World Neurosurg
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Review Meta Analysis Comparative Study
Mortality and outcome comparison between brain tissue oxygen combined intracranial pressure/cerebral perfusion pressure guided therapy and intracranial pressure/cerebral perfusion pressure guided therapy in traumatic brain injury: A meta-analysis.
The combination of brain tissue oxygen and standard intracranial pressure (ICP)/cerebral perfusion pressure (CPP)-guided therapy is thought to improve traumatic brain injury (TBI) prognosis compared with standard ICP/CPP-guided therapy. However, related results of previous observational studies and recently published cohort studies and randomized controlled trials (RCTs) remain controversial. The objective of this study was to compare the effect of the combined therapy with that of standard ICP/CPP-guided therapy on mortality rate, favorable outcome, ICP/CPP, and length of stay (LOS). ⋯ Compared with standard ICP/CPP-guided therapy, brain tissue oxygen combined with ICP/CPP-guided therapy improved long-term outcomes without any effects on mortality, ICP/CPP, or LOS.
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The effect of patient age on the likelihood of recurrence of ruptured aneurysms after endovascular coil embolization is not well understood. Our aim was to compare the incidence of aneurysmal recurrence after coiling between young and old patients. ⋯ Our results suggest that elderly age may confer a reduced risk of aneurysmal recurrence after endovascular coiling, providing further evidence that coiling should be considered a first-line therapy in elderly patients with a ruptured aneurysm.
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Review Multicenter Study
Endoscopic endonasal management of rare sellar lesions: clinical and surgical experience on 78 cases and review of the literature.
In the present study we aim to provide further definition of a group of rare sellar diseases treated by the endoscopic endonasal approach. ⋯ Endoscopic endonasal approaches offer some specific benefits in the treatment of these patients.
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Review Meta Analysis
Safety and Efficacy of Surgical and Endovascular Treatment for Distal Anterior Cerebral Artery Aneurysms: A Systematic Review and Meta-analysis.
Aneurysms of the distal anterior cerebral artery (DACA) are rare, representing between 1% and 9% of all intracranial aneurysms. The best treatment strategy for these aneurysms continues to be debated. ⋯ Our meta-analysis showed that both treatment modalities are technically feasible and effective with sufficient long-term aneurysm occlusion and acceptable recurrence/rebleed rates. Surgical treatment is associated with superior angiographic outcomes. There were no substantial differences in procedure-related morbidity and mortality. These findings are important because they suggest that therapy of DACA aneurysms should be performed on a selective, case-by-case basis to maximize patient benefits.
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Randomized Controlled Trial Comparative Study
Comparative study of two skin incisions for microscopic lumbar discectomy.
Microscopic lumbar discectomy is a common minimally invasive surgery. A transverse skin incision has sound theoretical cosmetic advantages compared with the classic vertical incision. We compared transverse and vertical skin incisions for microscopic discectomy regarding cosmetic outcome, postoperative pain, and the provided surgical cutaneous inlet. ⋯ Transverse skin incision for microscopic lumbar discectomy is an applicable alternative to classic midline or paramedian vertical incision with better esthetic results.