World Neurosurg
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Meta Analysis
Risk Factors for Cerebrospinal Fluid Leakage after Extradural Spine Surgery: A Meta-analysis and Systematic Review.
Cerebrospinal fluid (CSF) leakage is 1 of the common complications of spine surgery and is largely caused by intraoperative or postoperative dural tears. Associations of different factors with postoperative CSF leakage have not been consistent. In this study we aimed to identify demographic, disease-related, and surgical risk factors for CSF leakage after extradural spine surgery in a systematic review and meta-anlysis. ⋯ This study will provide a reference for the identification of patients at high risk of developing CSF leakage, which suggests clinicians to strengthen the observation of drainage fluid in high-risk groups.
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Meta Analysis
SUPRATOTAL RESECTION - AN EMERGING CONCEPT OF GLIOMABLASTOMA MULTIFORME SURGERY - SYSTEMATIC REVIEW AND META-ANALYSIS.
The severe neurologic tumor known as glioblastoma (GBM), also referred to as a grade IV astrocytoma, is rapidly progressive and debilitating. Supratotal resection (SpTR) is an emerging concept within glioma surgery, which aims to achieve a more extensive resection of the tumor than is possible with conventional techniques. ⋯ SpTR is associated with greater overall survival and PFS when compared with other glioblastoma surgeries like GTR or SubTR.
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Arteriovenous malformations (AVMs) are high-pressure, low-resistance arterial-venous shunts without intervening capillaries. Up to 60% of AVMs present with an intracranial hemorrhage; however, noninvasive neuroimaging has increasingly diagnosed incidental AVMs. AVM management depends on weighing the lifetime rupture risk against the risks of intervention. ⋯ Quantitative hemodynamic studies on the relationship between AVM flow and rupture risk have not reached a clear consensus; however, the preponderance of data suggests that higher arterial inflow and lower venous outflow in the AVM nidus contribute to increased hemorrhagic risk. Future studies should consider using larger sample sizes and standardized definitions of hemodynamic parameters to reach a consensus. In the meantime, classic angioarchitectural features may be more strongly correlated with AVM rupture than the amount of blood flow.
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Awake craniotomy is a unique method to prevent motor deficits during the resection of lesions located in or close to functional areas. We sought to study the outcomes of pediatric craniotomy on published studies. ⋯ This systematic review summarized that awake brain surgery can prevent significant motor and language deficits postoperatively in children after tumor resection as it is considered a feasible and safe procedure.