Surgical neurology international最新文献

{"title":"Awake neurosurgery: Advancements in microvascular decompression for trigeminal neuralgia.","authors":"Areeba Fareed, Zoha Iftikhar, Ramsha Haider, Safa Irfan Shah, Michelle Ennabe, Albert Alan, Martin Weinand","doi":"10.25259/SNI_286_2024","DOIUrl":"10.25259/SNI_286_2024","url":null,"abstract":"<p><strong>Background: </strong>The treatment landscape for trigeminal neuralgia (TN) involves various surgical interventions, among which microvascular decompression (MVD) stands out as highly effective. While MVD offers significant benefits, its success relies on precise surgical techniques and patient selection. In addition, the emergence of awake surgery techniques presents new opportunities to improve outcomes and minimize complications associated with MVD for TN.</p><p><strong>Methods: </strong>A thorough review of the literature was conducted to explore the effectiveness and challenges of MVD for TN, as well as the impact of awake surgery on its outcomes. PubMed and Medline databases were searched from inception to March 2024 using specific keywords \"Awake Neurosurgery,\" \"Microvascular Decompression,\" AND \"Trigeminal Neuralgia.\" Studies reporting original research on human subjects or preclinical investigations were included in the study.</p><p><strong>Results: </strong>This review highlighted that MVD emerges as a highly effective treatment for TN, offering long-term pain relief with relatively low rates of recurrence and complications. Awake surgery techniques, including awake craniotomy, have revolutionized the approach to MVD, providing benefits such as reduced postoperative monitoring, shorter hospital stays, and improved neurological outcomes. Furthermore, awake MVD procedures offer opportunities for precise mapping and preservation of critical brain functions, enhancing surgical precision and patient outcomes.</p><p><strong>Conclusion: </strong>The integration of awake surgery techniques, particularly awake MVD, represents a significant advancement in the treatment of TN. Future research should focus on refining awake surgery techniques and exploring new approaches to optimize outcomes in MVD for TN.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracranial pressure (ECP) monitoring in severe traumatic brain injury (TBI): A prospective study validating intra-abdominal pressure (IAP) measurement for predicting intracranial pressure (ICP).","authors":"Mohit Gupta, Jitender Chaturvedi, Farhanul Huda, Rahul Singh Poonia, Fnu Ruchika, Nishant Goyal, Rakesh Sihag, Saravanan Sadhasivam, Priyanka Gupta, Rajneesh Arora, Sanjay Agrawal, Dhaval Shukla","doi":"10.25259/SNI_108_2024","DOIUrl":"10.25259/SNI_108_2024","url":null,"abstract":"<p><strong>Background: </strong>Intracranial pressure (ICP)--guided therapy is the standard of care in the management of severe traumatic brain injury (TBI). Ideal ICP monitoring technique is not yet available, based on its risks associated with bleeding, infection, or its unavailability at major centers. Authors propose that ICP can be gauged based on measuring pressures of other anatomical cavities, for example, the abdominal cavity. Researchers explored the possibility of monitoring intra-abdominal pressure (IAP) to predict ICP in severe TBI patients.</p><p><strong>Methods: </strong>We measured ICP and IAP in severe TBI patients. ICP was measured using standard right frontal external ventricular drain (EVD) insertion and connecting it to the transducer. IAP was measured using a well-established technique of vesical pressure measurement through a manometer.</p><p><strong>Results: </strong>A total of 28 patients (<i>n</i> = 28) with an age range of 18-65 years (mean of 32.36 years ± 13.52 years [Standard deviation]) and the median age of 28.00 years with an interquartile range (21.00-42.00 years) were recruited in this prospective study. About 57.1% (<i>n</i> = 16) of these patients were in the age range of 18-30 years. About 92.9% (<i>n</i> = 26) of the patients were male. The most common mode of injury (78.6%) was road traffic accidents (<i>n</i> = 22) and the mean Glasgow Coma Scale at presentation was 4.04 (range 3-9). The mean ICP measured at the presentation of this patient cohort was 20.04 mmHg. This mean ICP (mmHg) decreased from a maximum of 20.04 at the 0 h' time point (at the time of insertion of EVD) to a minimum of 12.09 at the 96 hr time point. This change in mean ICP (from 0 h to 96 h) was found to be statistically significant (Friedman Test: χ² = 87.6, <i>P</i> ≤ 0.001). The mean IAP (cmH2O) decreased from a maximum of 16.71 at the 0 h' time point to a minimum of 9.68 at the 96 h' time point. This change was statistically significant (Friedman Test: χ² = 71.8, <i>P</i> ≤ 0.001). The per unit percentage change in IAP on per unit percentage change in ICP we observed was correlated to each other. The correlation coefficient between these variables varied from 0.71 to 0.89 at different time frames. It followed a trend in a directly proportional manner and was found to be statistically significant (<i>P</i> < 0.001) in each time frame of the study. The rise in one parameter followed the rise in another parameter and vice versa.