample sizes will be instrumental in validating its clinical application value.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"901"},"PeriodicalIF":2.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical evaluation, diagnosis, and decision-making for metastatic spine tumors: WFNS spine committee recommendations. 转移性脊柱肿瘤的临床评估、诊断和决策:WFNS 脊柱委员会建议。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-14 DOI: 10.1007/s10143-024-03154-w
Sandeep Vaishya, Vibha Gaonkar, Manbachan Singh Bedi, Onur Yaman, Mehmet Zileli, Salman Sharif
{"title":"Clinical evaluation, diagnosis, and decision-making for metastatic spine tumors: WFNS spine committee recommendations.","authors":"Sandeep Vaishya, Vibha Gaonkar, Manbachan Singh Bedi, Onur Yaman, Mehmet Zileli, Salman Sharif","doi":"10.1007/s10143-024-03154-w","DOIUrl":"https://doi.org/10.1007/s10143-024-03154-w","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal metastases are a significant concern for patients with advanced cancer, leading to pain, neurological deficits, and reduced quality of life. They occur in up to 70% of cancer patients, with the vertebral column being the most common osseous site for metastatic disease<sup>1-3</sup>. An approximate 10% of patients with vertebral body metastases eventually develop spinal cord compression, which can potentially cause severe and permanent disability<sup>4-6</sup>. This article aims to summarize the consensus statements developed by the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the clinical evaluation, diagnosis, and decision-making for metastatic spine tumors.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed and Google Scholar from 2014 to 2023 using the search terms \"clinical evaluation\" + \"spine metastases,\" \"spine metastases\" + \"diagnosis,\" and \"spine metastases\" + \"decision making\" + \"treatment.\" Based on the review of this literature, six members of the WFNS Spine Committee developed five consensus statements using the Delphi method, which were voted on during two rounds of voting at two international meetings.</p><p><strong>Results: </strong>We agree that a high index of suspicion is required for early detection and diagnosis of spinal metastasis in cancer patients and adult patients more than 60 years presenting with new onset fractures / neurological deficits. Pain is the most common symptom followed by motor deficit. Bowel and bladder dysfunction is noted in nearly half of patients with metastatic spinal cord compression. An effective treatment for spinal metastases should be able to achieve pain relief, tumor control, prevention of neurological compromise and treat instability. Separation surgery combined with SRS is an effective treatment for spinal metastases.</p><p><strong>Conclusion: </strong>These consensus statements provide evidence-based guidelines for clinical evaluation, diagnosis, and decision-making in patients with metastatic spine tumors.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"902"},"PeriodicalIF":2.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cervical spine injuries in professional judo: a cross-sectional analysis of prevalence, risk factors, and preventive measures.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-12 DOI: 10.1007/s10143-024-03146-w
Lucca B Palavani, Bernardo V Nogueira, Marcelo Costa, Lucas P Mitre, Manuella K Frediani, Gustavo Rielo, Rafael C de Lira, Adriano R Dos Santos, Leandro M Guilheiro, Vinicius M P Guirado, Jean G de Oliveira, Jose Carlos E Veiga, Marcio S Rassi
{"title":"Cervical spine injuries in professional judo: a cross-sectional analysis of prevalence, risk factors, and preventive measures.","authors":"Lucca B Palavani, Bernardo V Nogueira, Marcelo Costa, Lucas P Mitre, Manuella K Frediani, Gustavo Rielo, Rafael C de Lira, Adriano R Dos Santos, Leandro M Guilheiro, Vinicius M P Guirado, Jean G de Oliveira, Jose Carlos E Veiga, Marcio S Rassi","doi":"10.1007/s10143-024-03146-w","DOIUrl":"https://doi.org/10.1007/s10143-024-03146-w","url":null,"abstract":"<p><strong>Introduction: </strong>Judo, a martial art created by Jigoro Kano in 1882, is a martial art promoting physical and spiritual development. Despite its \"gentle way\" philosophy, it poses a significant risk for cervical spine injuries, often resulting from throws and ground techniques.</p><p><strong>Methods: </strong>This cross-sectional study analyzed cervical injuries among professional judo athletes from January to July 2024. Data were collected via an online questionnaire covering demographics, injury details, circumstances, and prevention. The study included athletes from seven countries, with exclusion criteria being pre-existing non-judo-related cervical conditions and incomplete questionnaires. Descriptive and inferential statistical analyses were performed using RStudio 4.4.0.