World Neurosurg
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Review Meta Analysis
Autologous Cranioplasty is Associated with Increased Reoperation Rate: A Systematic Review and Meta-Analysis.
Consensus regarding selection of synthetic versus autologous flap reimplantation for cranioplasty after decompressive craniectomy has not been reached and the multiple factors considered for each patient make comparative analysis challenging. This study examines the association between choice of material and related complications. ⋯ Autologous implants had significantly more reoperations primarily because if the intrinsic risk of resorption (level of evidence 3b).
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Review Case Reports
Long-Term Follow-Up After Radiosurgery of Papillary Tumor of Pineal Region: 2 Case Reports and Review of Literature.
Tumors of the pineal region are rare in adulthood, accounting for approximately 1% of intracranial neoplasms in this age range. Because of their rarity, it has proven to be difficult to establish the optimal therapy. Furthermore, microsurgical total resection in this eloquent location is associated with not low rates of morbidity. ⋯ After a diagnosis of papillary tumors of the pineal region, radiosurgery is an alternative treatment, with high local control and low morbidity.
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The development of stereotaxy can be dated back 100 years. However, most stereotactic neurosurgery still relies on the workflow established about half a century ago. With the arrival of computer-assisted navigation, numerous studies to improve the neurosurgical technique have been reported, leading to frameless and magnetic resonance imaging (MRI)-guided/verified techniques. ⋯ Clinical benefits have been shown in the recent surge of robot-assisted surgical interventions. We review the state-of-the-art intraoperative MRI-guided robotic platforms for stereotactic neurosurgery. To improve the surgical workflow and achieve greater clinical penetration, 3 key enabling techniques are proposed with emphasis on their current status, limitations, and future trends.
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Multicenter Study
Technique of Whole-Sellar Stereotactic Radiosurgery for Cushing's Disease: Results from a Multicenter, International Cohort Study.
Stereotactic radiosurgery (SRS) is used to manage patients with Cushing disease (CD) who have failed surgical/medical management. Because many patients with recurrent/persistent CD lack an identifiable adenoma on neuroimaging, whole-sellar SRS has been increasingly used. Thus, we sought to define the outcomes of patients undergoing whole-sellar SRS. ⋯ Whole-sellar GKRS is effective in controlling CD when an adenoma is not clearly defined on imaging or when an invasive adenoma is suspected at the time of initial surgery. Patients who undergo whole-sellar SRS have outcomes and rates of new pituitary hormone deficiency similar to those of patients who undergo discrete adenoma-targeted GKRS.