World Neurosurg
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Ventriculostomy, one of the most common neurosurgical procedures, involves inserting a draining catheter into the brain's ventricular system to alleviate excessive cerebrospinal fluid accumulation. Traditionally, this procedure has relied on freehand techniques guided by anatomical landmarks, which have shown a high rate of misplacement. Recent advancements in virtual reality (VR) and augmented reality (AR) technologies have opened up new possibilities in the field. This comprehensive review aims to analyze the existing literature, examine the diverse applications of VR and AR in ventriculostomy procedures, address their limitations, and propose potential future directions. ⋯ The review delves into the fundamental challenges encountered in the implementation of VR and AR systems in ventriculostomy. Additionally, potential future directions and areas for improvement are proposed, addressing the identified limitations and paving the way for further advancements in the field.
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Review Meta Analysis
Clinical Characteristics as Predictors of Early and Delayed Cerebral Infarction in Aneurysmal Subarachnoid Hemorrhage Patients: A Meta-Analysis of 4527 Cases.
Predictors of delayed cerebral infarction (DCI) and early cerebral infraction (ECI) among aneurysmal subarachnoid hemorrhage (aSAH) patients remain unclear. We aimed to systematically review and synthesize the literature on predictors of ECI and DCI among aSAH patients. ⋯ Female sex, admission disease severity, presence of vasospasm and Fisher grading can predict DCI risk post-aSAH. Significant knowledge gaps exist for ECI predictors. Further large standardized cohorts are warranted to guide prognosis and interventions.
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Review Meta Analysis
Endoscopic Treatment of Thoracolumbar Spondylodiscitis: A Systematic Review and Meta-Analysis.
Endoscopic surgery is a minimally invasive procedure that has been shown to relieve intradiscal pressure, irrigation of inflammatory factors, and visual debridement, which are crucial for the successful treatment of spondylodiscitis. This study proposes a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic treatment of thoracolumbar spondylodiscitis. ⋯ Endoscopic discectomy for thoracolumbar spondylodiscitis has been shown to be a safe technique with satisfactory clinical outcomes and a high causative pathogen identification rate.
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Review Meta Analysis
Safety and Technical Efficacy of Pediatric Brainstem Biopsies: An Updated Meta-Analysis of 1000+ Children.
Brainstem tumors represent ∼10% of pediatric brain tumors, ∼80% of these are diffuse midline glioma. Given invariably poor prognosis in diffuse midline glioma, there continues to be immense variation worldwide in performing biopsy of these lesions. Several contemporary studies in recent years have provided new data to elucidate the safety profile of biopsy and an updated meta-analysis is thus indicated. ⋯ When counseling families on the merits of brainstem biopsy in children, it is reasonable to state that permanent morbidity is rare (<2%). If biopsy is performed specifically to facilitate enrollment in clinical trials requiring a molecular diagnosis, the risks of biopsy outlined here should be weighed against potential benefits of trial enrollment.