World Neurosurg
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Review Meta Analysis
Endovascular embolization of intracranial aneurysms: to use stent(s) or not? A systematic review and meta-analysis.
We sought to review the literature concerning stent-assisted coiling (SAC) in comparison with coiling without stents for treating intracranial aneurysms and to evaluate the safety and effectiveness of SAC by conducting a meta-analysis of published studies. ⋯ Compared with coiling without stent, stent-assisted coiling of intracranial aneurysms achieved satisfactory results, with higher long-term angiographic occlusion rate and lower recurrence rate. However, ischemic stroke remains a problem that cannot be ignored.
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From Luessenhop's early clinical experience until the present day, experimental methods have been introduced to make progress in endovascular neurosurgery. ⋯ We must learn how to safely practice endovascular neurosurgery in the presence of uncertainty and verify patient outcomes in real time.
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Review Meta Analysis
How best to manage the Spinal Epidural Abscess? A Current Systematic Review.
A spinal epidural abscess is a medical emergency. Despite urgent surgical intervention and adjuvant antibiotic therapy, neurologic prognosis remains variable and guarded. The optimal approach to managing this condition is debated with substantial variability in clinical practice, dependent on patient demographic and pretreatment neurologic status as well as radiologic appearance. ⋯ Surgery with adjuvant antibiotics remains the optimal treatment for the neurologically symptomatic patient with spinal epidural abscess. If antibiotic therapy alone is considered for the neurologically intact patient, we recommend interdisciplinary medical and surgical consultations with an in-depth dialogue on the potential for failure in isolated medical management and the recommendation for close neurologic monitoring.
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Multicenter Study Clinical Trial
Subthalamic nucleus deep brain stimulation for Parkinson's disease in Hong Kong: A prospective territory-wide 2 year follow-up study.
We assessed the effects of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson disease at the 1-year and 2-year follow-up evaluations. Unified Parkinson's Disease Rating Scale (UPDRS) motor score at "off" medication ("on" DBS) and quality-of-life assessments (39-item Parkinson's Disease Questionnaire [PDQ-39]) were conducted. The percentage of awake "on" time and awake "off" time and levodopa requirement were also assessed. ⋯ The effects of STN DBS in patients with Parkinson disease in Hong Kong were satisfactory. The results showed that reduction in UPDRS motor score, awake "off"-time, and daily levodopa dosage were the major drivers of overall improvement in PDQ-39.
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Pleomorphic adenoma is a benign neoplastic tumor of the salivary gland. Salivary gland tumors in the intracranial cavity are generally restricted to the pituitary gland and sellar region. To our knowledge, there has been only 1 previous case report of a primary central nervous system pleomorphic adenoma outside of the sellar region. In that case report of a posterior fossa pleomorphic adenoma, typical myxochondroid stroma was not identified on histology, and its pathogenesis was not explored. ⋯ This case study illustrates a classic primary central nervous system pleomorphic adenoma in an unusual intracranial site. Its pathogenesis is postulated to involve salivary gland heterotopia.