World Neurosurg
-
Review Meta Analysis Comparative Study
Open versus Minimally Invasive Surgery for Extraforaminal Lumbar Disk Herniation: A systematic review and meta-analysis.
Extraforaminal disk herniation (EDH) accounts for 3%-11% of all disk herniations. Despite the heterogeneity of spinal procedures, there is a paucity of literature comparing the outcomes from different surgical approaches. ⋯ Minimally invasive procedures for EDHs are associated with a similar incidence of complications and reoperation but lower estimated blood loss, shorter operative time, shorter hospital stay, and faster return to work time compared to OS. Tubular microscopic have the lowest reoperation rate of MIS procedures.
-
Review Meta Analysis Comparative Study
Endovascular thrombectomy alone versus combined with intravenous thrombolysis.
To date, no randomized trial has directly addressed the question of whether intravenous (IV) tissue plasminogen activator (tPA) improves outcomes in IV tPA-eligible patients who will eventually undergo endovascular therapy (EVT), or whether a direct EVT strategy is equally effective. We performed a systematic review and meta-analysis to compare the efficacy and safety of direct EVT versus endovascular treatment with IV tPA (EVT+IV tPA) in adults with acute ischemic stroke. ⋯ No significant differences between the 2 groups were found in terms of favorable functional outcome, mortality rate, or complications based on contemporary endovascular therapies.
-
This systematic review and meta-analysis was aimed to evaluate the predictive values of shape irregularity and density heterogeneity of hematoma on noncontrast computed tomography (NCCT) for hematoma expansion (HE). ⋯ Considering the relatively low sensitivity and specificity, the predictive values of shape irregularity and density heterogeneity of hematoma for HE are limited. Further studies are still needed to find optimal NCCT predictors for HE in spontaneous intracerebral hemorrhage patients.
-
Review Case Reports
The Long and Winding Road: Thoracic Myelopathy associated with Occipitocervical dAVF.
Spinal dural arteriovenous fistulas (DAVFs) have diverse presentations. Magnetic resonance imaging (MRI) reveals spinal cord swelling in only 45% to 74% of cases. We present an unusual case of a 57-year old man with a craniocervical junction DAVF in which the edema appeared in the thoracolumbar region, skipping the cervical spinal cord. ⋯ This rare presentation highlights the importance of diagnostic persistence when unexplained cord findings are seen on MRI. Repeated angiography and the inclusion of proximal vascular lesions may be considered in the evaluation of isolated thoracic edema.
-
Review Case Reports
Marginal en bloc resection of C2-3 chordoma with bilateral vertebral artery preservation and mesh cage reconstruction with review of previously published cases.
Chordomas arise from remnants of the notochord and occur throughout the neuroaxis. En bloc resection of chordomas can prove especially challenging in the upper cervical spine secondary to the unique structural anatomy and intimate relationship to the vertebral arteries and spinal cord. ⋯ Chordomas in the upper cervical spine pose a surgical challenge but are amenable to en bloc resection. With careful planning and intraoperative adaptability, the surgeon can achieve a suitable reconstruction with off-the-shelf products.