World Neurosurg
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Anterior skull base (ASB) fractures are reported in 4% of head injuries and represent 21% of all skull fractures. Cerebrospinal fluid (CSF) leaks may follow, severely exacerbating outcomes. We systematically reviewed the literature to analyze and compare the roles of endoscopic surgery, open surgery, and combined approaches in the management of CSF leak repair after posttraumatic ASB fractures. ⋯ ASB fractures are frequently treated as late surgery, 24 hours from injury or later, especially for endoscopic surgery. Overall, the endoscopic approach is preferred, mostly because of its safety and effectiveness, offering lower failure rates than does open surgery.
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Review
10-Year Trends in the Surgical Management of Patients with Spinal Metastases: A Scoping Review.
Spinal metastases are present in approximately 20% of patients with cancer, giving a risk for neurologic dysfunction and instability. In already frail patients, surgeons strive to improve quality of life. Our goal was to review a 10-year trend in the surgical management of spinal metastases. ⋯ Minimally invasive techniques for decompression and stabilization seem to be the preferred method to surgically treat metastatic spine disease, with good outcomes. More research with high level of evidence is required to support the long-term outcomes of these approaches.
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Meta Analysis
Natural history of brainstem cavernous malformations: on the variation in hemorrhage rates.
Hemorrhage rates of conservatively managed brainstem cavernous malformations (BSCMs) vary widely in the literature. We aimed to elucidate the reason for the variation and to add the results of our experience of BSCMs management over the past decade. ⋯ The reported hemorrhage rates are calculated in 2 different ways. In our patient cohort, both the retrospective and prospective hemorrhage rates were in accordance with those in the literature. The long-term hemorrhage rate lies between the prospective and retrospective rate.
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Multicenter Study Comparative Study
Chronic subdural hematoma drainage under local anesthesia with sedation versus general anesthesia and its outcome.
Burr hole drainage is the criterion standard treatment for chronic subdural hematoma (CSDH), a common neurosurgical condition. However, apart from the surgical technique, the method of anesthesia also has a significant impact on postoperative patient outcome. Currently, there are limited studies comparing the use of local anesthesia with sedation (LA sedation) versus general anesthesia (GA) in the drainage of CSDH. The objective of this study was to compare the morbidity and mortality outcomes of using LA sedation versus GA in CSDH burr hole drainage. ⋯ This study demonstrates that CSDH drainage under LA sedation is safe and efficacious, with a significantly lower risk of postoperative mortality and morbidity when compared with GA.
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Review Comparative Study
A COMPARATIVE SCIENTOMETRIC ANALYSIS OF THE 100 MOST CITED ARTICLES OF ACTA NEUROCHIRURGICA AND WORLD NEUROSURGERY.
Acta Neurochirurgica (ANCH) and World Neurosurgery (WN), are 2 journals of significant importance in the neurosurgical community and have been associated with international federations. These journals carry a similar impact factor. The difference is the years they have been active (ANCH starting publication in 1973 and WN in 2010). This factor allows for a unique opportunity to delve deep into comparative, scientometric parameters, to understand the evolution of neurosurgical research. ⋯ Neurotrauma and consensus guidelines have been shown to have maximal citations for ANCH whereas endoscopy and skull base lesions garnered the most for WN. Author subspecialization and increased collaboration across specialties with more articles on refinement of technique and outcome have emerged as recent trends.