</p><p><strong>Conclusion: </strong>In this study, we established that the ICP of severe TBI patients correlates well with IAP at presentation. This correlation was strong and constant, irrespective of the timeframe during the treatment and monitoring. This study also established that draining cerebrospinal fluid to decrease ICP in severe TBI patients is reflected in IAP. The study validates that IAP is a strong proxy of ICP in severe TBI patients.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroanatomical insights into neuro-ophthalmic presentations of skull base meningiomas: Pathways to precision medicine - A meta-analysis.","authors":"Najah K Mohammad","doi":"10.25259/SNI_421_2024","DOIUrl":"10.25259/SNI_421_2024","url":null,"abstract":"<p><strong>Background: </strong>Skull base meningiomas are intricately related to neuro-ophthalmic functions and have been related to direct influences on both the afferent and efferent visual pathways due to close contacts with crucial neurovascular structures. The present article reviews the neuro-ophthalmic presentations of these tumors, necessitating the need for precise anatomic information for the delivery of customized diagnostic and therapeutic approaches.</p><p><strong>Methods: </strong>A literature review was conducted using PubMed and Scopus, focusing on terms related to skull base meningiomas and their neuro-ophthalmic impacts. The review included recent and seminal articles to assess advances in understanding and managing these tumors from an anatomical perspective.</p><p><strong>Results: </strong>The findings underscore the diversity in neuro-ophthalmic manifestations based on the meningioma's location, affecting visual pathways differently. For instance, meningiomas in the optic nerve sheath typically lead to isolated optic neuropathy and are often managed with radiation therapy. In contrast, those extending from the sphenoid wing require more aggressive approaches like open surgery. This review highlights how the tumor's location dictates the choice of treatment, ranging from conservative management to multidisciplinary surgical interventions.</p><p><strong>Conclusion: </strong>Proper recognition of the sites of skull base meningiomas results in a treatment tailored to provide therapy aimed explicitly at neuro-ophthalmic outcomes related to the site of the tumors. This approach will not only help to treat effectively but also avoid a wide range of complications and, in turn, increase the effectiveness of the treatment results that a patient will receive. Future studies should aim to refine these anatomical insights toward further advancements in modes of treatment.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retained wood penetrating the inferior orbital fissure removed after several months from injury: A case report and a comprehensive literature review.","authors":"Sara J Aljabber, Abdulaziz M Alghamdi, Dania E Faidah, Yousof Fahad Allarakia, Sarah Bin Abdulqader, Gmaan A Alzahrani","doi":"10.25259/SNI_324_2024","DOIUrl":"10.25259/SNI_324_2024","url":null,"abstract":"<p><strong>Background: </strong>Intraorbital wooden foreign bodies (IOWFBs) constitute a relatively rare ocular trauma. Clinically, it can be difficult to diagnose them due to their wide variety of clinical manifestations. In addition, radiologic diagnosis of IOWFBs is always uncertain and challenging since their low density and low intensity on initial images are identical to air and fat. Therefore, IOWFBs are commonly missed and may not be confirmed for days or months after the initial injury. This article endeavors to contribute to the existing literature on IOWFBs by adding a case of an unusual occurrence of retained wood penetrating the inferior orbital fissure (IOF). To date, there have been no documented instances of a similar occurrence in this particular anatomical location.</p><p><strong>Case description: </strong>A 58-year-old female with a history of trauma sustained by a slipping accident 10 months before her referral to our hospital. She underwent multiple surgeries and was referred to us due to persistent right eye pain, periorbital swelling, recurrent eye discharge, and inferior orbital paresthesia. The imaging revealed a retained foreign body located in the right orbital floor inferior to the inferior rectus muscle extending to the sub-temporal fossa through the IOF. The residue was successfully removed without complications.