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.

Transcranial Magnetic Stimulation-Based Machine Learning Prediction of Tumor Grading in Motor-Eloquent Gliomas.

Background: Navigated transcranial magnetic stimulation (nTMS) is a well-established preoperative mapping tool for motor-eloquent glioma surgery. Machine learning (ML) and nTMS may improve clinical outcome prediction and histological correlation.

Methods: This was a retrospective cohort study of patients who underwent surgery for motor-eloquent gliomas between 2018 and 2022.

The use of e-consent in surgery and application to neurosurgery: a systematic review and meta-analysis.

Introduction: The integration of novel electronic informed consent platforms in healthcare has undergone significant growth over the last decade. Adoption of uniform, accessible, and robust electronic online consenting applications is likely to enhance the informed consent process and improve the patient experience and has the potential to reduce medico-legal ramifications of inadequate consent. A systematic review and meta-analysis was conducted to evaluate the utility of novel electronic means of informed consent in surgical patients and discuss its application to neurosurgical cohorts.

Ventriculosubgaleal shunts in the management of neonatal post-haemorrhagic hydrocephalus: technical note.

Introduction: Germinal matrix / intraventricular haemorrhage (GMIVH) remains a significant complication of prematurity. The more severe grades are associated with parenchymal haemorrhagic infarction (PHI) and hydrocephalus. A temporising procedure is usually the first line in management of neonatal post-haemorrhagic hydrocephalus (nPHH) as the risk of failure of a permanent cerebrospinal fluid (CSF) diversion is higher in the early stage.

Intraoperative Neuromonitoring of the Visual Pathway in Asleep Neuro-Oncology Surgery.

Brain tumour surgery in visual eloquent areas poses significant challenges to neurosurgeons and has reported inconsistent results. This is a single-centre prospective cohort study of patients admitted for asleep surgery of intra-axial lesions in visual eloquent areas. Demographic and clinical information, data from tractography and visual evoked potentials (VEPs) monitoring were recorded and correlated with visual outcomes.

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.

H3 G34-mutant high-grade gliomas: integrated clinical, imaging and pathological characterisation of a single-centre case series.

Background: Diffuse hemispheric glioma, H3 G34-mutant, is a novel paediatric tumour type in the fifth edition of the WHO classification of CNS tumours associated with an invariably poor outcome. We present a comprehensive clinical, imaging and pathological review of this entity.

Methods: Patients with confirmed H3 G34R-mutant high-grade glioma were included in a single-centre retrospective cohort study and examined for clinical, radiological and histo-molecular data.

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.

Intradural extramedullary meningeal melanocytoma: a case report and literature review.

Primary meningeal melanocytomas are extremely rare, benign tumours arising from the leptomeninges. While they are considered to be benign lesions, there is potential for their growth and transformation into malignant melanomas. They are commonly found in the cervical spine, with a decreased incidence in the thoracic and lumbar regions.

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.

Factors Influencing Driving following DBS Surgery in Parkinson's Disease: A Single UK Centre Experience and Review of the Literature.

Parkinson's disease (PD) is a complex neurodegenerative disorder, leading to impairment of various neurological faculties, including motor, planning, cognitivity, and executive functions. Motor- and non-motor symptoms of the disease may intensify a patient's restrictions to performing usual tasks of daily living, including driving. Deep Brain Stimulation (DBS) associated with optimized clinical treatment has been shown to improve quality of life, motor, and non-motor symptoms in PD.