Proton versus photon radiation therapy for pediatric medulloblastomas: a systematic review and meta-analysis.

Background: The rapid development of technologies that allow a more precise radiation-based treatment has constantly changed the current scenario of malignant central nervous system diseases. This study aimed to compare different complications and survival rates of pediatric patients with medulloblastomas treated with proton radiation therapy (PBRT) and photon radiation therapy (XRT).

Methods: We performed a systematic review and comparative meta-analysis.

Biomarkers in normal pressure hydrocephalus: A mini review.

Background: Normal Pressure Hydrocephalus (NPH) is a neurological disorder characterized by the classic triad of gait disturbances, cognitive impairment, and urinary incontinence. However, despite its clinical significance and prevalence, the diagnosis of NPH remains challenging due to symptom overlap with other neurodegenerative conditions. This mini-review aims to identify biomarkers for Normal Pressure Hydrocephalus (NPH) that could address this diagnostic gap, improving diagnostic accuracy and guiding treatment strategies.

Drug-Coated Balloon Versus Stent Angioplasty in Patients with Intracranial Atherosclerotic Disease: A Systematic Review and Meta-Analysis.

Introduction: Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke, particularly in high-risk populations. Endovascular treatment options, including drug-coated balloon (DCB) angioplasty and stent angioplasty (SA), have been explored as alternatives for patients with severe stenosis or refractory symptoms. However, the comparative efficacy and safety of these interventions remain a topic of debate.

The impact of neuroendoscopic drainage in intraventricular hemorrhage: an updated meta-analysis.

External ventricular drainage (EVD) is a mainstay for intraventricular hemorrhage (IVH) treatment, improving ventricular clearance and reducing mortality but with suboptimal complications and morbidity. Meanwhile, several studies have shown that neuroendoscopic drainage (NED) provides superior results and is a promising therapy. Thus, we aimed to compare NED and EVD in patients with IVH.

Virtual simulation for flow-diverter selection and sizing in the endovascular treatment of intracranial aneurysms: A systematic review and meta-analysis.

Background: Endovascular treatment (EVT) of intracranial aneurysms (IAs) has improved significantly with the integration of virtual simulation software (VSS) in surgical planning and device selection. Despite promising outcomes, discrepancies remain between physician and VSS recommendations. This review synthesizes evidence on (1) comparisons between VSS-chosen and physician-chosen dimensions; (2) VSS-chosen and postoperative measured dimensions; and (3) the success rate of VSS-guided device deployment.

Thrombolysis for Ischemic Stroke Beyond the 4.5-Hour Window: A Meta-Analysis of Randomized Clinical Trials.

Background: A minority of patients with stroke qualify for intravenous thrombolysis (IVT) within 4.5-hour window. The safety and efficacy of IVT beyond this period have not been well studied.

In the era of transition from fiction to reality: Robotic-assisted neurointervention-a systematic review and meta-analysis.

Objective: In recent years, the application of robotic assistance in diagnostic and therapeutic endovascular neurointerventional procedures has gained notable attention. In this systematic review and meta-analysis, we aim to evaluate the feasibility, safety, and current indications of robotic-assisted neurointerventions and to assess the degree of robotic assistance and reasons for unplanned manual conversion from robotic assistance.

Methods: We searched Medline, Scopus, Web of Science, and Cochrane Library databases following PRISMA guidelines and included studies with ≥ 4 patients reporting on robotic-assisted neurointerventions.

Awake Craniotomy for Eloquent Brain Arteriovenous Malformations: A Systematic Review and Individual Patient Data Meta-Analysis.

Background: Arteriovenous malformations (AVMs) pose a risk of neurologic deterioration, particularly when located in eloquent areas. While awake surgery is well-established for treating low-grade gliomas near eloquent areas, its efficacy for AVMs is less conclusively reported.

Methods: This study conducted a systematic review and individual patient data meta-analysis following Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Treatment of ruptured intracranial aneurysms with parent artery flow diverter devices: A comprehensive systematic review and meta-analysis.

Background: Surgical clipping and endovascular coiling are well-established treatments for acutely ruptured intracranial aneurysms leading to acute subarachnoid hemorrhage (aSAH). However, these modalities have limitations, particularly in cases involving wide-necked, bifurcating, or dissecting aneurysms. Flow diverter (FD) devices, initially used for unruptured aneurysms, have emerged as an alternative treatment for ruptured aneurysms despite concerns about hemorrhagic complications.

