Recurrent trigeminal neuralgia following MVD: a meta-analysis of second-line treatment strategies.

Objective: This study aimed to compare pain outcomes and complication rates between reexploration microvascular decompression (MVD), percutaneous rhizotomy (PR), and stereotactic radiosurgery (SRS) as second-line treatments for recurrent or persistent trigeminal neuralgia (TN) following an initial MVD.

Methods: A systematic review and meta-analysis was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines. Studies were included if they reported outcomes of reexploration MVD, PR, or SRS in adult patients with classic or idiopathic TN after a failed initial MVD.

Lumbar Drain Infection Rates: A Comprehensive Risk Factor Analysis From a Multicenter Retrospective Study of 1000+ Cases.

Background And Objectives: Lumbar drain (LD) insertion is a common cerebrospinal fluid (CSF) diversion method in neurosurgery; however, infection remains a major complication with significant morbidity. We evaluated the incidence, etiology, and associated risk factors of LD infection across 4 neurosurgical units over 15 years.

Methods: This retrospective multicenter cohort study included all adults requiring a LD between January 2009 and February 2024.

The use of Bevacizumab in the treatment of brain arteriovenous malformations: a systematic review.

Brain arteriovenous malformations (bAVMs) are high-flow vascular anomalies associated with a significant risk of intracranial haemorrhage, particularly in young individuals. Standard treatments-including microsurgery, stereotactic radiosurgery (SRS), and endovascular embolization-are not feasible for all patients, especially those with high-grade or surgically inaccessible lesions. Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor (VEGF), has emerged as a potential medical therapy aimed at modulating angiogenesis and managing post-treatment complications.

Surgical management and outcomes of ankylosing spondylitis fractures in adults: a systematic review and meta-analysis.

Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory condition affecting the vertebral column. Surgical management of traumatic spinal fractures in patients with AS is often the first line treatment, however it has a high risk of perioperative complications. This systematic review explored current operative techniques and their outcomes in patients with AS sustaining traumatic spinal fractures.

Surgical outcomes of unilateral painful foot drop secondary to lumbar disc herniation: a multicenter retrospective study.

Objective: Foot drop is characterized by weakness in ankle dorsiflexion, primarily due to failure of activation of dorsiflexor muscles secondary to neural compromise. The aim of this study was to evaluate surgical outcomes for unilateral painful foot drop secondary to lumbar disc herniation, specifically excluding cases with cauda equina syndrome.

Methods: This retrospective study spanned 7 centers, focusing on adult patients who underwent lumbar discectomies from September 2011 to September 2022 due to painful unilateral foot drop (Medical Research Council [MRC] grade ≤ 3).

The impact of prolapse to canal ratio (PCR) in cauda equina syndrome outcomes and operative management.

Purpose: This study aimed to evaluate the prolapse to canal ratio (PCR) and its long-term impact on outcomes in cauda equina syndrome (CES).

Methods: A 5-year retrospective cohort study was conducted across two neurosurgical centers, including adult patients diagnosed with CES due to herniated lumbar discs, treated with laminectomy and/or discectomy, with available radiological data and follow-up. PCR was calculated as the proportion of the disc prolapse cross-sectional area to the total spinal canal area.

Systematic Review Comparing Open Versus Minimally Invasive Surgical Management of Intradural Extramedullary Tumours (IDEM).

: Intradural extramedullary (IDEM) spinal tumours are relatively rare and predominantly benign. Gross total resection (GTR) has been demonstrated as an effective treatment, with increasing evidence supporting the use of minimally invasive techniques to achieve GTR. This study reviews the current surgical management options for IDEM tumours and their outcomes.

Prognostic factors and surgical outcomes of foot drop secondary to lumbar degenerative disease: A systematic review and Individual patient data meta-analysis.

Objective: To determine the surgical outcomes and prognostic factors in patients with unilateral footdrop secondary to lumbar disc herniation undergoing surgical intervention.

