World Neurosurg
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Meta Analysis
The epidemiology, cause, and prognosis of painful tic convulsif syndrome: an individual patient data analysis of 192 cases.
Characterized by the coexistence of trigeminal neuralgia and ipsilateral hemifacial spasm (HFS), painful tic convulsif (PTC) is a rare entity that has not yet been systematically studied. ⋯ PTC occurs more in middle-aged women between 40 and 60 years old, initiates as HFS, and affects the left side. Vertebrobasilar artery compression is the most common single cause of PTC. Microvascular decompression effectively treated PTC, with a cure rate >80%. Anterior inferior cerebellar artery/posterior inferior cerebellar artery involvement predicts successful surgery and older age predicts recurrence.
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Increasing focus has been placed on patient education to optimize care. In the second part of a 2-part systematic review, we characterize the scope of interventions specifically created to improve neurosurgery patient education, assess the effectiveness of these interventions, and extract features of existing interventions that may be incorporated into future patient education interventions. Our findings may help promote the creation of effective, patient-centered educational interventions. ⋯ Electronic interventions using multiple modalities in concert with each other may be most effective. Interventions should incorporate baseline knowledge and health literacy and address patient concerns and needs in a manner that is valid cross-contextually, uses clear communication, and is continuous. These interventions will improve the patient-friendliness of discussions with patients.
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Patient education has become increasingly important in neurosurgery. However, little is known regarding how to comprehensively educate neurosurgical patients. In the first part of a 2-part systematic review, we identify baseline patient understanding and educational needs, examine existing patient education materials, and characterize shortcomings in neurosurgical patient education practices. Our findings may guide neurosurgeons, departments, and professional associations in improving communication with patients. ⋯ Current in-clinic discussions and education materials show shortcomings, promoting poor comprehension. Neurosurgeons, departments, and professional organizations can act to improve the effectiveness of patient education initiatives. This policy will better inform patients, increase rapport between neurosurgeons and patients, and improve patient decision making and satisfaction.
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Glioma and meningioma are the most common primary brain tumors in adults. Epidemiologic studies of the relationship between female hormone exposure and exogenous hormone use and the risk of meningioma and glioma in females have yielded inconsistent results. ⋯ OC use may not increase the risks of glioma and meningioma in females. Instead, the long-term use of OCs may significantly decrease the risk of glioma, and the benefits are even more pronounced when the time window is >7.5 years. Nonetheless, the pooled results in this study suggest that OC use may not increase the risk of meningioma. Therefore, our conclusion should be validated and supplemented in future larger studies.
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Brain metastases from endometrial cancer are rare and poorly described. We aimed to estimate the proportion of brain metastases at our institution that arose from endometrial cancer, and to detail clinicopathologic features and survival outcomes. ⋯ We describe the largest cohort to date of patients with brain metastases originating from endometrial cancer. These patients represent a small fraction of all patients with brain metastases and have poor prognoses. These data enable providers caring for patients with brain metastases from endometrial cancer to appropriately counsel their patients.