World Neurosurg
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Perioperative management of antithrombotic therapy is a necessary preprocedural consideration for patients prescribed direct oral anticoagulants (DOACs), vitamin K antagonists, or antiplatelet medications. There is a lack of evidence-based guidelines to help inform decision-making in managing antiplatelet and anticoagulation medications in the perioperative period around brain tumor resection. The objective of this study was to provide an example of the heterogeneity in practice and raise awareness for the need to create standardized guidelines for managing these medications. ⋯ Respondents demonstrated significant heterogeneity in their perioperative management of antiplatelet and anticoagulation medication in brain tumor resection. This may lead to an unacceptable level of heterogeneity in practice that has the potential to cause patient harm due to errors in medication management.
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The aim was to conduct a comprehensive bibliometric analysis of meningioma research, focusing on publication trends, top authors, universities, countries, and thematic analysis of keywords. ⋯ Our findings may provide insights into the evolution of meningioma research and its scholarly impact. The analysis underscores the pivotal contributions of top authors and institutions, outlines thematic research trends, and highlights areas of significant interest and growth in the field. Our study may contribute to understanding the landscape of meningioma research, guiding future research directions and collaborations.
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Given the benefits of neuroendovascular simulation to resident education, this study aimed to assess the efficacy of simulation-based training for neuroendovascular intervention with primary and secondary catheters using a transradial approach (TRA). ⋯ Residents demonstrated proficiency at Simmons catheter formation and vessel selection in a type II arch over a short time period (4 attempts and <1 hour total). Residents can use simulator-based training to increase their proficiency of vessel selection using a primary or secondary catheter for a TRA.
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Despite effective treatment for aneurysmal subarachnoid hemorrhage (aSAH), delayed cerebral ischemia (DCI) is a common complication that has a significant impact on the recovery of neurologic function. In this study, we aimed to investigate the efficacy of hyperbaric oxygen therapy (HBOT) in the rehabilitation treatment of aSAH. ⋯ In summary, early HBOT reduced the DCI rate in aSAH patients and consequently promoted improvement of the executive control function of ANT.
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Intraoperative photodynamic diagnosis (PDD) using 5-aminolevulinic acid (5-ALA) is a widely adopted technique to enhance the extent of resection during high-grade glioma (HGG) surgery. Recent updates to the package insert for 5-ALA in Japan now allow its use in combination with drugs that may induce photosensitivity, such as talaporfin sodium (TS). TS is employed in intraoperative photodynamic therapy (PDT) and has been shown to improve overall survival. The combination of 5-ALA with TS is expected to offer further benefits. However, the safety of this combination had not been established. This study reports on the safety of 5-ALA-PDD with TS-PDT in the treatment of recurrent HGG. ⋯ The combined use of 5-ALA-PDD and TS-PDT for HGG surgery did not increase the risk of serious adverse events in our study. Further investigations with a larger number of cases are needed for a more accurate assessment of its safety and efficacy.