World Neurosurg
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Review Meta Analysis
Risk Factors for Restenosis Following Carotid Revascularization: a Meta-analysis of Hazard Ratios.
Carotid artery restenosis after carotid endarterectomy (CEA) or carotid artery stenting (CAS) will occur in 3%-30% of cases. Restenosis can lead to more frequent clinical and imaging monitoring and the potential for reoperation. We sought to define the demographic, clinical, and radiographic characteristics that influence the restenosis risk after carotid revascularization. ⋯ Diabetes, dyslipidemia, female gender, renal failure, hypertension, and smoking were associated with an increased risk of restenosis, and patch endarterectomy and symptomatic status at presentation were associated with a decreased risk of carotid restenosis. Both female gender and current smoking status were only associated with recurrent stenosis after CEA, and hypertension was only associated with restenosis after CAS.
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Review Meta Analysis
Intra-operative neuromonitoring in patients with intramedullary spinal cord tumor: a systematic review, meta-analysis, and case series.
Intramedullary spinal cord tumors (IMSCT) comprise the least common types of spinal neoplasms; surgery is mostly conducted with intraoperative neuromonitoring (IONM). However, although IONM is widely used to prevent neurologic damage and many single-center studies have been reported, the added value, in terms of overall sensitivity and specificity, of different monitoring techniques used in IMSCT surgery remains to be clearly defined. ⋯ IONM showed high but not perfect sensitivity and specificity. IONM prevents neurologic damage but can also limit the extent of tumor resection. Prospective studies will have to define the definitive value of IONM.
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Review Meta Analysis
The reliability of fMRI in brain tumor patients: a critical review and meta-analysis.
Formal studies that validated functional magnetic resonance imaging (fMRI) against direct cortical stimulation (DCS) have shown inconsistencies. ⋯ The results from the present analysis of the available reported evidence suggest that fMRI itself (due to neurovascular uncoupling) or analysis of the findings have limitations regarding reliability when validated against DCS. From the existing studies, our results indicate that using fMRI alone for surgical planning could lead to undesirable outcomes.
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Review Case Reports
Treatment and survival outcomes of primary intracranial squamous cell carcinoma.
Primary intracranial squamous cell carcinoma (SCC) is a rare neoplasm associated with malignant transformation of benign epidermoid or dermoid cysts. The optimal treatment and prognosis of this rare disease are unclear. ⋯ Primary intracranial SCC shows poor prognosis, with controversial management. The results of this study indicate that complete resection of tumor when possible, followed by radiotherapy, is the optimal treatment for improving patient outcome.
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Review Case Reports
Neurenteric cyst of the ventral craniocervical junction: Case report and a literature review.
Neurenteric cysts (NCs) are rare, non-neoplastic lesions arising from a failure of dissolution of the transient neurenteric canal between the foregut and the notochord. They are most frequently seen in the intradural extramedullary space in the lower cervical and upper thoracic spine. The authors describe a rare case of NC arising from the ventral cervicomedullary junction that was totally resected via a posterior approach. ⋯ NC is a rare lesion of the craniospinal junction and should be considered among differential diagnoses. Complete excision is the treatment of choice. In most instances a dorsal surgical approach will be satisfactory.