World Neurosurg
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Review Meta Analysis
Ultra-early angiographic vasospasm following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.
After aneurysmal subarachnoid hemorrhage (aSAH), prognosis is affected heavily by the presence of delayed cerebral ischemia (DCI). There is growing recognition of ultra-early angiographic vasospasm (UEAV) occurring within 48 hours of aSAH; however, its relationship with DCI and ultimately prognosis remains unclear. ⋯ UEAV was significantly associated with symptomatic cerebral vasospasm, DCI/infarction, unfavorable outcome at follow-up, and greater mortality. Patients with intracerebral hematoma, intraventricular hemorrhage (Fisher Grade IV), larger ruptured aneurysms >12 mm, and an MCA location were more likely to have UEAV.
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Randomized Controlled Trial Multicenter Study
Stereotactic Radiosurgery for A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA)-Eligible Spetzler-Martin Grade I and II Arteriovenous Malformations: A Multicenter Study.
ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations) found better short-term outcomes after conservative management compared with intervention for unruptured arteriovenous malformations (AVMs). However, because Spetzler-Martin (SM) grade I-II AVMs have the lowest treatment morbidity, sufficient follow-up of these lesions may show a long-term benefit from intervention. The aim of this multicenter, retrospective cohort study is to assess the outcomes after stereotactic radiosurgery (SRS) for ARUBA-eligible SM grade I-II AVMs. ⋯ For ARUBA-eligible SM grade I-II AVMs, long-term SRS outcomes compare favorably with the natural history. SRS should be considered for adult patients harboring unruptured, previously untreated low-grade AVMs with a minimum life expectancy of a decade.
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Review Meta Analysis
Comparative outcomes of cortical screw trajectory fixation and pedicle screw fixation in lumbar spinal fusion: A systematic review and meta-analysis.
We conducted a systematic review and meta-analysis to compare the postoperative outcomes of cortical screw and pedicle screw (PS) fixation techniques for posterior lumbar interbody fusion (PLIF). ⋯ PLIF with CBT screw fixation had postoperative back and leg pain, disabilities, and function score.
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Multicenter Study Clinical Trial
Prophylactic levetiracetam for seizure control after cranioplasty: a multicenter prospective controlled study.
To study efficacy and safety of prophylactic levetiracetam (LEV) administration in adults undergoing cranioplasty. ⋯ Postoperative seizure is a common complication of cranioplasty, especially in patients with preoperative or postoperative abnormal EEG with spikes or sharp waves. Prophylactic LEV administration significantly reduced postcranioplasty seizures during LEV usage and had few side effects.
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Review Historical Article
History, Evolution and Continuing Innovations of Intracranial Aneurysm Surgery.
Evolution in the surgical treatment of intracranial aneurysms is driven by the need to refine and innovate. From an early application of the Hunterian carotid ligation to modern-day sophisticated aneurysm clip designs, progress has been made through dedication and technical maturation of cerebrovascular neurosurgeons to overcome challenges in their practices. ⋯ Concepts of how to best treat intracranial aneurysms have evolved over generations and will continue to do so with further technological innovations. As with the evolution of any type of surgery, innovations frequently arise from the criticism of current techniques.