World Neurosurg
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We aimed to characterize the expression of transforming growth factor-α (TGF-α) and Ki-67 and to assess the relationship between TGF-α and Ki-67 expression and prognostic factors in skull base chordoma. ⋯ Our results have shown that high levels of TGF-α and Ki-67 are associated with shorter PFS in patients with chordoma. We have confirmed the role of Ki-67 as a functional molecular marker of poor prognosis. We also identified TGF-α as a potential novel biomarker for predicting prognosis for patients with skull base chordoma.
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Almost one half of currently practicing physicians in Europe are women. Despite advances in access to training positions and the entry of women into neurosurgery, it has remained a male-dominated field, with an underrepresentation of female leaders. We designed a 2-part study to better understand the current situation of European female neurosurgeons. ⋯ Unfortunately, a gender gap still exists in European neurosurgery. The extent thereof has not yet been systematically analyzed. Our project offers a glimpse into the inequalities and obstacles women perceive in our field; however, more comprehensive data are required.
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The globus pallidus internus (GPi) and subthalamic nucleus (STN) are therapeutic targets for deep brain stimulation (DBS) in the treatment of isolated dystonia. We conducted a meta-regression analysis on long-term studies of bilateral DBS in the GPi and STN to compare the relative effects of the 2 approaches. ⋯ A shorter disease duration correlated positively with better DBS outcomes. The STN appeared to be an optimized stimulation target for the treatment of isolated dystonia, although randomized controlled trials are needed to compare the treatment efficacy of GPi DBS and STN DBS.
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Surgical approaches for posterior C1-C2 arthrodesis, such as C1-C2 transarticular and C1-C2 screw stabilization, are known to be demanding because of the anatomic close proximity of cervical vertebrae to neurovascular structures. Currently, navigation by fluoroscopy or intraoperative computed tomography (ICT) is the standard practice. However, fluoroscopy has various limitations, and ICT is time consuming and not available in many centers; furthermore, both diagnostic tools lead to exposure of the operating room staff to radiation exposure. We evaluate the safety, efficacy, and facility of a navigation system using only preoperative cervical computed tomography and computed tomographic angiography (CT/CTA), to prevent the risk of neurovascular damage in atlantoaxial stabilization. ⋯ The use of a neuronavigation system, based on preoperative acquired cervical CT and intraoperative single-vertebra registration, may provide a valuable support for the improvement of the surgical accuracy of posterior C1-C2 screw fixation.
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The Woven EndoBridge (WEB) device is an innovative tool for endovascular treatment of wide-necked bifurcation aneurysms. Numerous studies of primary aneurysm treatment with the WEB device have been reported. We analyzed the safety and efficacy of WEB embolization for recurrent and residual aneurysms. ⋯ The results of the present study have indicated that WEB embolization of previously treated aneurysms is reasonably safe. However, careful aneurysm selection could be necessary to achieve adequate mid-term occlusion rates.