World Neurosurg
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Chiasmatic cavernous hemangioma (CCH) is a rare disease. Most cases are treated with surgical resection through approaches such as pterional and orbitozygomatic craniotomy. However, with advancements in surgical technique and heightened patient demand for improved postoperative quality of life, there have been reports in recent years exploring more minimally invasive surgical approaches, such as the subfrontal trans-eyebrow keyhole and endoscopic endonasal transsphenoidal approach. In this article, the cases of CCH in the reported literature are reviewed, the indications and techniques of minimally invasive surgery for the removal of CCH through the subfrontal trans-eyebrow keyhole approach are discussed, and the effects of different surgical approaches are analyzed. ⋯ According to our results, the subfrontal trans-eyebrow keyhole approach for the resection of CCH is mainly suitable for cases in which the lesions are located above and anterior to the optic chiasm, the medial or superior aspect of the intracranial segment of the optic nerve is involved, and there is no invasion into the optic nerve canal. Compared with the traditional surgical approach, the minimally invasive subfrontal trans-eyebrow keyhole approach has demonstrated better clinical outcomes in the resection of CCH. However, according to the specific conditions of different patients, it is still necessary to comprehensively consider the choice of surgical approach. This study provides a valuable reference for further exploration of the treatment of CCH.
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N-butyl cyanoacrylate (n-BCA) is often used for preoperative transarterial embolization (TAE) of meningiomas. However, factors affecting the embolization effect with n-BCA remain unclear. This study aimed to clarify the factors associated with the embolization rate after TAE using n-BCA in meningioma, from the aspect of feeder architecture. ⋯ The OphA feeder group was associated with a lower embolization rate. Our study suggested that the vascular architecture in meningioma affected the efficacy of TAE with n-BCA.
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Patients with acute ischemic stroke (AIS) have limited evidence regarding the relationship between blood urea nitrogen and albumin. Aiming to investigate the relationship between the blood urea nitrogen to albumin ratio (BUN/ALB ratio) and poor outcomes in AIS patients at 3 months was the purpose of this study. ⋯ The BUN/ALB ratio and poor outcomes in AIS patients show a nonlinear correlation. For AIS patients, a BUN/ALB ratio of approximately 0.326 is associated with the lowest risk of adverse outcomes at 3 months. Specifically, for nonsmoking AIS patients, a BUN/ALB ratio of approximately 0.295 is associated with the lowest risk of adverse outcomes at 3 months.
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Despite advancements in gender equality within neurosurgery, the field continues to encounter challenges related to the under-representation of women and reports of gender-based disparities. This study examines the impact of these disparities on the experiences, professional development, and well-being of female neurosurgery residents in Germany, identifying specific challenges within the neurosurgical community. ⋯ The survey highlights gender disparities affecting female neurosurgery residents in Germany, negatively influencing job satisfaction and career advancement. Tackling gender discrimination and harassment requires a multifaceted approach, and further studies are warranted to assess these methods. The neurosurgical community must ensure a supportive environment by adopting no-tolerance policies against discrimination for all residents, paving the way for a future where professional excellence and patient care are free from gender inequalities.
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AtlasGPT represents an innovative generative pretrained transformer, trained using neurosurgery literature. Its ability to construct its response according to the training level of the user is unique; however, whether its responses can be comprehended at each user's training level remains unknown. This study aimed to analyze the readability of responses provided by AtlasGPT. ⋯ AtlasGPT-generated content demonstrates readability variations according to the user profile selected; however, the readability of patient content still exceeds recommendations set by United States departmental agencies, necessitating a call to action.