World Neurosurg
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Review Meta Analysis
Clazosentan for Aneurysmal Subarachnoid Hemorrhage: An Updated Meta-Analysis with Trial Sequential Analysis.
Clazosentan, an endothelin receptor antagonist, reduced vasospasm and delayed ischemic neurologic deficit (DIND) but did not improve outcome after subarachnoid hemorrhage (SAH) in clinical trials. However, a lack of dose-dependent analysis and potential overestimation of clazosentan's effect are concerning. We used stratified analysis and trial sequential analysis (TSA) of existing data to investigate the effects of clazosentan on SAH outcome. ⋯ Clazosentan reduced the risk of DIND requiring rescue therapy and moderate-to-severe vasospasm. Further meta-analyses based on individual patient data with different clazosentan doses and more refined outcome measures are necessary to clarify clazosentan's efficacy in improving post-SAH outcome.
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Review Meta Analysis
Does concomitant degenerative spondylolisthesis influence the outcome of decompression alone in degenerative lumbar spinal stenosis? A meta-analysis of comparative studies.
To investigate whether the preoperative presence of degenerative spondylolisthesis (DS) worsens the outcome of patients undergoing decompression alone for degenerative lumbar stenosis. ⋯ Our meta-analysis revealed that concomitant DS (Meyerding grade I-II) does not influence the outcome of decompression alone in degenerative lumbar spinal stenosis, especially when a minimally invasive procedure was performed and patients did not have predominant symptoms of mechanical back pain. The presence of DS should not be an indication for fusion surgery in degenerative lumbar spinal stenosis.
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Review Case Reports Meta Analysis
Diagnosis and Treatment of Isolated Cerebral Mucormycosis: Patient-Level Data Meta-Analysis and Mayo Clinic Experience.
Isolated cerebral mucormycosis is a rare and serious infection associated with intravenous drug abuse. ⋯ Isolated cerebral mucormycosis has a pooled mortality rate of 65%. The presence of lesions in the basal ganglia, rapidly progressive symptoms, and a history of intravenous drug abuse should raise suspicion for the early initiation of amphotericin B and stereotactic aspiration.
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Review Case Reports
Endovascular Retrieval of Dislodged Neurovascular Devices with a Stentriever: Case Series and Technical Review.
Endovascular treatment of neurovascular disorders is now well established as effective and safe; however, the nature of the intracranial vasculature poses unique challenges. The unintentional dislodgement or fracture of a device and its migration within cerebral vessels is a complication with serious potential morbidity that must be managed urgently. In this series, the authors describe 7 cases of a stentriever being used to remove foreign objects from within the cerebral vasculature. ⋯ The migration of foreign devices during neurointerventional procedures is a serious complication requiring urgent treatment. This case series highlights the efficacy and advantages of using a stentriever and suggests its consideration as a first-line technique in recovering dislodged foreign bodies in the cerebral vasculature.