World Neurosurg
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Halo gravity traction (HGT) is an effective way of managing pediatric spinal deformities in the preoperative period. This study comprehensively reviews the existing literature and evaluates the effect of HGT on various radiographic parameters regarding spinal correction and, secondarily, evaluates the improvement in pulmonary function as well as nutritional status. ⋯ HGT has been shown to significantly improve coronal deformities, sagittal deformities, nutritional status, and pulmonary function in the preoperative period.
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The adoption of the transradial approach (TRA) has been increasing in popularity as a primary method to conduct both diagnostic and therapeutic interventions. As this technique gains broader acceptance and use within the neuroendovascular community, comparing its complication profile with a better-established alternative technique, the transfemoral approach (TFA), becomes more important. This study aimed to evaluate the safety of TRA compared with TFA in patients undergoing diagnostic, therapeutic, and combined neuroendovascular procedures. ⋯ Patients undergoing TFA are significantly more likely to experience access site complications and neurological complications compared with patients undergoing TRA. Patients undergoing TRA are more likely to experience complications such as wound infections and vascular spasm.
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Review
Endovascular Management of AVM-Associated Intracranial Aneurysms: A Systematic Literature Review.
Intracranial aneurysms are present in up to 18% of arteriovenous malformations (AVMs) and increase the risk of intracranial hemorrhage. No consensus exists on the optimal treatment strategy for AVM-associated aneurysms. The goal of this study was to systematically review endovascular treatment methods of AVM-associated intracranial aneurysms, radiographic outcomes, and periprocedural complications. ⋯ Endovascular management options of AVM-associated intracranial aneurysms are limited and mostly comprised primary aneurysmal coil embolization or parent vessel sacrifice using coils or liquid embolics. Embolization strategy depends on factors such as AVM angioarchitecture, rupture status, and adjunct AVM treatments.
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Case Reports Meta Analysis
Complete Corpus Callosotomy for Refractory Epilepsy in Children: a video article.
Corpus callosotomy is an interhemispheric disconnection by callosal commissural fiber ablation. Its rationale is the disruption of ictal spread to prevent seizure generalization. The objective pursued is alleviation of intractable, debilitating, and injurious manifestations of generalized epilepsy.1 Eight decades of experience support this procedure's safety and effectiveness for appropriately selected patients with drug-resistant epilepsy not amenable to optimal resection; particularly, favorable outcomes for tonic or atonic seizures with drop attacks have been reported.2,3 Children may benefit more than adults from callosotomy for improved daily function, psychosocial adjustment, and family satisfaction.4 A meta-analysis found a better seizure reduction from total than partial callosotomy (88.2% vs. 58.6% of worthwhile reduction) comprising drop-attacks (77.8% vs. 45.4%) with an increased but transient (i.e., resolution within 6 weeks) risk of significant disconnection syndromes (12.5% vs. none).5 Here, we present the illustrative case of a 4-year-old boy with Lennox-Gastaut syndrome who underwent open single-stage complete callosotomy. ⋯ We showcase critical steps such as dissection of cingulate gyri and anterior and then posterior callosotomy while highlighting crucial anatomic landmarks. This procedure may be accessible for epilepsy surgeons worldwide in resource-constrained environments6 while serving as a basis for promising high-technology development (e.g., endoscopic, radiosurgical, laser interstitial thermal therapy, or magnetic resonance-guided focused ultrasound callosotomies). In this video article, we aim to provide a streamlined and stepwise approach to this rare but important epilepsy surgery.
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Multicenter Study
Mindfulness training for young neurosurgeons: a virtual multi-centre prospective pilot study.
Burnout is prevalent among neurosurgeons and can negatively impact both technical and nontechnical skills and subsequent patient care. Mindfulness training has previously been shown to ameliorate the effects of burnout and improve performance in health care workers and high-stress occupations, but no such evaluation has been formally conducted for neurosurgeons. We aimed to determine the effectiveness and feasibility of a virtual mindfulness-based intervention (MBI) in neurosurgeons. ⋯ Preliminary evidence from this trial cautiously supports the effectiveness and feasibility of a virtual MBI for dealing with stress, burnout, and improving dexterity among young neurosurgeons. Further research is warranted to validate these findings.