World Neurosurg
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To compare fractionated stereotactic radiotherapy (FSRT) with staged stereotactic radiosurgery (SSRS) in patients with brain metastases >2 cm without prior whole brain radiotherapy. ⋯ SSRS and FSRT were found to be comparable for treating brain metastases >2 cm not previously irradiated. Given the paucity of such studies, trials directly comparing the two treatment strategies are warranted to support these findings.
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Transvenous embolization (TVE) of brain arteriovenous malformations (bAVMs) is an emerging endovascular technique that has shown high cure rates in selected cases. The rationale of our study was to determine authorship and worldwide institutional trends and contributions to the knowledge in this topic. ⋯ TVE of bAVMs is an emerging technique. Our search identified some scientific articles, without randomized clinical trials, but many case series from single institutions. French and German institutions are the pioneers in the field, and further research is required in specialized endovascular centers.
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This paper aims to bring back to life an underrated, even forgotten surgeon of the late first century B. C. E., Meges of Sidon. ⋯ Celsus, a Roman encyclopedist of the first century, would later erroneously receive credit for ancient surgical innovations, such as the nonslipping cranial drill and the treatment of depressed skull fractures, even though he was not a surgeon. However, as Celsus was going over the history of surgery, he described Meges as the "most learned" of its prominent figures. Meges' neurosurgic techniques and teachings are deduced from Celsus, who shortly succeeded him, did not practice surgery, and acknowledged him as his primary source on surgical topics.
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Intracranial pressure (ICP) management based on predetermined thresholds is not accurate in light of recent research on cerebrovascular physiology. Interpersonal and intrapersonal variations will lead ICP elevations to reach individualized thresholds for intracranial compliance impairment from one subject to another. Therefore reuniting the modern techniques of neuromonitoring besides ICP enables practitioners to have a more whole picture in anticipating neuro worsening and improving timing in decision making. ⋯ The authors' point of view is of particular importance for regions with resource heterogeneity and scarcity, where ICP monitoring is not available for all those in need and noninvasive techniques may provide a surrogate approach. If physicians who deal with acute-brain-injured patients in lower-resource areas understand that several tools besides ICP may improve their practice, it is possible to reduce acute brain injury morbimortality.
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Multicenter Study
Predictive factors for dysphagia after anterior cervical spine surgery: A prospective multicentre study.
To identify the incidence and predictors of postoperative dysphagia in patients who undergo anterior cervical spine surgery (ACSS) by utilizing the Eating Assessment Tool (EAT-10). ⋯ Dysphagia is common after ACSS, affecting more than 67.5% of patients at 7 days postoperatively, but over time, the incidence of dysphagia gradually decreases. Involvement of the vertebral bodies at C4 and above is a risk factor for dysphagia after ACSS, and intraoperative neurophysiological monitoring is a protective factor.