World Neurosurg
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Review Meta Analysis Comparative Study
A Comprehensive Meta-Analysis on the Efficacy of Stereotactic Radiosurgery versus Surgical Resection for Cerebral Arteriovenous Malformations.
Cerebral arteriovenous malformations (AVMs) pose significant management challenges, with treatment options such as stereotactic radiosurgery (SRS) and surgical resection (SR) often debated. This meta-analysis seeks to compare the efficacy and safety of SRS versus SR in treating cerebral AVMs. ⋯ SRS appears to offer several advantages over SR, including lower rates of embolization, hemorrhage, shorter operative times, and fewer neurologic deficits post-treatment. These findings suggest SRS may be a preferable treatment modality for cerebral AVMs, particularly for lesions located in eloquent brain regions or in patients where traditional surgery presents significant risks.
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Review Meta Analysis
Failure rates of Conservative Management of Minimally Symptomatic Chronic Subdural Hematoma: A Systematic Review and Meta-analysis.
Conservative treatments for minimally symptomatic chronic subdural hematoma (cSDH) are debated, with surgery as the primary option. ⋯ The rate of rescue surgery in conservatively managed cSDH patients remains high. Corticosteroids or atorvastatin demonstrates some potential benefit in reducing the failure rate but collective effectiveness is unknown.
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Review Meta Analysis
Clinical Application of Artificial Intelligence in Prediction of Intraoperative Cerebrospinal Fluid Leakage in Pituitary Surgery: A Systematic Review and Meta-Analysis.
Postoperative cerebrospinal fluid (CSF) leakage is the leading adverse event in transsphenoidal surgery. Intraoperative CSF (ioCSF) leakage is one of the most important predictive factors for postoperative CSF leakage. This systematic review and meta-analysis aimed to evaluate the effectiveness of artificial intelligence (AI) models in predicting ioCSF. ⋯ AI models have demonstrated promising performance for predicting the ioCSF leakage in pituitary surgery and can optimize the treatment strategy.
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Review Meta Analysis
Predictive modeling of early neurological deterioration in patients with Acute Ischemic Stroke.
Ischaemic stroke is the leading cause of death worldwide, and early neurological deterioration(END) occurs in 20%-40% of patients, which is the main cause of severe neurological deficits and disability, and even increased mortality. The occurrence of END is closely related to the poor prognosis of the patients, so it is important to identify the risk factors for the occurrence of END in patients with AIS and target intervention at an early stage factors and targeted intervention is of great significance. ⋯ Clinical practitioners should closely monitor high-frequency predictors of END in patients. However, the varying quality of current models necessitates the selection of models that balance performance with operational simplicity in clinical practice.
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To clarify a rational surgical priority, clinical characteristics were compared between brain metastases (BM) from renal cell carcinoma (RCC) and other cancers. ⋯ Generally, symptomatic BM were indicated for surgery. BM from RCC were characteristically single, low-volume lesions with expanding edema and intratumoral hemorrhage, causing symptoms. These results suggest that surgery should be a high priority for BM from RCC.