World Neurosurg
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Review Meta Analysis
Association Between Supratotal Glioblastoma Resection and Patient Survival: A Systematic Review and Meta-Analysis.
Gross total resection (GTR) of the contrast enhancing (CE) area will improve the survival of patients with glioblastoma (GBM). However, GBM can infiltrate into the brain parenchyma, beyond the CE margins. It remains unclear whether resection beyond the CE area (supratotal resection [SPTR]) can improve survival without causing additional neurological deficits. The aim of the present meta-analysis was to study the association between SPTR and overall survival of patients of GBM. ⋯ Compared with GTR, SPTR of GBM resulted in a lower risk of mortality and longer median overall survival. However, the quality of evidence of the available studies was poor. Therefore, it remains unclear whether SPTR is safe and actually improves the survival of patients with GBM. Future prospective trials and a standardized definition of SPTR are needed.
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Review Meta Analysis
Does tranexamic acid improve bleeding, transfusion, and hemoglobin level in patients undergoing multi-level spine surgery? A systematic review and meta-analysis.
To investigate the influence of tranexamic acid (TXA) on blood loss and blood transfusion in multiple-level spine surgery and evaluate whether hemoglobin and platelet levels are altered as a result. ⋯ The application of TXA can effectively reduce intraoperative blood loss and perioperative blood transfusion in patients undergoing multiple-level spine surgery, and it can restore hemoglobin levels after surgery.
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Review Case Reports
Morphologic changes after denosumab therapy in patients with giant cell tumor of the spine: Report of four cases and a review of the literature.
To evaluate the quantitative, radiologic, morphologic, and histologic effects of neoadjuvant denosumab treatment (DT) on 4 patients with spinal giant cell tumor of bone (GCTB) and determine the tumor shrinkage effects of DT for spinal GCTB. ⋯ In all patients, osteolytic tumor volume decreased after DT. This tumor shrinkage effect of DT may increase the mechanical stress on the thin cortical rim, leading to the acute collapse of the affected vertebral body if it consists mostly of osteolytic lesions. The presence of adequate anterior cortical bone could prevent acute vertebral collapse after DT.
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Patients with complex, multisutural, and syndromic craniosynostosis (CSO) frequently exhibit intracranial hypertension. The intracranial hypertension cannot be entirely attributed to the craniocephalic disproportion with calvarial restriction because cranial vault expansion has not consistently alleviated elevated intracranial pressure. Evidence has most strongly supported a multifactorial interaction, including venous hypertension along with other pathogenic processes. ⋯ Obstructive sleep apnea, occurring as a consequence of midface hypoplasia, can also contribute to intracranial hypertension in patients with syndromic CSO. Thus, correction of facial deformities, as well as posterior fossa decompression, could also play important roles in the treatment of intracranial hypertension. Determining the precise mechanistic underpinnings underlying intracranial hypertension in any given patient with CSO requires individualized evaluation and management.
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Review Case Reports
Hemangioblastoma of the Cerebral Aqueduct Removed via a Sitting, Supracerebellar Intracollicular Approach.
Tumors protruding into the cerebral aqueduct are rare, and tumors arising from within the cerebral aqueduct are rarer still. ⋯ We report the first case of an aqueductal hemangioblastoma and describe our use of a sitting, supracerebellar, intracollicular approach to access tumors occupying this cerebrospinal fluid space.