World Neurosurg
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The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patient quality of life. The aim of this study was to analyze the effect of conventional surgery supported by intraoperative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined the postoperative Karnofsky Performance Status Scale (KPS) scores and tumor resection grades. ⋯ IOUS may improve postoperative KPS scores and decrease residual tumor volumes in CM surgeries. These findings should be confirmed in future studies.
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Insular gliomas are challenging tumors to surgically resect owing to the anatomy surrounding them. This study evaluates the role of extent of resection (EOR) and molecular markers in surgical outcome and survival for insular gliomas. ⋯ Extensive resections of insular gliomas can be achieved with low morbidity and can improve overall survival and PFS. In this series of LGGs, EOR was associated with longer malignant PFS, and 1p/19q codeletion was predictive of PFS.
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Many investigators endeavor to predict the outcome based on admission characteristics using some established models to determine which management should be applied. However, the efficacy and applicability of the models using in the geriatric patients with severe traumatic brain injury (TBI) have not yet been evaluated. ⋯ The IMPACT prognosis calculator showed just fair discrimination when predicting the outcome of the elderly patients with severe TBI. Management decisions should be made on a case-by-case basis rather than by relying on the predicted risks identified by this model; conservative treatment might be preferable when expected risk of fatal outcome is >90%.
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To evaluate the impact of surgical resection and adjuvant treatment on the course of patients after malignant progression of previously treated isocitrate dehydrogenase 1 (IDH1)-mutated World Health Organization (WHO) grade II astrocytoma. ⋯ Patients in good clinical condition with malignant progression of previously treated low-grade gliomas should receive aggressive treatment, including re-resection.