Background: Levetiracetam (Lev), an antiepileptic drug (AED), enhances alkylating chemotherapy sensitivity in glioblastoma (GB) by inhibiting MGMT expression. This meta-analysis evaluates Lev's impact on GB treatment by analyzing overall survival of individual patient data (IPD) from published studies.
Methods: IPD was reconstructed using the R package IPDfromKM.
Objective: Maximum extent of resection in glioma yields enhanced survival outcomes. The contemporary literature presents contradictory results regarding the benefit of intraoperative MRI (iMRI). This meta-analysis aimed to investigate the efficacy and safety of iMRI-guided surgery.
View Article and Find Full Text PDFBackground: Ventriculoperitoneal (VP) shunt therapy is a crucial intervention for normal-pressure hydrocephalus (NPH). This meta-analysis delves into survival time and the impact of baseline symptom burden on survival after VP shunt therapy for NPH, employing reconstructed pooled survival curves and a one-stage meta-analysis.
Methods: IPD regarding overall survival (OS) were acquired from published Kaplan-Meier charts, utilizing the R package IPDfromKM in R (Version 4.
Background And Importance: Arteriovenous malformations (AVMs) are complex vascular anomalies that pose significant risks, including intracranial hemorrhage and neurological deficits. Surgical resection is the preferred treatment, requiring precise intraoperative imaging to ensure complete removal while preserving critical structures. This case report presents the first combined use of hyperspectral imaging (HSI) and indocyanine green video angiography (ICG VA) to visualize perfusion during brain AVM surgery, highlighting the potential benefits of these advanced imaging techniques.
View Article and Find Full Text PDFObjectives: Artificial intelligence (AI) is thought to improve lesion detection. However, a lack of knowledge about human performance prevents a comparative evaluation of AI and an accurate assessment of its impact on clinical decision-making. The objective of this work is to quantitatively evaluate the ability of humans to detect focal cortical dysplasia (FCD), compare it to state-of-the-art AI, and determine how it may aid diagnostics.
View Article and Find Full Text PDFFacial nerve paralysis is a severe dysfunction after vestibular schwannoma (VS) surgery. This monocentric study analyzed 61 patients who underwent sporadic VS surgery in a standardized manner. The primary endpoint was the facial nerve outcome (FNO) at 3 months after VS surgery.
View Article and Find Full Text PDFObjective: Cranial meningioma surgeries often involve significant blood loss and transfusions. Tranexamic acid (TXA) has been used to reduce blood loss in various surgeries. This meta-analysis of randomized placebo-controlled trials (RCTs) evaluates the impact of TXA in cranial meningioma surgery.
View Article and Find Full Text PDFBackground: Although postoperative quality of life (QoL) has been studied in relation to a variety of aspects following meningioma resection, the impact of meningiomas on sexual life has not been investigated. The aim of this study is to determine the impact of cranial meningioma surgery on patients' postoperative sexual life.
Methods: A standardized questionnaire, anonymous and based on the Arizona Sexual Experiences Scale (ASEX), was sent to 87 patients who had been selected for participation in the study based on the following criteria: a postoperative Karnofsky performance of ≥ 80 and below 60 years of age at diagnosis.
Tractography has become a widely available tool for the planning of neurosurgical operations as well as for neuroscientific research. The absence of patient interaction makes it easily applicable. However, it leaves uncertainty about the functional relevance of the identified bundles.
View Article and Find Full Text PDFAlthough the initial functional outcome findings of the International Subarachnoid Aneurysm Trial (ISAT) study favored coiling at one year after aneurysmal subarachnoid hemorrhage (aSAH), concerns arose regarding limited long-term rerupture data. This meta-analysis is the first to analyze longitudinal individual patient data (IPD) of target aneurysm rerupture in terms of treatment modality. The present meta-analysis included studies that compared clipping with coiling of ruptured aneurysms regarding long-term rerupture.
View Article and Find Full Text PDFObjective: Spinal meningiomas (SM) account for 25%-46% of all primary spinal tumors and show an excellent long-term disease control in case of complete resection. Therefore, the postoperative functional outcome is of high importance. To date, reports on dorsally located SM are scarce.
View Article and Find Full Text PDFObjective: Despite mixed reality being an emerging tool for tailored neurosurgical treatment and safety enhancement, the use of mixed reality in the education of German medical students is not established in the field of neurosurgery. The present study aimed to investigate medical students' perspectives on the use of mixed reality in neurosurgical medical education.
