World Neurosurg
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Review Meta Analysis Comparative Study
Structural Allograft versus Polyetheretherketone (PEEK) Implants in patients undergoing Spinal Fusion Surgery: A Systematic Review and Meta-analysis.
Interbody spacers have been successfully used in spinal fusion procedures with the aim to restore disc height, provide stability, and promote bone fusion. The authors evaluated the efficacy of structural body allograft versus polyetheretherketone (PEEK) implants in patients undergoing spinal fusion surgery. ⋯ Our results corroborate that structural allografts are highly effective in promoting bony fusion compared with PEEK implants in patients undergoing spinal fusion surgery.
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Review Meta Analysis Comparative Study
Subperiosteal versus Subdural Drain after Burr-hole Drainage for Chronic Subdural Hematomas: A Systematic Review and Meta-analysis.
The use of drains has been considered to be superior to no drains after burr hole drainage of chronic subdural hematomas (CSDHs). Therefore, routine placement of a subdural drain (SDD) is supported by most neurosurgeons. However, whether the drain location after CSDH burr hole evacuation influences patient outcomes is unclear. Therefore, we compared the efficacy and safety of subperiosteal drains (SPDs) with those of SDDs for patients with CSDHs. ⋯ The results from the present meta-analysis suggest that the use of an SPD is safer and might be more effective than an SDD in the treatment of CSDH. However, more large randomized controlled trials are needed to investigate the use of SPDs in the management of CSDH.
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Review Case Reports
Chronic epidural hematoma caused by traumatic intracranial pseudoaneurysm of the middle meningeal artery: review of the literature with a focus on this unique entity.
Pseudoaneurysms of the middle meningeal artery represent fewer than 1% of all intracranial aneurysms; it can be associated with different patterns of intracranial hemorrhages. A chronic epidural hematoma (CEDH) caused by post-traumatic pseudoaneurysm of the middle meningeal artery (MMA) has not yet been reported. ⋯ Pseudoaneurysms are considered unstable because of the poor support of the aneurysmal wall. They tend to progressively increase in size and ultimately rupture, leading to delayed intracranial bleeding. A univocal definition of the interval of time between the acute head trauma and the diagnosis to classify the CEDH is still debated. To our knowledge, this is the first case described of a CEDH secondary to a pseudoaneurysm of the MMA. In our study we suggest defining CEDHs as extradural hematomas diagnosed and/or treated 21 days or more after a head injury.
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Review Case Reports
Symptomatic Brain Hemorrhages from Cavernous Angioma Following Botulinum Toxin Injections, a role of TLR/MEKK3 Mechanism? A Case Report and Review of the Literature.
Cavernous angiomas (CAs) are vascular malformations that may result in stroke. ⋯ Recently, bacterial lipopolysaccharide has been reported to contribute to CA development through Toll-like receptor signaling, causing hemorrhagic angiogenic proliferation. Lipopolysaccharide and Btx share a common intracellular signaling pathway driving CA development and hemorrhage. Significance of these observations is demonstrated by previous works on plasma molecules showing prognostic associations with symptomatic hemorrhages in human CA, related to the same canonical pathways. Authors suggest careful tracking of the association of Btx and hemorrhage in CA patients.
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Review Meta Analysis
Exploration of efficacy and safety of interventions for intraventricular hemorrhage: A network meta-analysis.
To explore whether endoscopy surgery (ES) and extraventricular drainage (EVD) combined with intraventricular fibrinolytic (IVF) are superior to EVD alone in patients with intraventricular hemorrhage (IVH) and to determine which procedure is more suitable in such patients. ⋯ Our analysis showed that ES is more suitable for patients with IVH. ES not only improved the survival and prognosis but also had the lowest risk of ventriculoperitoneal shunt and intracranial rebleeding or infection.