</p><p><strong>Conclusion: </strong>A history of trauma followed by persistent symptoms should raise the suspicion of a retained foreign body, regardless of the severity of trauma or the time between trauma and clinical presentation. Appropriate and timely imaging, followed by surgical removal, remains the cornerstone of treatment with a favorable prognosis.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications, limitations and advancements of ultra-low-field magnetic resonance imaging: A scoping review.","authors":"Ahmed Altaf, Muhammad Shakir, Hammad Atif Irshad, Shiza Atif, Usha Kumari, Omar Islam, W Taylor Kimberly, Edmond Knopp, Chip Truwit, Khan Siddiqui, S Ather Enam","doi":"10.25259/SNI_162_2024","DOIUrl":"10.25259/SNI_162_2024","url":null,"abstract":"<p><strong>Background: </strong>Ultra-low-field magnetic resonance imaging (ULF-MRI) has emerged as an alternative with several portable clinical applications. This review aims to comprehensively explore its applications, potential limitations, technological advancements, and expert recommendations.</p><p><strong>Methods: </strong>A review of the literature was conducted across medical databases to identify relevant studies. Articles on clinical usage of ULF-MRI were included, and data regarding applications, limitations, and advancements were extracted. A total of 25 articles were included for qualitative analysis.</p><p><strong>Results: </strong>The review reveals ULF-MRI efficacy in intensive care settings and intraoperatively. Technological strides are evident through innovative reconstruction techniques and integration with machine learning approaches. Additional advantages include features such as portability, cost-effectiveness, reduced power requirements, and improved patient comfort. However, alongside these strengths, certain limitations of ULF-MRI were identified, including low signal-to-noise ratio, limited resolution and length of scanning sequences, as well as variety and absence of regulatory-approved contrast-enhanced imaging. Recommendations from experts emphasize optimizing imaging quality, including addressing signal-to-noise ratio (SNR) and resolution, decreasing the length of scan time, and expanding point-of-care magnetic resonance imaging availability.</p><p><strong>Conclusion: </strong>This review summarizes the potential of ULF-MRI. The technology's adaptability in intensive care unit settings and its diverse clinical and surgical applications, while accounting for SNR and resolution limitations, highlight its significance, especially in resource-limited settings. Technological advancements, alongside expert recommendations, pave the way for refining and expanding ULF-MRI's utility. However, adequate training is crucial for widespread utilization.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of <i>Centella asiatica</i>, cinnamon, and spirulina as neuroprotective based on histopathological findings in ratus Sprague Dawley with traumatic brain injury.","authors":"Rohadi Muhammad Rosyidi, Dewa Putu Wisnu Wardhana, Bambang Priyanto, Januarman Januarman, Decky Aditya Zulkarnaen, Lale Maulin Prihatina, Hanan Anwar Rusidi, Rozikin Rozikin","doi":"10.25259/SNI_170_2024","DOIUrl":"10.25259/SNI_170_2024","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a global health problem with the potential to cause dangerous neurological problems. Based on histopathological findings in Sprague Dawley (SD) rats with TBI in the acute phase, the study seeks to discover the effect of <i>Centella asiatica</i>, cinnamon, and spirulina as neuroprotective.</p><p><strong>Methods: </strong>We conducted an experimental study with 30 SD rats randomly divided into three groups. The intervention was the administration of <i>C. asiatica</i>, cinnamon, and spirulina to the control and the experimental groups. Histological features were assessed using hematoxylin and eosin (H&E) staining and immunohistochemical examination. The data were analyzed using statistical analysis through correlation tests.</p><p><strong>Results: </strong>The test samples' average body weights had <i>P</i> > 0.05, indicating no significant difference in the test sample body weights. Therefore, the variations in the expression level of the dependent variable were expected to be caused by the induction of brain injury and the administration of <i>C. asiatica</i>, cinnamon, and spirulina. In addition, the variables were not normally distributed. Thus, the Spearman test was carried out and showed the correlation was very strong, with a value of r = 0.818 and <i>P</i> < 0.05.