World Neurosurg
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Review Multicenter Study
Intraoperative monitoring of the integrity of the anterior visual pathways: a methodological review and meta-analysis.
Diverse methods have been developed for intraoperative monitoring of the integrity of the visual pathways. We performed a review of the literature to determine the methodology of each technique as well as their recent development. The predictive power of each eligible technique was determined based on a meta-analysis. ⋯ Each technique had limitations. Visual evoked potentials had a high predictive power for detection of deterioration but with low sensitivity. Fractional anisotropy of the optic chiasma had high predictive power for improvement of vision with low predictive power for deterioration.
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Review Meta Analysis
Decompressive craniectomy for spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
Spontaneous intracerebral hemorrhage (sICH) is a devastating disease with high mortality and morbidity, and the application of decompressive craniectomy (DC) in sICH is controversial. We conducted a systematic review to verify the effects of DC on improving outcome in sICH. ⋯ The application of DC effectively reduced mortality in patients with sICH. DC might improve functional outcomes in certain populations and needs further verification. DC is not associated with increased incidences of postoperative rebleeding and hydrocephalus.
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Review Meta Analysis
The Effect of Obesity on Clinical Outcomes Following Minimally Invasive Spine Surgery: A Systematic Review and Meta-analysis.
Obesity is associated with increasing morbidity and mortality in many prevalent diseases, especially lumbar degenerative disease. The relationship between minimally invasive surgery (MIS) of the spine and perioperative adverse events in obese patients with lumbar degenerative disease has not been well evaluated. ⋯ There does not seem to be an increased risk of developing perioperative complications in obese patients undergoing spine MIS. Spine MIS was a safe and effective technique for obese patients. However, according to our pooled data, longer surgery time was observed in obese patients.
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The Effect of Steroids on Complications, Readmission, and Reoperation After Posterior Lumbar Fusion.
The effects of chronic corticosteroid therapy on complications, readmission, and reoperation after posterior lumbar fusion (PLF) remain underinvestigated, and were examined to determine differences in outcomes. ⋯ The use of corticosteroid therapy is associated with a moderately increased risk of overall complications, but no association was found with readmission or reoperation.
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Cavernous malformations (CMs) are uncommon lesions occurring in the central nervous system, with an incidence of approximately 0.5% in the general population and constituting 5%-10% of all intracranial vascular malformations. Among CMs, prevalence within the brainstem as reported in the literature has ranged from 4% to 35%. With their precarious location and potentially devastating clinical events, brainstem CMs have attracted attention from neurosurgeons, and with these surgeons' unrelenting efforts, the microsurgical techniques to treat these lesions in the brainstem have greatly improved in recent decades. ⋯ Thus, it is advisable to operate on patients with symptomatic lesions abutting the pial or ependymal surface of the brainstem or where lesions are accessible to safe entry zones, which have caused more than 1 significantly symptomatic hemorrhage and can be defined as aggressive. However, treatment remains controversial for deep-seated lesions away from the surface of the brainstem or lesions that are inaccessible to safe entry zones. Other treatments, such as radiosurgery and medication, are still debatable, which might be as an alternative for lesions amenable to but at high risk with surgery.