World Neurosurg
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Meta Analysis
Mechanical Thrombectomy for M2 Segment Occlusion in Acute Ischemic Stroke：a systematic review and meta analysis.
The safety and benefit of mechanical thrombectomy (MT) in the treatment of acute ischemic stroke (AIS) patients with M2 segment middle cerebral artery occlusions remain uncertain. ⋯ Compared with M1 occlusion, patients with M2 occlusion treated by MT demonstrated similar clinical outcomes in this study. Moreover, there was no difference between stent retriever and aspiration in treating M2 occlusion in terms of functional independence at 90 days. However, aspiration exerted a conspicuously higher recanalization rate in M2 occlusion than in M1 occlusion.
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Anterior communicating artery aneurysms (ACoAAs) are challenging to treat both surgically and endovascularly. In this study, we evaluate the treatment-related morbidity and clinical outcome of microsurgical clipping and endovascular treatment for a consecutive series of unruptured ACoAAs while the treatment paradigm was in transition from surgical to endovascular first. ⋯ We did not find any major differences regarding complications and outcomes after the treatment paradigm shift from clipping to endovascular of unruptured ACoAAs. Prospective studies evaluating durability of treatments are needed to compare overall effectiveness.
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Treatment of multiple intracranial aneurysms is challenging. Neurologic status, aneurysm morphology, location, ruptured/unruptured status, availability of equipment, and patient preference are among the factors influencing the choice of treatment modality.1 Ideally, a 1-stage procedure is recommended whenever possible.2 However, patients with multiple aneurysms located in both the anterior and posterior circulation are less likely to be treated with a single procedure.3 We present the case of a 52-year-old patient who presented with recurrent headaches and progressive onset of a right eye ptosis evolving for 2 months. Her medical history was significant: an episode of eclampsia 20 years ago and high blood pressure managed with amlodipine. ⋯ Thirty days later, she underwent an endovascular coiling of the vertebro-basilar junction aneurysm uneventfully. She was able to return to work 2 weeks after discharge. The patient consented to publication of her images.
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Vestibular schwannomas are benign, slow-growing tumors that often reduce patient quality of life by compressing nearby nerves. Neurological function preservation is one of the indicators of treatment success, with hearing preservation being the most difficult to obtain. This paper provides a bibliometric analysis of hearing preservation in treating acoustic neuromas and a greater understanding of the most highly cited articles, which have enhanced our understanding of this topic. ⋯ Bibliometric analyses summarize and assess potential areas of strength and knowledge gaps within the literature. Studies on hearing preservation in vestibular schwannomas mostly consist of retrospective reviews that assess postoperative outcomes of microsurgery and radiosurgery. Prospective studies and novel treatment options for hearing preservation in vestibular schwannomas are needed to increase current literature diversity.
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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.