Methods: A comprehensive literature search was conducted across PubMed, Ovid, Scopus, and Web of Science for relevant literature from inception to 26 March 2023. The quality of the studies was evaluated per the NHLBI Quality Assessment Tools.

Preoperative and intraoperative neuromonitoring and mapping techniques impact oncological and functional outcomes in supratentorial function-eloquent brain tumours: a systematic review and meta-analysis.

Background: Supratentorial function-eloquent brain tumour surgeries challenge the balance between maximal tumour resection and preservation of neurological function. This study aims to evaluate the efficacy of preoperative and intraoperative mapping techniques on resection outcomes and post-operative deficits.

Methods: This systematic review and meta-analysis examined literature up to March 2023, sourced from PubMed, Embase, and Medline.

Transcranial Magnetic Stimulation-Electroencephalography (TMS-EEG) in Neurosurgery: Unexplored Path Towards Personalized Brain Surgery.

Transcranial Magnetic Stimulation-Electroencephalography (TMS-EEG) is a non-operative technique that allows for magnetic cortical stimulation (TMS) and analysis of the electrical currents generated in the brain (EEG). Despite the regular utilization of both techniques independently, little is known about the potential impact of their combination in neurosurgical practice. This scoping review, conducted following PRISMA guidelines, focused on TMS-EEG in epilepsy, neuro-oncology, and general neurosurgery.

Cerebrospinal fluid diversion prior to posterior fossa tumor resection in adults: A systematic review.

Background: Posterior fossa tumors (PFTs) comprise 15%-20% of adult brain tumors, with the reported frequency of hydrocephalus (HCP) ranging between 3.7% and 58%. Most HCP resolves after resection of PFTs, but studies report persistent or new-onset HCP occurring in between 2% and 7% of cases.

Ethnicity in neuro-oncology research: How are we doing and how can we do better?

Purpose: This study systematically reviews and meta-analyses the extent of ethnic minority representation in neuro-oncology Phase III and IV clinical trials, explores the effect of ethnicity on outcomes, and identifies predictors for the inclusion of ethnicity data in publications.

Methods: Adhering to PRISMA guidelines, we conducted a comprehensive literature search across multiple databases, on Phase III and IV trials in neuro-oncology that reported on adult and/or paediatric subjects. Through meta-analysis, we synthesized information on overall survival, event-free survival, and the incidence of adverse outcomes across ethnicities.

Cost-effectiveness of repeat delayed imaging for spontaneous subarachnoid hemorrhage.

Background: In patients with intracranial aneurysm presenting with spontaneous subarachnoid hemorrhage (SAH), 15% of them could be missed by the initial diagnostic imaging. Repeat delayed imaging can help to identify previously undetected aneurysms, however, the cost-effectiveness of this strategy remains uncertain.

Objective: The aim of this study is to assess the cost-effectiveness of repeat delayed imaging in patients with SAH who had a negative result during their initial imaging.

MGMT Promoter Methylation: Prognostication beyond Treatment Response.

MGMT promoter methylation is related to the increased sensitivity of tumour tissue to chemotherapy with temozolomide (TMZ) and thus to improved patient survival. However, it is unclear how the extent of MGMT promoter methylation affects outcomes. In our study, a single-centre retrospective study, we explore the impact of MGMT promoter methylation in patients with glioblastoma who were operated upon with 5-ALA.

Fat in the Fossa and the Sphenoid Sinus: A Simple and Effective Solution to CSF Leaks in Transsphenoidal Surgery. Cohort Study and Systematic Review.

 Cerebrospinal fluid (CSF) leak following endoscopic transsphenoidal surgery (TSS) remains a challenge and is associated with high morbidity. We perform a primary repair with f at in the pituitary f ossa and further fat in the s phenoid sinus (FFS). We compare the efficacy of this FFS technique with other repair methods and perform a systematic review.

Prognostic Factors for Surgically Managed Spontaneous Spinal Epidural Hematoma: A Single-Center Case Series of 18 Patients.

Background: Spontaneous spinal epidural hematoma (SSEH) is a rare pathology, which carries a significant morbidity.

