World Neurosurg
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To describe recent trends in treatment and outcomes of endovascular coil embolization and microsurgical clipping treatment strategies for ruptured intracranial aneurysms. ⋯ Analysis revealed no difference in 1-year mortality between coiling and clipping. Clinical outcomes, including intensive care, surgical complications, and vasospasm, favored coiling regardless of aneurysm location. Patients with coiling of anterior communicating artery aneurysms had significantly less hydrocephalus and patients with coiling of posterior communicating artery aneurysms had substantially less vasospasm treatment within 1 year compared with the clipping cohort.
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The UK neurosurgical community has a track record of delivering high-quality, practice-changing clinical research studies, facilitated by a robust clinical research infrastructure and close collaborations between neurosurgical centers. More recently, these large-scale studies have been conceived, developed, and delivered by neurosurgical trainees, working under the umbrella of the British Neurosurgical Trainee Research Collaborative (BNTRC). ⋯ Importantly, we focus on our experience of trainee-led studies, including the development of the network, current challenges, and future directions. We believe that a similar model can be applied in different settings and countries, which will drive up the quality of neurosurgical research, ultimately benefiting future neurosurgical patients.
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The practice of neurosurgery has been profoundly affected by the coronavirus disease 2019 (COVID-19) pandemic in Kazakhstan. Many elective surgeries were postponed or canceled, which resulted in difficulties in hospitalization. In the present study, we aimed to describe the effects of COVID-19 on neurosurgical practice and to determine whether a discrepancy was present in the effects between metropolises and regional cities in Kazakhstan. ⋯ The true effect of the pandemic remains unknown for Kazakhstan. A discrepancy between the metropolitan and regional cities was found in the present study. Efforts are required and relevant guidelines must be developed to ensure that the neurosurgical treatment of various conditions continues to be available during health emergencies and that the disparities are addressed.
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To perform measurements in normal brain imaging studies from the free edge of the falx cerebri to the genu and the body of the corpus callosum and perform a statistical analysis based on age, type of study, and sex highlighting potential surgical implication of these measurements. ⋯ There is a distance from the free edge of the falx cerebri to the genu and body of the corpus callosum of at least 1 cm in both CT and magnetic resonance imaging studies of normal brains. Statistically significant differences were found in the measurements in relation to the type of study and in relation to age in the measurements made in CT studies. These measurements could be important in determining the extent of bone resection in certain types of decompressive craniectomies.
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Randomized Controlled Trial
Case-Control Study Design in Neurological Surgery.
The hallmark of case-control study design involves dividing groups based on outcome and looking back at exposures to determine associations. Case-control studies are ideal for scenarios when outcomes are rare, making them well suited to the infrequent events often found among neurosurgical diseases. ⋯ Case-control studies are powerful but often misapplied and mislabeled. This article provides an overview of case-control study design along with discussion of a real-world example of an effectively executed case-control study.