World Neurosurg
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Review Meta Analysis
Cholesterol-reducing agents for treatment of aneurysmal subarachnoid haemorrhage: systematic review and meta-analyses of randomized controlled trials.
Aneurysmal hemorrhage induced cerebral vasospasm; delayed ischemic neurologic deficit (DIND), poor neurologic outcome, and mortality are major causes of mortality and morbidity. The effects of cholesterol-lowering agents in these patients remain controversial. This up-to-date systematic review and meta-analysis aimed to evaluate the efficacy of statin use in patients with aneurysmal subarachnoid hemorrhage. ⋯ The outcome of this meta-analysis showed that use of statins in aneurysmal subarachnoid hemorrhage might have the potential to decrease occurrence of vasospasm and DIND. However, there was no benefit in the reduction of mortality and poor neurologic outcome. This is a call for further research.
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Reports of Baastrup disease have been underrepresented in the medical literature. Therefore, the current comprehensive review was performed by searching standard search engines using the terms "Baastrup's," "disease," "lumbar," "interspinous bursitis," and "kissing spine disease." Baastrup disease appears to be more common than once believed. Baastrup disease is associated with other degenerative disease processes of the spine that could potentially lead a physician to perform unnecessary surgery. Appreciation of this disease and identification on imaging can improve diagnosis and appropriate treatment of associated back pain.
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Surgical resection of a lesion that correlates with seizure onset in patients with epilepsy can dramatically improve seizure burden and quality of life. For bilateral hippocampal lesions, bilateral resection comes with a risk of severe cognitive deficits. Responsive neurostimulation (RNS) devices offer a new modality to treat multifocal lesions in a reversible manner including bilateral hippocampal stimulation. We describe technical aspects of Nexframe-assisted placement of bilateral NeuroPace mesial temporal electrodes and case examples. ⋯ We report herein the technical nuances of adapting Nexframe to hippocampal-based depth electrode RNS system placement. Our group has extensive experience with Nexframe for accurate and safe deep brain stimulation electrode placement. Our preliminary data with bitemporal RNS placement suggest similar accuracy and safety.
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Percutaneous endoscopic surgery is increasingly used as an alternative to open microsurgery for treating lumbar spinal diseases. The purpose of this study was to determine the feasibility and efficacy of contralateral keyhole endoscopic surgery for treating unilateral radiculopathy. ⋯ Contralateral keyhole endoscopic surgery is a safe and useful technique to decompress unilateral lateral recess stenosis or facet cyst.
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Case Reports
Dramatic shrinkage with reduced vascularization of large meningiomas after cessation of progestin treatment.
The relationship between long-term intake of progestin and meningioma growth is now well-known and has become a model of hormone-driven meningioma growth. Conversely, it has been demonstrated that cessation of treatment often leads to tumor regression. Consequently, watchful observation has become the strategy of choice in the case of multiple meningiomas in asymptomatic patients undergoing progestin treatment. ⋯ This observation adds new insights into the role of progesterone in meningioma tumorigenesis and could lead to future discoveries on the molecular relationships between meningioma tumorigenesis, progesterone dependence, and tumor vascularization.