World Neurosurg
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Hydrocephalus is a common neurosurgical condition treated primarily through ventriculoperitoneal (VP) shunt placement. This study aims to investigate the relationship between the timing of VP shunt surgery (on-call vs regular hours) and shunt failure rates. ⋯ The rate of shunt failure was significantly greater in surgeries conducted during on- call hours as opposed to regular hours, but this was not statistically significant after adjusting for confounders. Therefore, the timing of VP shunt surgery may not be an independent risk factor for shunt failure. High-risk scenarios still deserve added caution, and further research is needed to identify factors influencing shunt outcomes and develop strategies to minimize failure rates.
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Sutural anatomy variation has long been a topic of debate among anatomists, paleontologists, and morphologists. While the exact reasons for the prevalence of this variance remain a topic of ongoing discussion, developmental and genetic factors are hypothesized to be the main reasons. Understanding the morphology and occurrence of normal sutural variations in pediatric patients is essential to making the right diagnosis, where a misinterpretation of a sutural bone may lead to an inaccurate assessment, completely misleading the diagnostic process. ⋯ The current study provides valuable insights into the prevalence and characteristics of skull suture variations in the Saudi pediatric population under the age of one, based on 3D CT imaging data. Our findings indicate a notable occurrence of sutural bone variations, including the presence of Wormian bones and different patterns of suture patency.
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Mendelian randomization was employed to investigate the impact of circulating lipids, specifically residual lipids, on the risk of susceptibility to cerebral hemorrhage and ischemic stroke. ⋯ This study provides evidence for the beneficial impact of Apo A1 and HDL-C in reducing the risk of ischemic stroke, as well as the protective effect of HDL-C against cerebral hemorrhage. It highlights the detrimental effects of Apo B, TG, and LDL-C in increasing the risk of ischemic stroke, particularly in cases of large artery stroke. Furthermore, the study underscores the heterogeneity and two-sided effects of the causal relationship between triglyceride-rich lipoproteins and ischemic stroke, offering a promising avenue for the treatment of ischemic stroke.
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The safety of spontaneous vaginal delivery in pregnant patients with known unruptured intracranial aneurysms (UIAs) has been supported by increasing evidence over the past two decades. However, the extent to which this increased evidence has since influenced changes, if any, in actual clinical practice, has yet to be studied. ⋯ There was a significant trend over the 2010s toward permitting more spontaneous vaginal deliveries for obstetrical patients with known UIAs.
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Spinal meningiomas (SM) are rare, predominantly benign tumors that account for 1.2-12.7% of all meningiomas. While surgical resection is the primary treatment, recurrence occurs in a subset of patients, necessitating subsequent therapies such as re-operation or definitive radiation therapy (RT). This study evaluates the outcomes of definitive RT versus third surgery for recurrent WHO grade 1 SM, focusing on progression-free survival (PFS) and treatment-related toxicities. ⋯ Definitive RT appears to be a feasible alternative to third surgery for recurrent SM in selected patients, providing comparable PFS and manageable toxicities. Larger prospective studies are needed to validate these findings and refine treatment approaches for recurrent SM.