Neurosurgery
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Scaphocephaly is a craniofacial deformity caused by the premature fusion of the sagittal suture, which can affect skull growth and shape. For decades, surgical treatment or craniosynostosis has involved open procedures, ranging from the removal of a single suture to complex cranial remodeling techniques with large skin incisions. Since the 1990s, endoscopic approaches have emerged as potentially less invasive options. This study aimed to evaluate the efficacy of and differences between endoscopic scaphocephaly correction techniques. ⋯ Our results suggest that less invasive techniques, involving smaller incisions and excisions, can achieve comparable success with traditional techniques. These findings have significant implications for clinical practice, underscoring the importance of exploring less invasive options for scaphocephaly correction to improve patient outcomes and reduce morbidity.
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The performance of select neurosurgical procedures is being transitioned to an outpatient setting rather than an inpatient setting to increase healthcare cost-effectiveness. Despite numerous technological advancements in the treatment of unruptured intracranial aneurysms (UIAs), the procedures are solely performed in an inpatient setting. We aimed to compare the rate of short-term outcomes associated with inpatient endovascular treatment of UIAs with those for established outpatient neurosurgical procedures, including anterior cervical discectomy and fusions (ACDFs) and lumbar discectomies. ⋯ Inpatient elective endovascular treatment of UIAs had similarly low rates of intraprocedural complications and short-term readmissions compared with the established outpatient spine procedures. We hope that our findings may serve as the foundation for future, prospective studies assessing the safety and utility of performing endovascular procedures for UIAs in an outpatient setting.
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Adults with achondroplasia are more vulnerable to suffer from neurogenic claudication because of a congenital narrow spinal canal, which makes them susceptible to lumbar spinal stenosis (LSS). The study aims to investigate the correlations between sagittal alignment parameters and the degree of LSS in patients with achondroplasia with LSS. ⋯ The upper LSS may be attributed to an increased kyphosis of the thoracolumbar spine. On the contrary, the lower LSS seemed to be correlated with a more backward tilt of the pelvis.
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Review Meta Analysis
Primary Embolization of Cerebral Arteriovenous Malformations With Intention to Cure: A Systematic Review of Literature and Meta-Analysis.
The treatment of brain arteriovenous malformations (AVMs) involves multiple approaches, including embolization, microsurgical resection, and radiosurgery. With the advent of new embolisates, dual-lumen balloon catheters, detachable tip microcatheters, and transvenous embolization, endovascular AVM obliteration has become more effective. Although adjuvant embolization and embolization are commonly used, the safety and effectiveness of curative embolization remain unclear. ⋯ Curative embolization of AVM is primarily reserved for small and low-grade AVMs, with highly variable outcomes. Our findings suggest poor radiographic outcomes and increased risk of complications. Outcomes are highly dependent on patient selection and technique used. Large multicenter prospective studies are required to further guide patient selection, categorize clinical and radiographic outcomes, and identify subgroup of patients that may benefit from curative embolization.
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This study aimed to investigate the clinical, radiological, pathological features, treatment options, and outcomes of isocitrate dehydrogenase (IDH)-mutant brainstem gliomas (BSG-IDH mut ). ⋯ BSG-IDH mut represents a unique subgroup of brainstem gliomas with distinctive features and more favorable prognosis compared with other brainstem gliomas. Further research is required to better understand the molecular mechanisms and optimize treatment strategies for this rare and complex disease.