World Neurosurg
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Meta Analysis Comparative Study
Clinical and radiological outcome after treatment of unruptured paraophthalmic internal carotid artery aneurysms: A comparative and pooled analysis of single-center experiences.
Unruptured paraophthalmic aneurysms present unique challenges, and the ideal management remains unknown. ⋯ Endovascular therapies have benefits over surgical clipping in terms of fewer intracranial hemorrhage complications, fewer NCs, and lower unfavorable visual outcome rate. Flow diversion showed comparative safety and effectiveness to stent-assisted coiling, and they both achieved better radiologic results than coiling alone. Further validation by randomized cohort studies is still needed to provide robust evidence.
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Observational Study
Surgical resident education in non-instrumented lumbar spine surgery: a prospective observational study with a 4.5-year follow-up.
To review the outcomes of noninstrumented lumbar spine surgery performed by trainees as primary operators versus the outcomes of surgery performed by board-certified faculty neurosurgeons. ⋯ The global outcome, as measured by HRQOL response after a mean follow-up of 4.5 years, was similar for teaching and nonteaching cases. Patients from both groups scored virtually equal results on various pain, functional, and HRQOL metrics, and the reoperation rate was similar.
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Endoscopic ventriculostomy is an attractive surgical alternative to ventriculoperitoneal shunt in the treatment of focal hydrocephalus, including trapped temporal horn (TTH). The major concern of this surgical approach is closure of a stoma, the risk of which may be minimized by placement of a stent after ventriculostomy. ⋯ The risk of recurrence of TTH after endoscopic ventriculocisternostomy may be minimized by combining ventriculostomy with stent placement. This surgical procedure would be beneficial, particularly in cases of TTH associated with malignant brain tumors, where the risk of delay or interruption of adjuvant oncologic treatments may negatively impact patient prognosis.
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Review
Seizure Freedom Rates and Prognostic Indicators following Resection of Gangliogliomas: A Review.
Gangliogliomas are rare tumors that comprise up to 40% of lesional epilepsy. Seizure control represents an important quality-of-life determinant in patients with these tumors. Here we present results of a literature review addressing rates of seizure freedom in in patients with gangliogliomas. ⋯ Although significant differences in study populations and treatments preclude meta-analysis, we discuss prognostic factors identified in individual studies. Increased extent of resection, lesser duration of epilepsy, and younger age at surgery have been associated with increased seizure freedom rates in at least 2 studies each. Although all studies were retrospective in nature and are consequently limited by the weaknesses inherent to such investigations, the literature suggests that surgery is able to relieve most ganglioglioma patients--regardless of patient demographics, tumor characteristics, and operative variables--of seizures.
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Case Reports
Primary cerebellar Gliosarcoma with extra-cranial metastases: An orphan differential diagnosis.
Gliosarcomas are rare, malignant primary brain tumors, most commonly located in the temporal lobe, that contain both glial and mesenchymal elements. Gliosarcomas located within the cerebellum are exceedingly rare. The previously unreported finding of a cerebellar gliosarcoma concurrently with an extracranial metastasis to the lungs is discussed here. ⋯ To the best of our knowledge, a primary infratentorial gliosarcoma with extracranial metastases has not been previously described.