Journal of neurosurgery
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Journal of neurosurgery · Jan 2025
Neurological and functional outcomes of 32 patients with hemorrhagic brainstem cavernous malformations: a practical guide for surgical planning.
Brainstem cavernous malformations (BSCMs) were once considered inoperable. Microsurgical resection now represents a valuable option for treating patients with hemorrhagic or symptomatic lesions. The aim of this study was to provide a practical guide for surgical planning by analyzing postoperative neurological and functional outcomes. ⋯ Early surgery after the first bleed following systematic surgical planning may be considered as an effective option for managing hemorrhagic BSCMs with acceptable operative morbidity and relatively favorable early- and long-term neurological and functional outcomes.
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Journal of neurosurgery · Jan 2025
Cost-effectiveness analysis of deep brain stimulation versus treatment as usual for treatment-resistant obsessive-compulsive disorder.
Deep brain stimulation (DBS) is an effective neurosurgical option for patients with treatment-resistant obsessive-compulsive disorder (OCD). Despite being more costly than neuroablative procedures of comparable efficacy, DBS has gained popularity over the years for its reversibility and adjustability. Although the cost-effectiveness of DBS has been investigated extensively in movement disorders, few economic analyses of DBS for psychiatric disorders exist. In this study, the authors present the first cost-effectiveness analysis of DBS for treatment-resistant OCD in the United States. ⋯ Rechargeable DBS models were cost-effective for treatment-resistant OCD compared with TAU. Nonrechargeable DBS models may be cost-effective, especially with improvement in battery longevity and changes in accepted WTP thresholds.
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Journal of neurosurgery · Jan 2025
Evaluating academic productivity and match outcomes in neurosurgery residents from medical schools without a neurosurgery residency program: a 2016-2022 bibliometric analysis.
Transition of the United States Medical Licensing Examination Step 1 to a pass/fail structure has focused attention on medical student research in residency application. Previous studies have explored how various factors affect the neurosurgery match success, but none have focused on applicants from schools without a neurosurgery residency program. ⋯ Median publication counts have increased in this cohort, but they do not distinguish top 40 program matches. Conversely, the h-index, correlating with publication quantity and journal impact factor, does.
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Journal of neurosurgery · Jan 2025
Randomized Controlled Trial Multicenter StudyREACT: a randomized trial to assess the efficacy and safety of clazosentan for preventing clinical deterioration due to delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
Ischemic complications account for significant patient morbidity following aneurysmal subarachnoid hemorrhage (aSAH). The Prevention and Treatment of Vasospasm with Clazosentan (REACT) study was designed to assess the safety and efficacy of clazosentan, an endothelin receptor antagonist, in preventing clinical deterioration due to delayed cerebral ischemia (DCI) in patients with aSAH. ⋯ Clazosentan administered for up to 14 days at 15 mg/hour had no significant effect on the occurrence of clinical deterioration due to DCI. Clinical trial registration no.: NCT03585270 (ClinicalTrials.gov) EU clinical trial registration no.: 2018-000241-39 (clinicaltrialsregister.eu).