World Neurosurg
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Motorcycle-associated head injury is one of the leading causes of disability and deaths, with its main victims being the motorcyclists, passengers, and pedestrians in their young productive age group. This study determines the role of severity and some predictive factors on survival and mortality of motorcycle-associated head injury. ⋯ Motorcycle-associated head injury predominantly occurred among young men who used a motorcycle for commercial purposes. The survival rate was higher among patients who had brain CT scan performed, extra-axial clots, and operative treatment. However, high mortality was seen among patients who could not afford brain CT scan, and who had bilateral pupillary dilatation, CT findings of abnormalities that are not surgically amenable, and severe head injury.
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Review Meta Analysis
Steroid in chronic subdural hematoma: an updated systematic review and meta-analysis post DEX-CSDH Trial.
Chronic subdural hematoma (CSDH) is a neurologic condition characterized as a hematoma in the subdural space with a period >3 weeks that primarily affects the elderly. Glucocorticoid, especially dexamethasone, either alone or combined with surgery, has been used to manage CSDH. We aimed to perform an updated systematic review and meta-analysis of the literature regarding the role of steroids in CSDH. ⋯ Treatment with steroids was associated with a lesser recurrence of CSDH. However, there was no benefit of steroid treatment in CSDH compared with nonsteroid treatment in terms of mortality and treatment success and some but significantly increased risk of adverse events.
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Meta Analysis
Supraorbital Keyhole Craniotomy Via Eyebrow Incision: A Systematic Review and Meta-Analysis.
Supraorbital eyebrow keyhole craniotomy is a minimally invasive alternative to a frontotemporal craniotomy and is often used for tumor resection and aneurysm clipping. The purpose of this study is to provide a contemporary review on the outcomes related to this approach and to determine whether they vary with the type of pathology and the addition of an endoscope. ⋯ The supraorbital craniotomy via an eyebrow incision is a feasible minimally invasive approach with an overall high technical success rate for both vascular and tumor pathologies.
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Flow diversion via a Pipeline embolization device (PED [Medtronic, Dublin, Ireland]) is one of the established modalities for the treatment of unruptured intracranial aneurysms that require a robust follow-up regimen. However, to date, no consensus has been reached regarding the optimal imaging modality and timing intervals for such a strategy. We studied the cost-effectiveness of different neuroimaging follow-up strategies after flow diversion with the PED. ⋯ Given the current data, delayed imaging follow-up at 1 year with DSA and 2 years with MRA after PED treatment of unruptured intracranial aneurysms is more cost-effective than early follow-up at 6 months.