World Neurosurg
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Review Meta Analysis
Survival benefit of maximal resection for glioblastoma reoperation in the temozolomide era: a meta-analysis.
Although reoperation likely confers survival benefit for glioblastoma, whether the extent of resection (EOR) of the reoperation affects survival outcome has yet to be thoroughly evaluated in the current temozolomide (TMZ) era. The aim of this meta-analysis was to pool the current literature and evaluate the prognostic significance of reoperation EOR for glioblastoma recurrence in the current TMZ era. ⋯ In the current TMZ era, when reoperation is feasible for recurrent glioblastoma, maximal safe resection appears to confer a significant OS benefit based on the current literature. This benefit is most pronounced with radiographic GTR, and likely irrespective of EOR at index surgery.
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Review Meta Analysis
Endovascular treatment of ruptured middle cerebral artery aneurysms: a single armed meta-analysis and systematic review.
The use of endovascular treatment for ruptured middle cerebral artery (MCA) aneurysms, which have been more likely to be recommended for neurosurgical clipping because of the complex anatomic configuration, remains controversial. In the present study, the angiographic and clinical outcomes of endovascularly treated ruptured MCA aneurysms were systematically reviewed. ⋯ Endovascular treatment of MCA aneurysms was related to a high incidence of procedure-related complications but a low rate of procedure-related mortality. The overall angiographic and clinical outcomes were comparable and warrant further investigation comparing clipping versus coiling for ruptured MCA aneurysms.
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There are some controversies about the surgical treatment strategy of mirror aneurysms. Whether to choose 1-stage or 2-stage surgery, bilateral or unilateral craniotomy, or surgical or interventional treatment are the main points in dispute. In this review, the different surgery strategies faced by patients are discussed. ⋯ The 3D Slicer can help surgeons undertake adequate preoperative preparation. In addition, we also introduce some ruptured factors (e.g., age, gender, hypertension, morphologic, and hemodynamic) concerning mirror aneurysm. Systematic discussion of the controversies and methods in surgical treatment of mirror aneurysms may provide new perspectives in future research for the prevention and treatment of mirror aneurysms.
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Review Case Reports
Pial arteriovenous fistula with multiple venous aneurysms resembling a vein of Galen aneurysmal malformation.
Pial arteriovenous fistulas are abnormal vascular connections between arteries and the cranial venous system on the surface of the brain in the pia mater. In contrast to vein of Galen aneurysmal malformations, they lack a true vascular nidus and may only indirectly involve the vein of Galen. ⋯ If cerebral venous dilations are encountered, one must keep in mind that the location of the fistula may not be in close proximity to the dilated veins, especially when there is a suspicion for vein of Galen aneurysmal malformation. Other pathologies, such as pial arteriovenous fistula, in a region away from the site of the vein of Galen must be considered.
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Review Case Reports
Meningioma Presenting with Spontaneous Subdural Hematoma: A Report of Two Cases and Literature Review.
Although meningiomas are considered benign, encapsulated brain tumors, their distinct intracranial location can lead to devastating complications. Although a highly vascularized tumor, a rarely reported complication of meningioma is hemorrhage. To the best of our knowledge, only 19 cases of meningioma presenting with a subdural hematoma have been reported. ⋯ We comprehensively reviewed the pertinent data for meningiomas presenting as subdural hematomas. The mechanism of hemorrhage in meningiomas remains unclear. Therefore, further studies are required to investigate the possible mechanisms of bleeding in such tumors.