Neurosurgery
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The purpose of transsphenoidal surgery (TSS) for a functioning pituitary tumor (FPT) is to achieve endocrinological remission. The biggest challenge is aggressive tumor resection invading the cavernous sinus (CS). ⋯ MWCS invasion occurred in 57% of cases confirmed histologically where it was unclear during surgery, and its resection can improve the overall complete remission rate in FPT cases.
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Review Meta Analysis
Stereotactic Radiosurgery for A Randomized Trial of Unruptured Brain Arteriovenous Malformations-Eligible Patients: A Meta-Analysis.
The outcomes of A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) were controversial, and they suggested that intervention is inferior to medical management for unruptured brain arteriovenous malformations (AVMs). However, several studies have shown that stereotactic radiosurgery (SRS) is an acceptable therapy for unruptured AVMs. ⋯ SRS carries a favorable risk to benefit profile for appropriately selected ARUBA-eligible patients, particularly those with smaller volume AVMs. Our findings suggest that the results of ARUBA do not reflect the real-world safety and efficacy of SRS for unruptured AVMs.
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Endovascular treatment (EVT) for cerebral vein thrombosis (CVT) has not been proven to be more effective than anticoagulation based on recent results of the Thrombolysis or Anticoagulation for Cerebral Venous Thrombosis (TO-ACT) randomized clinical trial. ⋯ In this large observational cohort, there was no evidence of benefit with EVT for CVT. These findings corroborate the results from the TO-ACT trial.
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Multicenter Study
Automated Detection and Surgical Planning for Focal Cortical Dysplasia with Multicenter Validation.
In patients with surgically amenable focal cortical dysplasia (FCD), subtle neuroimaging representation and the risk of open surgery lead to gaps in surgical treatment and delays in surgery. ⋯ The integrated platform validated based on multicenter, prospective cohorts exhibited advantages of easy implementation, high performance, and generalizability, thereby indicating its potential in the diagnosis and minimally invasive treatment of FCD.
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Frailty, a decline in physiological reserve, prognosticates poorer outcomes for several neurosurgical conditions. However, the impact of frailty on traumatic brain injury outcomes is not well characterized. ⋯ For patients with tICH, frailty predicted higher mortality and morbidity, independent of age or injury severity.