</p><p><strong>Conclusion: </strong>Based on histopathological findings from the brains of SD rats with TBI, pegagan, cinnamon, and spirulina will protect the brain (neuroprotective) in the acute phase.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Golf cart-related neurosurgical injuries.","authors":"Annelisse Torres-Urquia, Orlando De Jesus","doi":"10.25259/SNI_185_2024","DOIUrl":"10.25259/SNI_185_2024","url":null,"abstract":"<p><strong>Background: </strong>Head and spine injuries sustained following golf cart accidents have been rarely analyzed. This study aimed to describe a series of patients sustaining golf cart injuries requiring neurosurgical management for head or spine injuries.</p><p><strong>Methods: </strong>The University of Puerto Rico Neurosurgery database was used to retrospectively identify and investigate patients who sustained a golf cart-related injury requiring a neurosurgical evaluation during 15 years.</p><p><strong>Results: </strong>The analysis identified 25 patients with golf cart-related injuries requiring neurosurgical management with a median age of 16 (interquartile range 13-34). Seventeen patients (68%) were female. The primary mechanism of injury was ejection from the cart in 84% of the patients (<i>n</i> = 21). The most frequent head injury was a skull fracture in 80% of patients (<i>n</i> = 20). Intracranial hemorrhage was present in 76% of patients (<i>n</i> = 19), with brain contusions (<i>n</i> = 16, 64%) being the most common. Eighteen patients (72%) were admitted for surgery or neurological monitoring. The median hospital length of stay among hospitalized patients was 5.5 days. Ten patients (40%) were admitted to the intensive care unit (ICU) with a median stay of 8.5 days. Four patients (16%) required surgery for their injuries. At discharge, 80% of patients (<i>n</i> = 20) had a good outcome.</p><p><strong>Conclusion: </strong>This study showed that children and adolescents are at high risk for golf cart-related neurosurgical injuries. This form of transportation can produce considerable neurological injuries, the primary mechanism of injury being ejection from the cart. Approximately three-quarters of the patients need hospital admission, with half requiring an ICU stay.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adhesive surface electrodes versus needle-based neuromonitoring in lumbar spinal surgery.","authors":"Renuka Chintapalli, Dhiraj Pangal, Maria-Jose Cavagnaro, Maria Isabel Barros Guinle, Thomas Johnstone, John Ratliff","doi":"10.25259/SNI_394_2024","DOIUrl":"10.25259/SNI_394_2024","url":null,"abstract":"<p><strong>Background: </strong>The relative safety and more widespread utility of an adhesive surface electrode-based neuromonitoring (ABM) system may reduce the time and cost of traditional needle-based neuromonitoring (NBM).</p><p><strong>Methods: </strong>This retrospective cohort review included one- and two-level transforaminal lumbar interbody fusion procedures (2019-2023). The primary variables studied included were time (in minutes) from patient entry into the operating room (OR) to incision, time from patient entry into the OR to closure, and time from incision to closure. Univariate and bivariate analyses were performed to compare the outcomes between the ABM (31 patients) and NBM (51 patients) modalities.</p><p><strong>Results: </strong>We found no significant differences in the time from patient entry into the OR to incision (ABM: 71.8, NBM: 70.3, <i>P</i> = 0.70), time from patient entry into the OR to closure (ABM: 284.2, NBM: 301.7, <i>P</i> = 0.27), or time from incision to closure (ABM: 212.4, NBM: 231.4, <i>P</i> = 0.17) between the two groups. Further, no patients from either group required reoperation for mal-positioned instrumentation, and none sustained a new postoperative neurological deficit. The ABM approach did, however, allow for a reduction in neurophysiologist-workforce and neuromonitoring costs.</p><p><strong>Conclusion: </strong>The introduction of the ABM system did not lower surgical time but did demonstrate similar efficacy and clinical outcomes, with reduced clinical invasiveness, neurophysiologist-associated workforce, and overall neuromonitoring cost compared to NBM.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of radiation-induced changes in arteriovenous malformation patients undergoing radiosurgery: Insights from a Malaysian linear accelerator cohort.","authors":"Bih Huei Tan, Regunath Kandasamy, Siti Azleen Mohamad, Hari Chandra Thambinayagam","doi":"10.25259/SNI_366_2024","DOIUrl":"10.25259/SNI_366_2024","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced changes (RICs) post-stereotactic radiosurgery (SRS) critically influence outcomes in arteriovenous malformation (AVM) treatments. This study aimed to identify predictors of RICs, described the types and severity of RICs, and assessed their impact on patient's functional outcomes to enhance risk assessment and treatment planning for AVM patients.