World Neurosurg
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Meta Analysis
The Clinical Use of Serum Biomarkers in Traumatic Brain Injury: A Systematic Review Stratified by Injury Severity.
Serum biomarkers have gained significant popularity as an adjunctive measure in the evaluation and prognostication of traumatic brain injury (TBI). However, a concise and clinically oriented report of the major markers in function of TBI severity is lacking. This systematic review aims to report current data on the diagnostic and prognostic utility of blood-based biomarkers across the spectrum of TBI. ⋯ This review summarizes existing high-quality evidence that supports the use of severity-specific biomarkers in the diagnostic and prognostic evaluation of TBI. These data can be used as a launching platform for the validation of upcoming clinical studies.
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Review Historical Article
Legacies of Neurosurgery and its Implications on Global Neurosurgery Today.
Trephination, the practice of boring a hole in the skull, is one of the oldest surgical procedures performed by and on humans. Fossil records show evidence of trephined skulls on separate continents throughout ancient history. Even more remarkably, fossils show that ancient humans actually survived the procedure, some more than once. ⋯ In critical situations, neurosurgical intervention may be indicated. The burr hole procedure, or trephination, was identified as an essential surgical procedure that all first-level hospitals should be able to perform; however, there exists a dramatic lack of access to neurosurgical specialists and care globally, especially among low- and middle-income countries. Task-shifting/sharing is one paradigm that may be used effectively to broaden access to this life-saving procedure but it is at the moment a contested practice.
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Multicenter Study
Intracranial Aneurysms in Patients with Marfan Syndrome: A Multi-center Propensity Matched Analysis.
We sought to identify risk factors for intracranial aneurysms (IAs) in Marfan syndrome (MFS) patients and to describe their characteristics. ⋯ Prevalence of IAs in our series of MFS patients was 11.3%, and de novo formation was 5.5%. MFS patients with a history of CAD and current smoker status had an increased risk of IA. Neurovascular radiographic screening should be considered in all patients with MFS, particularly in patients who smoke or have a history of heart disease.
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Review Historical Article
The Evolution of 3D-Anatomical Models: A Brief Historical Overview.
For thousands of years, anatomical models have served as essential tools in medical instruction. While human dissections have been the regular source of information for medical students for the last few centuries, the scarcity of bodies and the religious and social taboos of previous times made the process of acquiring human cadavers a challenge. The dissection process was dependent on the availability of fresh cadavers and thus was met with a major time constraint; with poor preservation techniques, decomposition turned the process of employing bodies for instruction into a race against time. ⋯ Artists worked with physicians and anatomists to prepare these models, creating an interdisciplinary interaction that advanced anatomical instruction at a tremendous rate. These models have taken the form of metal, wood, ivory, wax, papier-mâché, plaster, and plastic and have ultimately evolved into computerized and digital representations currently. We provide a brief historical overview of the evolution of anatomical models from a unique neuroanatomical perspective.
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Comparative Study
Patient Reported Outcome for Endovascular Treatment versus Microsurgical Clipping in Aneurysmal Subarachnoid Hemorrhage.
Aneurysmal subarachnoid hemorrhage has a high mortality with significant impact on quality of life despite effective management strategies including endovascular treatment and/or microsurgical clipping. Although the modalities have undergone clinical comparison, they have not been evaluated on patient-reported outcomes (PROs). This study compared endovascular versus microsurgical treatment using a PRO measure. ⋯ Published evidence has supported clinical benefits of endovascular treatment for cerebral aneurysm treatment, but this study did not find any difference in PROs. Future studies of treatments should include PRO to identify potential differences from the patient's perspective.