World Neurosurg
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Robotic-assisted laser interstitial thermal therapy (LITT) is a minimally invasive method for ablating seizure foci and has gained prominence in epilepsy treatment. The use of robotic guidance in these procedures can minimize errors in probe placement, potentially leading to better clinical outcomes. In this meta-analysis, we assessed the accuracy, safety, and effectiveness of robot-assisted LITT for drug-resistant epilepsy. ⋯ Robot-assisted LITT offers high precision, positive seizure outcomes, and minimal complications, comparable to nonrobotic methods, and is suitable for treating drug-resistant epilepsy with multiple lesions.
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Cervical spondylotic myelopathy (CSM) is a leading cause of spinal cord dysfunction in adults, often progressing silently. Static magnetic resonance imaging (MRI) is the standard imaging tool but may miss compression caused by neck movement. Dynamic MRI, by capturing flexion and extension views, provides a clearer picture of spinal cord compression, aiding surgical planning and improving outcomes. However, its use is limited due to higher costs and specialized requirements, making its clinical value essential to assess. ⋯ Dynamic cervical MRI enhances the identification of compression levels overlooked by static MRI, improving surgical precision and postoperative outcomes in CSM patients. Incorporating dynamic MRI into routine preoperative evaluations may be particularly beneficial for complex, multilevel cases.
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Ventricular shunt infections lead to significant morbidity and mortality. This study aimed to identify risk factors for 30-day postoperative infection outcomes of ventricular shunt surgery for pediatric hydrocephalus. ⋯ Various modifiable and nonmodifiable factors are associated with postoperative shunt infections. Recognizing and modifying risk factors can reduce pediatric shunt infections, thereby preventing revisions and improving therapeutic outcomes and quality of life.
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Surgical resection in gliomas invading the thalamus poses significant challenges due to the deep location and its localization near the ventricle. Ventricular entry (VE) during such operation is somewhat inevitable. However, the impact of VE on clinical outcomes is unclear. Additionally, it is unknown whether VE is associated with increased medical costs. ⋯ Although surgical VE does not impact survival, it may impose undesirable events and higher financial burdens for patients with gliomas invading the thalamus.
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Neurosurgical care is difficult to access in many scenarios. Aeromedical evacuation of acutely unwell neurosurgical patients from remote, isolated, or poorly equipped locations can be considered. This article aims to provide a framework of logistical factors that deserve special consideration in the preparation of these patients for transfer. ⋯ Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients.