World Neurosurg
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The objective of this study was to assess the therapeutic efficacy of minimally invasive puncture and drainage (MIPD) facilitated by a 3-dimensional (3D)-printed guide plate in the management of primary brainstem hemorrhage (PBH). ⋯ MIPD guided by 3D printing technology is more effective than conservative treatment in PBH cases without extensive hemorrhage. This approach can alleviate hematoma pressure earlier, mitigate neurological deficits, reduce HAP incidence, shorten hospital stay, and decrease mortality and disability rates associated with PBH.
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Identification of Key Risk Factors for Rupture in Small Intracranial Aneurysms: A Multicenter Study.
Predicting rupture risk in small intracranial aneurysms (IAs) < 5 mm is crucial for guiding clinical decisions. This study aims to identify key clinical and morphological risk factors associated with rupture in small IAs, providing better insight for decision-making. ⋯ This study identifies and validates critical risk factors associated with small IA rupture and presents a clinically useful, high-accuracy predictive model to aid in individualized patient management.
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Evidence available to clinicians and patients to inform treatment decisions is ideally produced by randomized controlled trials (RCTs). The objective of this study was to assess the extent to which neurosurgical practice is supported by RCT-level evidence. ⋯ The RCT-level evidence supporting neurosurgical practice is varied and the outcomes tested remain predominantly heterogeneous. There remain important neurosurgical conditions where treatment strategies are not underpinned by high-quality evidence. Pragmatic RCTs, well-designed observational studies as well as robust audit and registry processes may provide the real-world evidence for treatment decisions in neurosurgical care.
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To (1) create a novel tissue-engineered bone graft comprising the osteoinductive oxysterol Oxy133 and (2) compare the osteogenic capability of this novel bone graft with bone graft substitutes previously examined. ⋯ BioMim-Oxy133 is a novel bone graft that led to superior bone volume and quality compared to ACS-rhBMP-2 in a clinically translatable rat model of spinal fusion. Future work is needed to further evaluate this material as a safe and efficacious bone graft substitute.
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The application of the transorbital (TO) approach for vascular lesions has been scarcely explored. In this anatomic study, we examine the carotid and middle cerebral arteries from the TO perspective and investigate the feasibility of vascular clipping in a pseudovascularized model. ⋯ The TO approach provides anatomic access to the lateral and dorsal carotid siphon, complete posterior communicating artery, and proximal middle cerebral artery. This preliminary study suggests potential application in the elective treatment of paraclinoid and posterior communicating aneurysms.