Objective: To review our institutional experience of surgically managed patients with SSEH, seeking to better understand clinical prognostic factors related to postoperative outcomes and thereby improve counseling of patients before treatment.

Methods: All patients who underwent surgical management of SSEH between September 2011 and 2021.

Obstructive hydrocephalus due to an enlarged massa intermedia treated with endoscopic third ventriculostomy.

The massa intermedia (MI) or interthalamic adhesion (ITA) is a band of tissue connecting the medial surfaces of the thalami and is present in the majority of healthy individuals. Its enlargement as well as its absence have been associated with some pathological states.We describe the first case report of a 3-year-old child presenting with obstructive hydrocephalus in the context of an enlarged massa intermedia.

Prognostic factors and surgical outcomes of spontaneous spinal epidural haematoma: a systematic review and meta-analysis.

Spontaneous spinal epidural haematoma (SSEH) is a rare disease defined as blood accumulation within the vertebral epidural space without a cause identified, which can lead to severe neurological deficits. We aim to provide a comprehensive understanding of the prognostic factors affecting surgical outcomes in true SSEH and propose a critical time frame for operative management. A systematic literature search was performed and registered, using OVID Medline and EMBASE, in line with the PRISMA guidelines.

Intraoperative Neurophysiological Monitoring for Intradural Extramedullary Spinal Tumours.

Study Design: Retrospective cohort study.

Objectives: Intraoperative neurophysiological monitoring (IONM) is widely used in spinal neurosurgery, particularly for intramedullary tumours. However, its validity in intradural extramedullary (IDEM) spinal tumours is less clearly defined, this being the focus of this study.

Prognostic factors for surgically managed intramedullary spinal cord tumours: a single-centre case series.

Purpose: Intramedullary spinal cord tumours (IMSCTs) are comparatively rare neoplasms. We present a single-centre clinical case series of adult patients with surgically managed IMSCTs.

Methods: We performed a retrospective analysis of electronic patient records in the time period spanning July 2010 to July 2021.

5-Aminolevulinic Acid-Guided Resection in Grade III Tumors-A Comparative Cohort Study.

Background: The benefits of using 5-aminolevulinic acid (5-ALA) in resection of grade IV tumors have been extensively researched. However, few studies have investigated the use of 5-ALA in grade III gliomas.

Objective: To discover whether 5-ALA provides significant benefit in assisting resection of grade III gliomas.

Is Cauda Equina Surgery Safe Out-of-Hours? A Single United Kingdom Institute Experience.

Background: Cauda equina syndrome (CES) can have devastating neurological sequelae if surgical treatment is delayed. However, out-of-hours surgery (weekdays from 6:00 pm to 8:00 am and all weekend operations) can potentially result in higher rates of intraoperative complications, resulting in worse outcomes. In the present study, we have described our outcomes for patients with CES during an 8-year period (December 2011 to October 2019) with the aim of assessing the risk of out-of-hours surgery.

Systematic Review of Surgical Management of Spinal Intradural Arachnoid Cysts.

Objective: Spinal intradural arachnoid cysts (SIACs) are rare pathological lesions that can arise via outpouchings of the arachnoid layer in the spinal canal that can result in neurological deficits. We performed a systematic literature review regarding the current surgical techniques used in the management of SIACs and discussed the prevailing hypotheses surrounding the etiology of SIACs.

Methods: A systematic search of the literature was performed in December 2020 using EMBASE and MEDLINE for reports regarding the surgical management of SIACs.

Surgical management and outcomes in spinal intradural arachnoid cysts: the experience from two tertiary neurosurgical centres.

Purpose: Evaluation of the presentation and outcomes of different surgical treatment approaches for spinal intradural arachnoid cysts (SIAC).

Methods: Cases were identified from electronic records of two major neurosurgical centres in London over the last 10 years (October 2009-October 2019) that have been surgically treated in both institutions. Clinical findings, surgical technique, and recurrence by procedure were statistically analysed.