World Neurosurg
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The objective of the study was to summarize the clinical characteristics, histo-genomic profiles, management strategies, and survival outcomes of H3K27M-altered adult diffuse midline gliomas (aDMGs). ⋯ H3K27M-altered aDMGs were associated with relatively poor survival. ATRX gene mutation was significantly associated with survival disadvantage, while radiotherapy was associated with survival benefit. Large, prospective studies are needed to establish a standard management strategy and provide reliable prognostic conclusions.
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Meta Analysis
Endovascular and Medical Management of Cerebral Venous Thrombosis: A Systematic Review and Network Meta-Analysis.
Management of cerebral venous thrombosis (CVT) involves minimizing expansion of the thrombus and promoting the recanalization of the venous sinus. While current guidelines include indications of endovascular management and anticoagulation with heparin and warfarin, the use of direct-acting oral anticoagulants (DOACs) has increased. In this study, we aim to conduct a network meta-analysis comparing these 3 therapeutic options: standard anticoagulation, DOACs, and endovascular treatments (EVTs). ⋯ This network meta-analysis evaluates the outcomes in CVT treatment, comparing standard anticoagulation, DOACs, and EVT, with evidence that DOACs have similar outcomes to standard anticoagulation in the treatment of CVT. EVT resulted in an increased risk of overall mortality but improved 6-month recanalization rates.
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Meta Analysis
Machine learning algorithms for the rupture risk assessment in intracranial aneurysms: a diagnostic meta-analysis.
Several machine learning algorithms have been increasingly applied to predict the rupture risk of intracranial aneurysms. We performed the present diagnostic meta-analysis to comprehensively evaluate the diagnostic value of machine learning algorithms for assessing the rupture risk of intracranial aneurysms. ⋯ Our findings have demonstrated that the diagnostic performance of machine learning algorithms for the rupture risk assessment of AIs is excellent. Considering that the negative effects resulted from the limited number of eligible studies, we suggest developing more well-designed studies with larger sample sizes to validate our findings.
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Review
Failure of Conservatively Managed Traumatic Vertebral Compression Fractures: A Systematic Review.
Most vertebral compression fractures (VCFs) are successfully managed conservatively; however, some patients fail conservative management and require further surgical treatment. We sought to identify significant variables that contribute to progressive vertebral collapse in nonoperative treatment of traumatic VCFs. ⋯ Identifying patients who are at risk for treatment failure may help select patients who would benefit from close clinical follow-up or early surgical/procedural intervention.