</p><p><strong>Results: </strong>Of the 104 participants, 42 athletes reported cervical injuries, primarily during practice and linked to high-risk techniques like uchi-mata and ippon-seoi-nage. Defensive maneuvers, especially involving the \"head dive,\" were significant risk factors. Injuries ranged from contusions to disc herniations and fractures, with symptoms like pain, numbness, and weakness. Most athletes received physical therapy, though some required surgery. Preventive measures were inconsistently applied, despite advice from coaches and physical therapists.</p><p><strong>Conclusion: </strong>Cervical spine injuries in judo are common, especially during defensive maneuvers and specific high-risk techniques. The variability in treatment outcomes underscores the need for better prevention strategies, education, and tailored training. Further research is essential to mitigate injury risks for judo athletes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"899"},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative efficacy and safety of therapeutic strategies for mirror aneurysms: A systematic review and meta-analysis.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-12 DOI: 10.1007/s10143-024-03138-w
Parisa Javadnia, Amir Reza Bahadori, Erfan Naghavi, Azadeh Imeni Kashan, Afshan Davari, Mehrdad Sheikhvatan, Abbas Tafakhori, Sajad Shafiee, Sara Ranji
{"title":"Comparative efficacy and safety of therapeutic strategies for mirror aneurysms: A systematic review and meta-analysis.","authors":"Parisa Javadnia, Amir Reza Bahadori, Erfan Naghavi, Azadeh Imeni Kashan, Afshan Davari, Mehrdad Sheikhvatan, Abbas Tafakhori, Sajad Shafiee, Sara Ranji","doi":"10.1007/s10143-024-03138-w","DOIUrl":"https://doi.org/10.1007/s10143-024-03138-w","url":null,"abstract":"<p><p>Mirror aneurysms are rare and pose therapeutic challenges, with both endovascular and microsurgical options available. Single-stage and two-stage procedures are employed, but the optimal strategy remains unclear. This systematic review and meta-analysis evaluate the efficacy and safety of different therapeutic strategies for managing mirror aneurysms. The study adhered to PRISMA guidelines and comprehensively analyzed data from multiple databases, including Pubmed, Scopus, Embase, Web of Science, and the Cochrane Library, up to 30th September 2024. Statistical analysis utilized the Comprehensive Meta-analysis (CMA) software version 3.0. This systematic review encompasses 42 studies, with 11 studies undergoing meta-analysis. The meta-analysis included 629 participants. Both microsurgical clipping and endovascular interventions achieved high rates of complete occlusion (RROC 1) (ES = 0.896; 95% CI: 0.840 to 0.931; P < 0.001) with low to moderate heterogeneity (I<sup>2</sup> = 46.46%). Favorable neurological outcomes (mRS ≤ 2) were significantly achieved among all patients (ES = 0.924; 95% CI: 0.891 to 0.948; P < 0.001) with low heterogeneity (I<sup>2</sup> = 15.52%). Subgroup analysis revealed that microsurgical clipping demonstrated superior occlusion rates and more consistent neurological outcomes compared to endovascular treatment. Also, complications were reported in seven studies (n = 492) and included cerebral infarction, hydrocephalus, and vasospasm. As well, mortality and recurrence were rare. Both microsurgical clipping and endovascular interventions are effective and safe for treating mirror aneurysms, with clipping showing superior occlusion rates and consistent outcomes. Single-stage procedures and unilateral craniotomy are associated with better neurological outcomes when feasible.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"900"},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical outcome after autologous bone chips replacement in depressed skull fractures: a single center experience.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-10 DOI: 10.1007/s10143-024-03128-y
Hossam Elnoamany, Ahmed Mansour, Mazen Lotfy Agour, Mohammed Dorrah, Nour Elnoamany, Anwar Hourieh, Hany Elkholy
