Journal of neurosurgery
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Journal of neurosurgery · Nov 2024
The feasibility and clinical outcome of endoscopic transorbital transcavernous approaches with or without petrosectomy for petroclival lesions.
Petroclival tumors such as petroclival meningiomas or trigeminal schwannomas extending to the posterior cranial fossa are challenging to treat due to their deep-seated location and proximity to critical neurovascular structures. This study aimed to evaluate the feasibility, safety, and clinical outcomes of endoscopic transorbital surgery for the resection of central skull base tumors involving the petroclival area. ⋯ Endoscopic transorbital surgery appears to be a safe and effective technique for the resection of petroclival lesions, offering excellent visualization and access to the tumor while minimizing morbidity. However, further studies with larger patient cohorts and longer follow-up are warranted to validate the long-term efficacy and safety of this approach. This study contributes to the growing body of evidence supporting the utility of endoscopic transorbital techniques in skull base surgery.
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Journal of neurosurgery · Nov 2024
Procedural outcomes of the transradial versus transfemoral approach for diagnostic cerebral angiograms according to BMI: a propensity score-matched analysis.
BMI has been shown to affect choice of access site in coronary intervention procedures, with lower complications reported during transradial (TR) access. To the authors' knowledge, the effect of BMI on outcomes in patients undergoing diagnostic cerebral angiography remains undescribed. This study compares outcomes for BMI subgroups based on access site (TR vs transfemoral [TF] access). ⋯ TR access in diagnostic cerebral angiography is associated with shorter procedure times and no increased risk of complications compared to TF access across all BMI subgroups. Obese patients experienced shorter LOS with TR access. This study adds to the literature on the safety and efficacy of TR access across all BMI subgroups. Further studies are necessary to validate these preliminary results.
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Journal of neurosurgery · Nov 2024
Multicenter StudySex-dependent characteristics and outcomes after clipping of unruptured intracranial aneurysms: a multicenter propensity score-matched study.
Disparities in the epidemiology and growth rates of aneurysms between the sexes are known. However, little is known about sex-dependent outcomes after microsurgical clipping of unruptured intracranial aneurysms (UIAs). The aim of this study was to examine sex differences in characteristics and outcomes after microsurgical clipping of UIAs and to perform a propensity score-matched analysis using an international multicenter cohort. ⋯ Despite overall differences between male and female patients in demographics, comorbidities, and treated aneurysm location, sex did not relevantly affect surgical performance or perioperative complication rates.
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Journal of neurosurgery · Nov 2024
Multicenter StudyStratified assessment of treatment approach for craniocervical junction arteriovenous fistulas: a multicenter cohort study and literature review.
Craniocervical junction arteriovenous fistulas (CCJ-AVFs) are complex vascular shunts that present a challenge for treatment. The aim of this study was to compare the clinical outcomes of microsurgery and endovascular embolization for CCJ-AVFs and to determine whether the treatment approach affected the obliteration rate and neurological improvement. ⋯ This study supports microsurgery as the best treatment modality for CCJ-AVFs, exhibiting the highest rates of complete obliteration. Conversely, embolization via the VA can result in a lower occlusion rate and less neurological improvement. In CCJ-AVFs with CA feeders, embolization via the CA can be a safe and effective alternative to microsurgery.