World Neurosurg
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Preoperative embolization (POE) of meningioma has been established to facilitate surgical resection, which may reduce intraoperative blood loss and surgical time. However, no consensus has been achieved in meningioma treatment and no meta-analysis has been conducted. The purpose of this study was to perform a systematic review and meta-analysis and provide evidence of the efficacy of meningioma treatment with POE and direct surgery. ⋯ This meta-analysis supports the hypothesis that POE of meningioma is a useful adjunct in meningioma treatment. This technique helps reduce blood loss and surgical time during meningioma resection.
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The impact of antithrombotic agents on patients with primary intracerebral hemorrhage (ICH) remains controversial, especially patients who require emergent craniotomy. This study was undertaken to evaluate clinical outcomes in operated patients with ICH with and without previous antithrombotic agents. ⋯ These findings suggested an increased risk of in-hospital mortality and poor short-term outcome among operated patients with ICH with previous antithrombotic therapy, particularly anticoagulant therapy, but not with antiplatelet therapy.
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Machine learning (ML) is an application of artificial intelligence (AI) that gives computer systems the ability to learn data, without being explicitly programmed. Currently, ML has been successfully used for optical character recognition, spam filtering, and face recognition. The aim of the present study was to review the current applications of ML in the field of neuro-oncology. ⋯ MLBAs in neuro-oncology have been shown to predict patients' outcomes more accurately than conventional parameters in a retrospective analysis. If their high diagnostic accuracy in imaging analysis and detection of somatic mutations are corroborated in prospective studies, the use of tissue diagnosis or liquid biopsy might be curtailed. Finally, MLBAs are promising to help guide targeted therapy, can lead to personalized medicine, and open areas of study in the cancer cellular signaling system, not otherwise known.
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The Sextant percutaneous pedicle screw fixation system is a commonly used technique. In this system, the pedicle screw and the sharp rod are placed through stab incisions. The unique mechanism of action of this system may cause unprecedented adverse effects, such as iatrogenic sacroiliac (SI) joint syndrome. ⋯ Surgeons need to be aware of iatrogenic SI joint syndrome using the Sextant system when performing percutaneous pedicle screw fixation. An endoscopy-based technique may be an effective alternative to conventional corrective surgery when treating iatrogenic SI joint syndrome using the Sextant system.
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Even though surgical conditions account for as much as 32% of the global burden of disease, 5 billion people worldwide do not have access to timely, affordable surgical and anesthetic care. Access to surgical care is separated along socioeconomic divides, and these disparities are most pronounced in low-and middle-income countries, such as the Caribbean nation of Haiti, where the availability of specialty surgical services like neurosurgery are scant, or completely absent. ⋯ The paper concludes with recommendations to guide the international neurosurgery community in future contributions.