World Neurosurg
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To present a global overview of the current research landscape and emerging trends in mechanical thrombectomy for acute ischemic stroke (AIS) over the past decade. ⋯ Interest in mechanical thrombectomy for AIS was progressively increasing. Future research directions may include minimizing intraoperative injuries, refining diagnostic techniques, investigating interventions for posterior circulation, and tailoring thrombectomy strategies based on stroke severity and large vessel occlusion etiology.
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This study aims to evaluate the prognostic factors and survival outcomes of pediatric patients with pineal region tumors (PRTs) using a large population-based registry. ⋯ Early age at diagnosis and aggressive histological types such as pineoblastomas are associated with poorer outcomes. Future research should focus on refining therapeutic protocols that integrate the histological and molecular profiles of these tumors.
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To identify the clinical and surgical characteristics and treatment options of patients suffering delayed (> 1 month) screw back-out after anterior cervical discectomy and fusion (ACDF). ⋯ The risk of screw back-out is low, but it can be a devastating complication. The majority of reported cases developed pharyngoesophageal injury and dysphagia. Surgery is often required to remove the hardware and repair any damage to the esophagus or hypopharynx, and may require prolonged antibiotics and NPO. Rarely, patients may be asymptomatic and treated conservatively; but in 7 patients in this series in whom back-out was initially managed conservatively there worsening back-out or injury that occurred an average of 29 months later.
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Cerebrospinal fluid diversion via shunt placement is a common neurosurgical intervention. Keen's Point is a widely used landmark for accessing the trigone of the lateral ventricle; however, it lacks clinical validation. This study re-evaluates Keen's Point scalp parameters using magnetic resonance imaging (MRI) to identify an ideal shunt entry point based on 3-dimensional reconstructions. ⋯ This modified Keen's Point is a reliable landmark for ventriculostomy. Incorporating PCA into preoperative planning enhances catheter placement accuracy, providing a prominent approach to shunting at Keen's Point.
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Review
Machine Learning Algorithms for Neurosurgical Preoperative Planning: A Comprehensive Scoping Review.
Preoperative neurosurgical planning is an important step in avoiding surgical complications, reducing morbidity, and improving patient safety. The incursion of machine learning (ML) in this domain has recently gained attention, given the notable advantages in processing large datasets and potentially generating efficient and accurate algorithms in patient care. We explored the evolving applications of ML algorithms in the preoperative planning of brain and spine surgery. ⋯ ML algorithms for preoperative neurosurgical planning are being developed for efficient, automated, and safe treatment decision-making. However, future studies are necessary to validate their objective performance across diverse clinical scenarios. Enhancing the robustness, transparency, and understanding of ML applications will be crucial for their successful integration into neurosurgical practice.