</p><p><strong>Methods: </strong>This retrospective study analyzed 87 AVM patients who underwent SRS at Hospital Kuala Lumpur between January 2015 and December 2020. RICs were identified through detailed magnetic resonance imaging evaluations, and predictive factors were determined using multiple logistic regression. Functional outcomes were assessed with the modified Rankin scale (mRS).</p><p><strong>Results: </strong>Among the cohort, 40.2% developed RICs, with radiological RICs in 33.3%, symptomatic RICs in 5.7%, and permanent RICs in 1.1%. Severity categorization revealed 25.3% as Grade I, 13.8% as Grade II, and 1.1% as Grade III. Notably, higher Pollock-Flickinger scores and eloquence location were significant predictors of RIC occurrence. There was a significant improvement in functional outcomes post-SRS, with a marked decrease in non-favorable mRS scores from 8.0% pre-SRS to 1.1% post-SRS (<i>P</i> = 0.031).</p><p><strong>Conclusion: </strong>The study identified the eloquence location and Pollock-Flickinger scores as predictors of RICs post-SRS. The significant reduction in non-favorable mRS scores post-SRS underscores the efficacy of SRS in improving patient outcomes. Their results highlighted the importance of personalized treatment planning, focusing on precise strategies to optimize patient outcomes in AVM management, reducing adverse effects while improving functional outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-to-lymphocyte ratio as a prognostic predictive marker on adults with traumatic brain injury: Systematic review.","authors":"Muhana Fawwazy Ilyas, Aldebaran Lado, Enrico Ananda Budiono, Gregorius Prama Suryaputra, Geizar Arsika Ramadhana, Revi Gama Hatta Novika","doi":"10.25259/SNI_878_2023","DOIUrl":"10.25259/SNI_878_2023","url":null,"abstract":"<p><strong>Background: </strong>The platelet-to-lymphocyte ratio (PLR) has emerged as a prognostic predictive marker in various diseases, but its role in traumatic brain injury (TBI) has not been fully elucidated. This study aims to evaluate the role of PLR as a prognostic predictive marker in adults with TBI.</p><p><strong>Methods: </strong>This systematic review was conducted according to the Preferred Reporting Items in the Systematic Review and Meta-analysis Guidelines 2020. A comprehensive search was performed using PubMed, Google Scholar, Scopus, Crossref, OpenAlex, Semantic Scholar, Library of Congress, and Jisc Library Hub Discover database to identify relevant studies published up to February 2023. Both prospective and retrospective observational studies written in English or Indonesian were included in the study. No restrictions were placed on the year and country of publication and duration of follow-up. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), and the risk of bias was estimated using the Cochrane Risk of Bias Assessment Tool for Nonrandomized Research (Ro-BANS) tool. A narrative synthesis was also conducted to summarize the findings.</p><p><strong>Results: </strong>We retrieved 1644 references using the search strategy, and 1623 references were excluded based on screening the title and abstract. The full text was retrieved for 20 articles and subjected to the eligibility criteria, of which 16 were excluded from the study. Four papers with a total of 1.467 sample sizes were included in the review. The median of NOS for study quality was 8-9, with the risk of selection bias using the Ro-BANS tool being low in all studies except for the blinding outcome assessments, which are all unclear. The study finding suggests that the PLR has the potential as an independent prognostic predictive marker in adult patients with TBI. In three studies, a high level of admission PLR may independently predict an increasing mortality risk in 30 days and adverse outcomes measured by the Glasgow outcome scale in 6 months following TBI. However, one study shows that PLR may have limited value as a predictor of mortality or favorable neurological outcomes compared to other hematological parameters. Further studies were needed to establish the clinical utility of PLR and fill the present gaps.</p><p><strong>Conclusion: </strong>This systematic review provides evidence supporting the utilization of PLR as a prognostic predictive marker in adult patients with TBI. The PLR can mainly be utilized, especially in rural practice, as PLR is a simple, low-cost, and routinely performed hematological examination.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}