Journal of neurosurgery
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Journal of neurosurgery · Feb 2025
A management algorithm for idiopathic intracranial hypertension in skull base meningoencephaloceles.
In this study, the authors assessed an algorithm for the diagnosis and management of idiopathic intracranial hypertension (IIH) in patients who had undergone surgical repair of skull base meningoencephaloceles presenting with spontaneous cerebrospinal fluid (sCSF) leakage. ⋯ Utilizing an algorithm of direct meningoencephalocele repair and selective shunting, acute and remote CSF leak recurrence rates were each 3.8%, and the VPS rate was 15.0%. These data provide further insight into CSF dynamics in this population and argue against the theoretical concern that CSF pressure will increase postrepair. Significant intraindividual variability suggests multiple LPs may be necessary before committing to invasive IIH treatment. Further work is necessary to determine the optimal IIH management strategy.
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Journal of neurosurgery · Feb 2025
Meta Analysis Comparative StudyAwake versus asleep deep brain stimulation for Parkinson's disease: a comprehensive systematic review and meta-analysis.
Deep brain stimulation (DBS) has become an effective and safe treatment in patients with Parkinson's disease (PD) not responding to conventional treatments. With the growing body of literature regarding the use of DBS in different movement disorders, there remain controversies regarding performing awake or asleep DBS. This systematic review provides the most comprehensive review of the literature comparing the two techniques from various aspects in detail. ⋯ These findings suggest comparable clinical outcomes between the two DBS approaches. The two methods had their salient differences in terms of lead passes and specific adverse events. The decision to perform awake or asleep DBS should be based on the patient's preference, the surgeon's experience, the availability of advanced intraoperative imaging, and the patient's tolerance for specific adverse events.
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Journal of neurosurgery · Feb 2025
Role of aneurysmal hemodynamic changes in pathogenesis of headaches associated with unruptured cerebral aneurysms.
One symptom commonly associated with the presence of unruptured intracranial aneurysms is headache. In this study, the authors aimed to analyze factors associated with headaches among patients with intracranial aneurysms, with special consideration of hemodynamic parameters. ⋯ Hemodynamic parameters of intracranial aneurysms might be associated with headaches and their relief after aneurysm treatment.
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Journal of neurosurgery · Feb 2025
Assessing superficial temporal artery-middle cerebral artery anastomosis patency using FLOW 800 hemodynamics.
The objective of this study was to investigate the use of indocyanine green videoangiography with FLOW 800 hemodynamic parameters intraoperatively during superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery to predict patency prior to anastomosis performance. ⋯ These results suggest that a high proximal speed measured in the recipient vessel prior to anastomosis can elevate the risk of perioperative no flow and long-term reduction of flow. With an increased dataset size, continued FLOW 800-based ROI metric analysis could be used to guide intraoperative anastomosis site selection prior to anastomosis and predict patency outcome.
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Journal of neurosurgery · Feb 2025
Clinical characteristics and therapeutic outcomes after endoscopic endonasal surgery for craniopharyngioma in the elderly.
Craniopharyngiomas (CPs) in adults are rare benign epithelial tumors, and few contemporary studies have explored outcomes after surgical treatment in elderly patients, especially with regard to endoscopic endonasal surgery (EES). ⋯ This study demonstrates that EES is a viable treatment option for older CP patients. With appropriate perioperative management, EES does not significantly increase mortality and, in selected populations, is well tolerated by patients.