World Neurosurg
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Review Case Reports
Microsurgical Clip Ligation of Ruptured, Previously Coiled A2-A3 Aneurysm Through Interhemispheric Approach In a Pediatric Patient.
Previously ruptured aneurysms treated with coil occlusion are at risk of recurrence and require thoughtful strategic planning for adequate aneurysm occlusion.1-3 Alternative strategies, such as coil extraction or trapping and bypass, are options when simple clipping is not feasible.2 A 15-year-old boy presented with a Hunt and Hess grade 4, Fisher grade 4 subarachnoid hemorrhage from a ruptured distal anterior cerebral artery aneurysm. The patient initially underwent coil embolization and craniotomy to evacuate an extensive corpus callosum hemorrhage. ⋯ We also describe various operative strategies with anatomical illustrations. The patient gave verbal consent for participating in the procedure and surgical video.
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The objective of the study was to establish a 5-year progression-free survival prediction nomogram using preoperative routine blood tests and magnetic resonance imaging to guide postoperative treatment. ⋯ The analysis results of the calibration curve and the decision curve show that the nomogram constructed by combining radiomics and preoperative blood tests has a good predictive value for 5-year progression-free survival in atypical meningioma and can provide a reference for selecting postoperative treatment options.
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Review Meta Analysis
Palliative surgery for drug resistant epilepsy in adult patients. A systematic review of the literature and a pooled analysis of outcomes.
Several types of palliative surgery to treat drug-resistant epilepsy (DRE) have been reported, but the evidence that is available is insufficient to help physicians redirect patients with DRE to the most appropriate kind of surgery. ⋯ Our analysis highlights the necessity of prospective studies, possibly randomized controlled trials, to compare different forms of palliative epilepsy surgery. Moreover, by identifying the outcome predictors associated with each technique, the best responder may be profiled for each procedure.
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Review Meta Analysis
The emerging relevance of H3K27 trimethylation loss in meningioma: A systematic review of recurrence and overall survival with meta-analysis.
It has been proposed in the most recent 2021 World Health Organization classification of brain tumors that the loss of trimethylation at histone 3 lysine site 27 (H3K27me3) might prognosticate meningioma outcomes. However, to date, the emerging literature has remained diffuse in its stance. Thus, the aim of the present study was to determine the prognostic relevance of H3K27me3 loss in meningioma. ⋯ The contemporary metadata favor a greater incidence of meningioma recurrence based independently on H3K27me3 loss, with a statistically significant difference. It is possible that these effects are more pronounced for grade 2 meningiomas; however, more robust data and analysis are needed to augment this position.
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The goal of this study was to systematically review the usefulness of serum biomarkers in the setting of ischemic stroke (IS) to predict long-term outcome. ⋯ Serum-based biomarkers have the potential to predict functional outcome in patients with IS. This meta-analysis has identified C-reactive protein, albumin, copeptin, and D-dimer to be significantly associated with long-term outcome after IS. These biomarkers have the potential to serve as a platform for prognosticating stroke outcomes after 30 days. These serum biomarkers, some of which are routinely ordered, can be combined with imaging biomarkers and used in artificial intelligence algorithms to provide refined predictive outcomes after injury. These tools will assist physicians in providing guidance to families regarding long-term independence of patients.