World Neurosurg
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Missing data is a typical problem in clinical studies, where the value of variables of interest is not measured or collected for some patients. This article aimed to review imputation approaches for missing values and their application in neurosurgery. ⋯ Missing values should be treated carefully. Advantages and disadvantages of multiple imputation methods along with imputation in small and big data should be considered depending on the research question and specifics of the study.
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Review
Extent of Resection Research in Skull Base Neurosurgery: Previous Studies and Future Directions.
Surgery is the first-line therapy for most benign and malignant skull base tumors. Extent of resection (EOR) is a metric commonly used for preoperative surgical planning and to predict risk of postoperative tumor recurrence. Therefore, understanding the evidence on EOR in skull base neurosurgery is essential to providing optimal care for each patient. ⋯ We propose that future investigations should focus on the following elements to improve EOR research in skull base neurosurgery: 1) multi-institutional collaboratives with treatment propensity matching; 2) expert consensus and mixed-methods study design; and 3) predictive analytics/machine learning. We believe that these methods offer several advantages that have been described in the literature and that they address limitations of previous studies. The aim of this review was to inform future study design and improve the overall quality of subsequent investigations on EOR in skull base neurosurgery.
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Primary central nervous system lymphoma is a rare form of extranodal non-Hodgkin lymphoma. Few cases of primary central nervous system lymphoma involving bone and subcutaneous tissue invasion have been reported. ⋯ Craniotomy and tumor removal were performed. Operative findings showed a posterior occipital soft tumor whose cells had invaded the skull and subcutaneous tissue.
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The surgical treatment of craniovertebral junction (CVJ) lesions remains a difficult process requiring advanced experience. The aim of this study was to present our experience and the clinical results of a posterior and posterolateral approach used for CVJ lesions in our clinic, and to discuss these in light of current literature. ⋯ A posterior or a posterolateral approach is a safe surgical technique that can provide total tumor resection for CVJ region lesions, including posterior, posterolateral, lateral, and anterolaterally located tumors. Isolated anterior and anterolateral tumors with small lateral extension may require a far lateral or extreme lateral approach combined with other cranial base techniques.
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Nationwide study results have suggested varying trends in the incidence of aneurysmal subarachnoid hemorrhage (aSAH) over time. Herein, trends over time for aSAH treated at a quaternary care center are compared with low-volume hospitals. ⋯ A decreasing number of patients were hospitalized with aSAH throughout the study. Compared with patients with aSAH admitted in 2004, those admitted more recently were sicker in terms of preexisting comorbidity and neurologic complexity. These trends could be attributable to the increasing availability of neurointerventional services at smaller-volume hospitals capable of treating healthier patients.