Methods: Between July 3, 2023, and August 31, 2023, an online survey was completed by German medical students through their affiliated student associations and educational institutions.
Objective: The placement of a ventricular catheter, that is, an external ventricular drain (EVD), is a common and essential neurosurgical procedure. In addition, it is one of the first procedures performed by inexperienced neurosurgeons. With or without surgical experience, the placement of an EVD according to anatomical landmarks only can be difficult, with the potential risk for inaccurate catheter placement.
View Article and Find Full Text PDFObjective: Current application of mixed reality as a navigation aid in the field of spinal navigation points to the potential of this technology in spine surgery. Crucial factors for acceptance include intuitive workflow, system stability, reliability, and accuracy of the method. The authors therefore aimed to investigate the accuracy of the system in visualization of anatomical structures using mixed reality in the example of pedicles of the thoracic spine in a human cadaveric study.
View Article and Find Full Text PDFHomozygous CDKN2A/B deletion has been associated with an increased risk of recurrence in meningiomas. However, the evidence is confined to a limited number of studies, and the importance of heterozygous CDKN2A/B deletions remains insufficiently investigated. Hence, the present meta-analysis reconstructs individual patient data (IPD) and reconstructs the probabilities of progression-free survival (PFS) stratified by CDKN2A/B status.
View Article and Find Full Text PDFBackground: Unplanned early readmission (UER) within 30 days after hospital release is a negative prognostic marker for patients diagnosed with glioblastoma (GBM). This work analyzes the impact of UER on the effects of standard therapy modalities for GBM patients, including the extent of resection (EOR) and adjuvant therapy regimen.
Methods: Records were searched for patients with newly diagnosed GBM between 2014 and 2020 who were treated at our facility.
Emerging evidence suggests that neuroinflammation may play a potential role in aneurysmal subarachnoid hemorrhage (aSAH). We aim to analyze the influence of anti-inflammatory therapy on survival and outcome in aSAH. Eligible randomized placebo-controlled prospective trials (RCTs) were searched in PubMed until March 2023.
View Article and Find Full Text PDFMedial sphenoid wing meningiomas (MSWM) are surgically challenging skull base tumors. Irregular tumor shapes are thought to be linked to histopathology. The present study aims to investigate the impact of tumor shape on postoperative functioning, progression-free survival, and neuropathology.
View Article and Find Full Text PDFTo date, gross total resection (GTR) of the contrast-enhancing area of glioblastoma (GB) is the benchmark treatment regarding surgical therapy. However, GB infiltrates beyond those margins, and most tumors recur in close proximity to the initial resection margin. It is unclear whether a supramarginal resection (SMR) enhances progression-free survival (PFS) time without increasing the incidence of postoperative surgical complications.
View Article and Find Full Text PDFDecompressive craniectomy is an option to decrease elevated intracranial pressure in poor-grade aneurysmal subarachnoid hemorrhage (SAH) patients. The aim of the present study was to analyze the size of the bone flap according to approach-related complications in patients with poor-grade SAH. We retrospectively analyzed poor-grade SAH patients (WFNS 4 and 5) who underwent aneurysm clipping and craniectomy (DC or ommitance of bone flap reinsertion).
View Article and Find Full Text PDFA non-convulsive status epilepticus (ncSE) is a potentially fatal complication for patients in neurointensive care. In patients with aneurysmal subarachnoid hemorrhage (SAH), ncSE remains scarcely investigated. In this study, we aim to investigate the frequency and influence of non-convulsive status epilepticus on outcome in patients with SAH.
View Article and Find Full Text PDFObjective: Patient positioning is a matter of ongoing debate in the surgical treatment of vestibular schwannoma (VS). Main endpoints of this discussion are preservation of facial nerve functioning, extent of resection, and complications. In this meta-analysis, we aim to investigate the impact of patient positioning on VS surgery the retrosigmoid approach.
View Article and Find Full Text PDFAlthoughanti-inflammatory drug therapy has been identified as potentially beneficial for patients suffering from chronic subdural hematoma (cSDH), contemporary literature presents contradictory results. In this meta-analysis, we aimed to investigate the impact of anti-inflammatory drug therapy on mortality and outcome. We searched for eligible randomized, placebo-controlled prospective trials (RTCs) on PubMed, Embase and Medline until July 2022.
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