World Neurosurg
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Review Meta Analysis Comparative Study
Outcomes of dura splitting decompression versus posterior fossa decompression with duraplasty in the treatment of Chiari I malformation: a systematic review and meta-analysis.
Surgery is the definitive treatment option for symptomatic Chiari malformation I (CMI), but there is no clear consensus as to the preferred surgical method. This study aimed to quantitatively assess and compare the effect and safety of dura splitting decompression (DSD) and posterior fossa decompression with duraplasty (PFDD) in treating patients with CMI. ⋯ This study confirmed that dura splitting decompression has clinical and syringomyelia improvement outcomes comparable to posterior fossa decompression with duraplasty. Compared with PFDD, DSD not only significantly shortened the operation time and length of stay, but also significantly reduced the overall complication rate, especially those related to incidence of CSF-related complications. More evidence from advanced multicenter studies are needed to require to validate the findings.
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Clinical Trial
Long-term independence in older patients with aneurysmal subarachnoid hemorrhage in the Barrow Ruptured Aneurysm Trial (BRAT).
Older patients have a higher risk for poor neurological outcomes following aneurysmal subarachnoid hemorrhage (aSAH). This study compared functional independence in older versus younger patients with aSAH and compared endovascular coiling with microsurgical clipping in the older cohort. ⋯ Patients ≥65 years old with aSAH are at increased risk for poor neurological outcomes compared with younger patients. Greater independence was observed in older patients after microsurgical clipping than after endovascular coiling at long-term follow-up.
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In this study, we aimed to examine the effect of myeloperoxidase on aneurysm rupture in patients with cerebral aneurysms with and without rupture. ⋯ In our study, finding myeloperoxidase scores higher in cases of ruptured aneurysms compared with unruptured aneurysms reveals the relationship of myeloperoxidase with ruptured cerebral aneurysms.