Safety and efficacy of the Contour Neurovascular System for treating intracranial aneurysms: a systematic review and meta-analysis.

Background: The Contour Neurovascular System (CNS, Stryker, Kalamazoo, MI) has a unique design that allows it to address various aneurysm morphologies, including wide-necked, irregular, and shallow-shaped lesions. However, evidence of its safety and efficacy remains limited. This systematic review and meta-analysis synthesizes the current data on CNS performance.

Translabyrinthine versus Retrosigmoid Approach for Vestibular Schwannoma: A Systematic Review and An Updated Meta-Analysis.

Objective: Several approaches can be used in the surgical treatment of vestibular schwannoma (VS), and the best approach remains uncertain in the literature. This systematic review and meta-analysis aim to compare the translabyrinthine approach (TLA) with the retrosigmoid approach (RSA) for VS in terms of postoperative complications.

Data Sources: PubMed, Web of Science, Embase, and Cochrane.

Presentation and management of cerebral proliferative angiopathy: a systematic review and meta-analysis on treatment outcomes.

Cerebral Proliferative Angiopathy (CPA) is a rare brain vascular malformation, similar to Arteriovenous Malformations (AVM) but lacking of early venous drainage. Presentation and treatment outcomes were investigated, examining for morbidity, mortality and complications. A meta-analysis was conducted according to PRISMA guidelines.

Decompressive Craniectomy with or Without Dural Closure: Systematic Review and Meta-analysis.

Decompressive craniectomy is used to alleviate intracranial pressure in cases of traumatic brain injury and stroke by removing part of the skull to allow brain expansion. Traditionally, this procedure is followed by a watertight dural suture, although evidence supporting this method is not strong. This meta-analysis examines the feasibility of the open-dura (OD) approach versus the traditional closed-dura (CD) technique with watertight suturing.

Comparing surgical clipping with endovascular treatment for unruptured middle cerebral artery aneurysms: a systematic review and updated meta-analysis.

Objective: Unruptured middle cerebral artery aneurysm (uMCAA) has traditionally been treated with open surgical clipping (SC). Endovascular treatments (EVTs) were designed to reduce surgical risks in these cases. Nevertheless, despite its potential benefits, many surgeons favor SC for uMCAA.

STA-MCA Double-Barrel Bypass: A Systematic Review of Technique and Single-Arm Meta-Analysis of Outcomes.

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.

Enhancing the quality of evidence, comparability, and reproducibility in ventriculoatrial shunt research for normal pressure hydrocephalus: A systematic review and VAS-NPH reporting guideline.

Background: Ventriculoatrial shunt (VAS) is an important treatment option for normal pressure hydrocephalus (NPH). However, clinical studies reporting the use of VAS for NPH lack sufficient standardization for meta-analytic comparisons that could provide robust evidence regarding its use. This study aims to assess the quality of reporting in these studies and develop a reporting guideline checklist to standardize terminology, concepts, and reporting while reinforcing the essential elements to ensure comparability and reproducibility.

Same-day discharge in craniotomy: A systematic review and meta-analysis.

Background: Traditionally, patients undergoing craniotomy were subject to extended hospital stays for intensive monitoring and management of potential complications. However, with the evolution of surgical methods, anesthesia, and postoperative protocols, the feasibility and interest in same-day discharge (SDD) are growing. This study aimed to evaluate whether same-day discharge is a safe and feasible approach in craniotomy through a meta-analysis of the available literature.

Enhancing the quality of evidence, comparability, and reproducibility in brain arteriovenous malformations treated with open surgery research: a systematic review and proposal of a reporting guideline for surgical and clinical outcomes.

Brain Arteriovenous Malformations (bAVMs) are rare but high-risk developmental anomalies of the vascular system. Microsurgery through craniotomy is believed to be the mainstay standard treatment for many grades of bAVMs. However, a significant challenge emerges in the existing body of clinical studies on open surgery for bAVMs: the lack of reproducibility and comparability.

Posterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery Bypass versus Occipital Artery-Posterior Inferior Cerebellar Artery Bypass for Treating Posterior Circulation Aneurysms: A Systematic Review and Comparative Meta-Analysis.

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.