{"title":"Surgical outcome after autologous bone chips replacement in depressed skull fractures: a single center experience.","authors":"Hossam Elnoamany, Ahmed Mansour, Mazen Lotfy Agour, Mohammed Dorrah, Nour Elnoamany, Anwar Hourieh, Hany Elkholy","doi":"10.1007/s10143-024-03128-y","DOIUrl":"10.1007/s10143-024-03128-y","url":null,"abstract":"<p><strong>Background: </strong>Surgery for depressed skull fractures (DSFs) is always faced by multiple challenges including ideal timing, defect reconstruction and complications. Few data are available regarding the aesthetic results and patients' satisfaction following DSFs management.</p><p><strong>Methods: </strong>A prospective non-randomized study included 59 traumatic brain injury (TBI) patients surgically treated for DSFs. Depressed bone fragments were elevated and washed with diluted hydrogen peroxide for 15 min then replaced within a net made of vicryl 0 through edges of the galea. Our objective was to evaluate outcome and patients' satisfaction of using autologous bone fragments for skull defect reconstruction.</p><p><strong>Results: </strong>The mean Glasgow Coma Scale (GCS) score on admission was 14.51 ± 1.237. The mean age was 16.505 ± 12.426 years. DSFs were of compound type in 81.4% with predominance towards the parietal region 54.2%. Associated intracranial pathologies were found in 39.0% of cases. Mean time to surgery was 5.79 ± 9.982 h. Dura was found torn in 19 cases (32.2%). Postoperative complications were encountered in 5 cases (8.5%). The mean hospital stay was 3.61 ± 3.157 days. 96.6% of cases had good discharge outcome. Factors with significant impact on outcome included; admission GCS score (P < 0.001), type of associated pathology (P = 0.006), and venous sinus involvement (P = 0.003). At the end of follow up, 46 patients (82.5%) were satisfied about the aesthetic results, while 10 patients (17.5%) were not satisfied and 9 of them underwent re-surgery for late cranioplasty.</p><p><strong>Conclusions: </strong>Using autologous depressed bone chips for skull defect reconstruction can be a safe and feasible surgical technique for TBI patients suffering DSFs with good aesthetic results, high patient satisfaction, decreased need for later cranioplasty and consequently low overall management cost.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"898"},"PeriodicalIF":2.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of levetiracetam use in glioblastoma: an individual patient-level meta-analysis assessing overall survival.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-09 DOI: 10.1007/s10143-024-03137-x
Martin Vychopen, Agi Güresir, Alim Emre Basaran, Erdem Güresir, Johannes Wach
{"title":"Impact of levetiracetam use in glioblastoma: an individual patient-level meta-analysis assessing overall survival.","authors":"Martin Vychopen, Agi Güresir, Alim Emre Basaran, Erdem Güresir, Johannes Wach","doi":"10.1007/s10143-024-03137-x","DOIUrl":"10.1007/s10143-024-03137-x","url":null,"abstract":"<p><strong>Background: </strong>Levetiracetam (Lev), an antiepileptic drug (AED), enhances alkylating chemotherapy sensitivity in glioblastoma (GB) by inhibiting MGMT expression. This meta-analysis evaluates Lev's impact on GB treatment by analyzing overall survival of individual patient data (IPD) from published studies.</p><p><strong>Methods: </strong>IPD was reconstructed using the R package IPDfromKM. Pooled IPD Kaplan-Meier charts of survival stratified by Lev therapy were created using the R package Survminer. One- and two-stage meta-analyses of Lev treatment regarding survival was performed.</p><p><strong>Results: </strong>Three articles covering 825 patients were included out of 3567 screened records. Lev usage prevalence was 0.36. IPD from 590 IDH wild-type glioblastomas, with a median follow-up of 16.1 months, were utilized. Pooled data revealed median survival times of 19.2 months (95%CI: 16.4-22.0) for Lev users versus 16.5 months (95%CI: 15.2-17.8) for partial/no use (p = 0.006). One-stage meta-analysis indicated a significant association between Lev use and survival in IDH wild-type GB (HR: 1.33, 95%CI: 1.08-1.64, p = 0.007). Two-stage meta-analysis confirmed these results.</p><p><strong>Conclusions: </strong>This meta-analysis highlights that Lev use may prolong survival in IDH wild-type GB patients. Further randomized trials are needed to confirm these findings and identify subgroups benefiting most from Lev treatment.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"897"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Clinical outcomes of patients undergoing reoperation with solitary fibrous tumors/hemangiopericytomas and malignant progression of tumors.
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-12-09 DOI: 10.1007/s10143-024-03114-4
Long Chen, Runfeng Wang, JianQing He, Haiyang Wu, Yunze Zhang, Yang Wu, Tianzhi Zhao, Yan Qu, Yingxi Wu
{"title":"Correction to: Clinical outcomes of patients undergoing reoperation with solitary fibrous tumors/hemangiopericytomas and malignant progression of tumors.","authors":"Long Chen, Runfeng Wang, JianQing He, Haiyang Wu, Yunze Zhang, Yang Wu, Tianzhi Zhao, Yan Qu, Yingxi Wu","doi":"10.1007/s10143-024-03114-4","DOIUrl":"https://doi.org/10.1007/s10143-024-03114-4","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"895"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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