World Neurosurg
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Review Meta Analysis
Systematic review and meta-analysis of the association between appearance of lesions on diffusion-weighted imaging and poor outcomes among patients with intracerebral hemorrhage.
Some patients with intracerebral hemorrhage show lesions on diffusion-weighted magnetic resonance imaging, and such lesions have been associated with a greater risk of worse prognosis. Here we meta-analyzed the available evidence for such an association. ⋯ Lesions on DWI after intracerebral hemorrhage were associated with a higher risk of poor outcome, but large longitudinal studies are needed to verify this association.
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Review Meta Analysis
Magnetic Resonance-guided Laser Interstitial Thermal Therapy in the Management of Hypothalamic Hamartomas: A Systematic Review and Meta-analysis.
Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is a promising new technique to ablate epileptic foci in patients with hypothalamic hamartoma (HH). We aim to systematically synthesize all available evidence and determine the effectiveness of MRg-LITT in reducing seizures in patients with HH. ⋯ MRg-LITT might be a feasible and effective technique for ablation of epileptic foci, leading to seizure freedom in a large proportion of patients with HH. However, there is a paucity of literature on the topic, and prospective clinical trials with larger number of participants comparing MRg-LITT to open surgery are needed.
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Review Meta Analysis
The Prognostic Utility of Frailty on the Outcomes of Primary Brain Tumor Surgery Patients: A Meta-analysis.
Frailty refers to a state of weakness that can arise due to age or illnesses, and frailty predisposes individuals to several adverse health outcomes. This has been postulated to prognosticate the outcome of various surgeries, including surgeries for primary brain tumors; however, no meta-analysis has validated this finding. ⋯ This study showed little correlation with postoperative mortality, readmission, nonroutine discharge, length of hospital stay, or overall survival, and fragility had less significance in these areas but showed no statistical significance in predicting postoperative complications following surgery for primary brain tumors.
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Review Meta Analysis
Friend or Foe? Preoperative Embolization in Jugular Paraganglioma Surgery-A Systematic Review and Meta-Analysis.
Jugular paragangliomas are highly vascularized tumors that can grow in challenging neurovascular compartments and are particularly challenging to resect. There is still no consensus whether preoperative embolization should be employed to minimize intraoperative morbidity. ⋯ Preoperative embolization may provide surgical efficiency with faster surgical times and less bleeding and safety with diminished overall recurrence via safe embolization with minimal risks. These results must be considered taking into account the nonrandomness of studies.
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Review Meta Analysis
Pituitary Apoplexy and The Current Understanding of Its Management: A Meta-Analysis of 908 Patients.
Pituitary apoplexy (PA) is characterized by acute hemorrhage or infarction of the pituitary gland. Management can be either conservative or surgical. Evidence favoring either is still limited to observational studies. This meta-analysis evaluates the effectiveness of both approaches on patient outcomes. ⋯ Both interventions provide comparable outcomes. These findings, though, are drawn from observational studies, and more severe cases typically undergo surgery. Larger studies are necessary to provide conclusive evidence.