World Neurosurg
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Brainstem cavernous malformations account for 15%-18% of all central nervous system cavernomas and are histologically characterized by thin-walled, low-pressure capillaries, classically without intervening brain tissue.1,2 Cavernomas may be sporadic, typically characterized by a single lesion, or inherited. The inherited form is most often autosomal dominant with incomplete penetrance and variable expression. ⋯ We demonstrate the exoscope's unparalleled visualization of the anterolateral brainstem, with nominal condylar drilling. The patient and his parents consented to the procedure and publication.
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Review Meta Analysis
The Safety and Effectiveness of Tranexamic Acid in Lumbar Interbody Fusion Surgery: An Updated Meta-analysis of Randomized Controlled Trials.
Several previous meta-analyses have been published, followed by additional randomized clinical trials investigating the effects of tranexamic acid (TXA) in patients undergoing posterior lumbar interbody fusion (PLIF) surgery. As a result, the purpose of this research is to present an updated quantitative analysis of the existing literature and to further explicate its effectiveness. ⋯ TXA can considerably decrease surgical blood loss, postoperative drainage, reduce operative times, hospital stays, and transfusion rates. Furthermore, the TXA group had lower postoperative hemoglobin drop values than the placebo group.
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Medical journals have a role in promoting representation of neurosurgeons who speak primary languages other than English. We sought to characterize the language of publication and geographic origin of neurosurgical journals, delineate associations between impact factor (IF) and language and geographic variables, and describe steps to overcome language barriers to publishing. ⋯ Language concordance represents a substantial barrier to research equity in neurosurgery, limiting dissemination of ideas of merit that currently have inadequate outlets for readership. Initiatives aimed at increasing the accessibility of neurosurgical publishing to underrepresented authors are essential.
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To compare patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) achievement following anterior or transforaminal lumbar interbody fusion for isthmic spondylolisthesis in patients presenting with predominant back pain versus predominant leg pain symptoms. ⋯ Compared with patients presenting for surgery with predominant leg pain symptoms, patients undergoing lumbar fusion at L4-L5 and L5-S1 for isthmic spondylolisthesis with predominant back pain symptoms may demonstrate improved long-term clinical outcomes for reported back pain, leg pain, and disability and reduced postoperative length of stay and narcotic consumption.
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External ventricular drain (EVD) and lumbar drain insertion are 2 of the most commonly performed neurosurgical procedures worldwide for acute hydrocephalus. Mechanical complications, such as obstruction or cerebrospinal fluid (CSF) leakage, are often seen and may contribute toward significant patient morbidity. Different CSF drainage methods are advocated to reduce the incidence of complications, but evidence regarding comparative effectiveness is limited. ⋯ Drain device has an influence on the occurrence of EVD-related complications. These preliminary findings suggest that choosing bolted EVDs and motor-assisted drainage can reduce drain-associated mechanical failure. A randomized controlled trial comparing drain devices is required to confirm these findings.