World Neurosurg
-
This meta-analysis assessed the impact of off-hour hospitalization (weekends, and evenings or nighttime on weekdays) on mortality and morbidity in patients with nontraumatic subarachnoid hemorrhage (SAH). ⋯ This meta-analysis has not shown an increased risk of mortality in the short-term and long-term among patients with nontraumatic SAH who were hospitalized during off-hour compared with on-hour periods, despite adjusting for potentially confounding patient factors. The delays to treatment and higher observed rates of pneumonia highlight areas in which hospital services and resources should be targeted during these off-hour periods in patients presenting with nontraumatic SAH.
-
This bibliometric analysis aims to identify the most impactful articles on hemangioblastoma (HB) and evaluate the trajectory of academic literature in the field. ⋯ This is the first bibliometric analysis to evaluate the most influential HB publications. Though a majority of HBs are sporadic, these results suggest a research focus on von Hippel-Lindau-associated tumors. Despite established evidence for the potential to control HB growth with vascular endothelial growth factor inhibition, there are no known clinical trials underway for this investigation. There is a need for consistent treatment guidelines for asymptomatic HBs, as resection can prevent the development of neurological deficits. An improved understanding of the etiology of these neoplasms could promote the development of novel diagnostic and treatment methods.
-
A cavernous sinus (CS) dural arteriovenous fistula (DAVF) is a form of abnormal arteriovenous communication that can be treated with endovascular embolization. Establishing an optimal access route should be based on vascular architecture. We reviewed 64 patients with CS-DAVF who underwent endovascular embolization and report the endovascular treatment approach selection and outcome. ⋯ The vascular architecture of CS-DAVF is closely related to endovascular treatment approach selection and outcome. Combined with the modified IPS recanalization technique, the trans-IPS approach is the safest and most effective approach. Dual microcatheter and balloon assistance techniques ensure the safety and completeness of embolization.
-
Multidisciplinary spine conferences (MSCs) are a strategy for discussing diagnostic and treatment aspects of patient care. Although they are becoming more common in hospitals, literature investigating how they impact patient care and outcomes is scarce. The aim of this study is to examine the impact of MSCs on surgical management and outcomes in elective spine surgical care. ⋯ To our knowledge, this is the first systematic review of outcomes of MSCs in elective spine surgery and it confirms that MSCs impact management plan and outcomes. Consistent MSCs that include surgeons and nonsurgeons have the potential to enhance communication between specialists, standardize treatments, improve patient care, and encourage teamwork. More analysis is warranted to determine if patient outcomes are improved with these measures.
-
Asymmetric features of nonfunctioning pituitary adenoma (NFPA) are poorly understood. We investigated the asymmetry in NFPA on magnetic resonance imaging. ⋯ Magnetic resonance imaging of NFPA frequently shows asymmetry. The tumor does not extend laterally on the normal pituitary side but extends laterally more freely on the cavernous sinus side. The ICA notch is often found on the normal pituitary side where the position of ICA does not move. This may be useful as a preoperative sign to indicate the normal pituitary side.