Neurosurgery
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Review Meta Analysis
Stereotactic Radiosurgery for A Randomized Trial of Unruptured Brain Arteriovenous Malformations-Eligible Patients: A Meta-Analysis.
The outcomes of A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) were controversial, and they suggested that intervention is inferior to medical management for unruptured brain arteriovenous malformations (AVMs). However, several studies have shown that stereotactic radiosurgery (SRS) is an acceptable therapy for unruptured AVMs. ⋯ SRS carries a favorable risk to benefit profile for appropriately selected ARUBA-eligible patients, particularly those with smaller volume AVMs. Our findings suggest that the results of ARUBA do not reflect the real-world safety and efficacy of SRS for unruptured AVMs.
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Medically refractory idiopathic intracranial hypertension (IIH) is frequently treated with venous sinus stenosis stenting with high success rates. Patient selection has been driven almost exclusively by identification of supraphysiological venous pressure gradients across stenotic regions based on theoretical assessment of likelihood of response. ⋯ Patients with IH with low venous pressure gradient venous sinus stenosis seem to benefit equally from venous stenting compared with their higher gradient counterparts. Re-evaluation of our restrictive criteria for this potentially vision sparing intervention is warranted. Future prospective confirmatory studies are needed.
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Multicenter Study
Automated Detection and Surgical Planning for Focal Cortical Dysplasia with Multicenter Validation.
In patients with surgically amenable focal cortical dysplasia (FCD), subtle neuroimaging representation and the risk of open surgery lead to gaps in surgical treatment and delays in surgery. ⋯ The integrated platform validated based on multicenter, prospective cohorts exhibited advantages of easy implementation, high performance, and generalizability, thereby indicating its potential in the diagnosis and minimally invasive treatment of FCD.