Publications by authors named "Leonardo Welling"

Background: Dissecting intracranial aneurysms (DIAs) have been treated through endovascular reconstructive manners, such as flow diverters (FDs) and stent-assisted coiling (SAC). Notably, no robust evidence has compared both approaches. Hence, the authors conducted a meta-analysis to compare their outcomes.

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Background: Among the reconstructive methods for treating dissecting posterior circulation aneurysms, there are stent-assisted coiling (SAC), and sole stenting (SS) therapy. Despite SAC being widely employed when compared to SS, no study systematically analyzed the difference in their outcomes.

Methods: The authors conducted a meta-analysis of studies employing both therapies to compare their outcomes.

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Article Synopsis
  • Neurosurgery is a hard field to get into, especially for international medical graduates (IMGs) who need to show they have done research to stand out.
  • Even though it’s tough, some Brazilian medical students have done really well by publishing important studies in big neurosurgery journals without needing a lot of money or resources.
  • The article suggests that IMGs can start their research careers by writing literature reviews and letters to the editor, which are easier ways to get involved in research.
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Cerebral vasospasm is determined as a temporary narrowing of cerebral arteries a few days after an aneurysmal subarachnoid hemorrhage. The onset of this vascular event usually evolves with new neurological deficits or progression of ischemic areas. The success of interventions to treat or revert this condition is not satisfying.

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Article Synopsis
  • Small anterior communicating artery (ACoA) aneurysms are challenging for neurosurgeons due to their risky location and the potential for severe complications if they rupture; both surgical clipping and endovascular treatments are common approaches.
  • A meta-analysis was conducted across thirteen studies involving 637 patients to compare the efficacy and outcomes of surgical clipping versus endovascular treatment techniques, primarily focusing on coiling.
  • Results demonstrated similar overall outcomes for both methods, but surgical clipping had a significantly lower retreatment rate (0% vs. 18% for endovascular), while endovascular treatment had slightly higher mortality and complication rates, emphasizing the importance of factors such as surgeon expertise and patient characteristics in treatment decisions.
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Introduction: Conventionally, one branch of the superficial temporal artery (STA) is utilized to revascularize the middle cerebral artery (MCA). However, there is the possibility of utilizing both branches of the STA when performing the bypass, characterizing the double-barrel (DB) STA-MCA bypass. Notably, a lack of studies evaluating this technique led the authors to conduct a systematic review and single-arm meta-analysis.

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Background: Some centers utilize ventriculopleural shunt (VPLS) for treating hydrocephalus when conventional approaches are not feasible. Nonetheless, the literature regarding this approach is scarce.

Purpose: Evaluate the outcomes of VPLS through a single-arm meta-analysis.

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Background: Despite the recent increase in publications centered on intracranial-intracranial (IC-IC) bypasses for complex aneurysms, there is no systematic evidence regarding their outcomes. The purpose was to assess the outcomes of patients subjected to IC-IC bypass for aneurysms.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, a systematic review was conducted.

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Article Synopsis
  • Chronic subdural hematoma (CSDH) is a prevalent condition in older adults, and recent studies suggest that atorvastatin may help lower its recurrence and improve patient outcomes.
  • A review of data from seven studies revealed that atorvastatin significantly reduces the recurrence of CSDH, particularly in patients initially treated conservatively, without increasing adverse effects.
  • More extensive and better-designed randomized trials are necessary to fully assess atorvastatin's effectiveness, safety, and ideal dosage for CSDH treatment.
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Background: When traditional therapies are unsuitable, revascularization becomes essential for managing posterior inferior cerebellar artery (PICA) or vertebral artery aneurysms. Notably, the PICA-PICA bypass has emerged as a promising option, overshadowing the occipital artery-PICA (OA-PICA) bypass. The objective was to compare the safety and efficacy of OA-PICA and PICA-PICA bypasses.

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Background And Objectives: High-grade gliomas (HGGs) are aggressive tumors of the central nervous system that cause significant morbidity and mortality. Despite advances in surgery and radiation therapy (RT), HGG still has a high incidence of recurrence and treatment failure. Intraoperative radiotherapy (IORT) has emerged as a promising therapeutic approach to achieve local tumor control while sparing normal brain tissue from radiation-induced damage.

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The utilization of the internal maxillary artery (IMAX) in subcranial-intracranial bypass for revascularization in complex aneurysms, tumors, or refractory ischemia shows promise. However, robust evidence concerning its outcomes is lacking. Hence, the authors embarked on a systematic review with pooled analysis to elucidate the efficacy of this approach.

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Background And Objectives: Ventriculoperitoneal shunt (VPS) is usually the primary choice for cerebrospinal fluid shunting for most neurosurgeons, while ventriculoatrial shunt (VAS) is a second-line procedure because of historical complications. Remarkably, there is no robust evidence claiming the superiority of VPS over VAS. Thus, we aimed to compare both procedures through a meta-analysis.

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Objective: Treating complex posterior circulation aneurysms poses challenges, and extracranial to intracranial (EC-IC) bypass techniques are potential therapeutic options. However, the safety and efficacy of this approach for posterior circulation aneurysms remain unclear. The study's objective was to assess the safety and efficacy of EC-IC bypass in these aneurysms.

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Background: Stellate ganglion block (SGB) may have protective effects in patients at risk of vasospasm following subarachnoid hemorrhage (SAH) due to reduced sympathetic activity. However, the safety and clinical outcomes of SGB in this scenario are not definitively known. The objective was to evaluate the safety, clinical outcomes, and cerebral blood flow velocity in patients submitted to SGB or cervical sympathectomy with SAH.

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Objective: To identify bibliometric parameters and research trends regarding to telerehabilitation of patients with stroke in the COVID-19 era.

Methodology: This is an integrative review carried out in the Scopus database, from June to July 2021, through the Biblioshiny graphical interface, provided by the Bibliometrix program. The search terms used were "Stroke," "COVID-19" and "Telerehabilitation.

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Background: Ventriculoatrial shunt (VAS) is considered the second option for treating hydrocephalus, but there remains a lack of robust evidence regarding its complications profile.

Purpose: Evaluate the complications associated with VAS.

Methods: Adhering to PRISMA guidelines, the authors searched Embase, PubMed, and Web of Science databases to identify articles reporting on the complications of VAS.

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