Abstract:
OBJECTIVE:Middle cerebral artery aneurysms (MCAAs) are regularly treated by both microsurgical clipping and endovascular coiling. We performed a systematic meta-analysis to compare the safety and efficacy of these 2 methods. METHODS:Literature was reviewed for all studies reporting angiographic occlusion and/or functional outcomes in adults with unruptured MCAA treated by endovascular coiling or microsurgical clipping. All studies in English that reported results for adults (≥18 years) with unruptured MCAAs, from 1990 to 2011 were considered for inclusion. RESULTS:Twenty-six studies involving 2295 aneurysms treated with clipping or coiling for unruptured MCAAs were included for analysis. There were 1530 aneurysms that were treated with clipping and 765 aneurysms treated with coiling. Pooled analysis revealed failure of aneurysmal occlusion in 3.0% (95% confidence interval [CI] 1.2%-7.4%) of clipped cases. Pooled analysis of 15 studies (606 aneurysms) involving coiling and occlusion revealed lack of occlusion rates of 47.7% (95% CI 43.6%-51.8%) with the fixed-effects model and 48.2% (95% CI 39.0%-57.4%) with the random-effects model. Thirteen studies examined neurological outcomes after clipping and were pooled for analysis. Both fixed-effect and random-effect models revealed unfavorable outcomes in 2.1% (95% CI 1.3%-3.3%) of patients. There were 17 studies evaluating potential unfavorable neurological outcomes after coiling that were pooled for analysis. Fixed-effect and random-effect models revealed unfavorable outcomes in 6.5% (95% CI 4.5%-9.3%) and 4.9% (95% CI 3.0%-8.1%) of patients, respectively. CONCLUSIONS:Based on this systematic review and meta-analysis of unruptured MCAAs, after careful consideration of patient, aneurysmal, and treatment center factors, we recommend surgical clipping for unruptured MCAA.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Smith TR,Cote DJ,Dasenbrock HH,Hamade YJ,Zammar SG,El Tecle NE,Batjer HH,Bendok BRdoi
10.1016/j.wneu.2015.05.073subject
Has Abstractpub_date
2015-10-01 00:00:00pages
942-53issue
4eissn
1878-8750issn
1878-8769pii
S1878-8750(15)00745-7journal_volume
84pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Os odontoideum is a smooth, independent ossicle separated from a hypoplastic odontoid process located cranially in the expected position of the odontoid tip. The pathogenesis of os odontoideum remains controversial, and several etiological theories have been suggested for congenital, developmental, and traum...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.019
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:Quantitative measurements of intracranial vessel walls are reliable in 3-T high-resolution magnetic resonance imaging (HR-MRI). However, few reports have assessed the arterial wall after endovascular treatment (EVT) by 3-T HR-MRI. This study aimed to quantitatively analyze vessel walls in vertebrobasilar arte...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.161
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Spinal cord injury (SCI) without computed tomography evidence of trauma is underreported in adults and is considered a subtype of SCI with relatively good outcome. Despite this, few studies have been performed to determine specific imaging-related prognostic factors. Our objective is to describe the imaging ...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2016.12.005
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Brain metastases from endometrial cancer are rare and poorly described. We aimed to estimate the proportion of brain metastases at our institution that arose from endometrial cancer, and to detail clinicopathologic features and survival outcomes. METHODS:We retrospectively identified and reviewed the charts...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.087
更新日期:2020-12-13 00:00:00
abstract:BACKGROUND:Subdural drain (SDD) and Subdural Evacuating Port System (SEPS) are bedside options for management of nonacute subdural hematomas (SDHs). These interventions have not been compared with each other. Our objective is to compare the need for second bedside procedure, need for craniotomy, complication rate, and ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.03.226
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Chronic subdural hematoma (cSDH) is a common neurosurgical condition, with an estimated incidence of 3-15.5 per 100,000 people, with significantly higher rates in the elderly population. Recurrence rates range from 2%-37% after surgical drainage. Studies have shown that leaving a drain postoperatively can re...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.08.069
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To identify the potent metabolic biomarkers of cauda equina injury (CEI). METHODS:A total of 50 Sprague-Dawley rats were used to establish the CEI model in this study. The serum was collected at 12 hours, 1 day, 2 days, and 7 days after surgery. Ultra-high-performance liquid chromatography coupled with quadr...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.077
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Metastatic meningiomas (MMs) are rare (0.1 of 100 cases). Their treatment requires a multimodal approach, with surgery, radiotherapy, chemotherapy, and radiosurgery, which allows a long-term local control (LC) and an extension of free survival. In this study, the authors performed a review of the literature ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.058
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Traumatic brain injury (TBI) remains a life-threatening condition characterized by growing incidence worldwide, particularly in the aging population, in which the primary goal of treatment appears to be avoidance of chronic institutionalization. METHODS:To identify independent predictors of 30-day mortality...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.060
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The existing body of literature on postoperative neurosurgical infections lacks large multicenter reports on postoperative neurosurgical infections. This is the largest study to date of postoperative neurosurgical infections rates, time to event, and risk factors. METHODS:Demographics, medical history, and ...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2016.09.056
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Attainment of basic microsurgical skills in neurosurgery presents a departmental challenge worldwide. Models for teaching are either not readily available or expensive and are incompatible with a resident's busy schedule, requiring lengthy and proper setup. We present a model and a set of measurable tasks, b...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.060
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:Flow diversion (FD) has emerged as an effective treatment modality for aneurysms of the posterior communicating artery (PCOM). Whether or not a fetal posterior circulation (FPC) affects PCOM aneurysm occlusion rates after FD remains undetermined. METHODS:We performed a retrospective cohort study in which tr...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2019.04.112
更新日期:2019-07-01 00:00:00
abstract::Control of bleeding in the confined area of the skull is imperative for successful neurosurgery and the prevention of devastating complications such as postoperative hemorrhage. This paper reviews the historical evolution of methods to achieve successful hemostasis in neurosurgery from the early1800s to today. The maj...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.12.015
更新日期:2018-12-19 00:00:00
abstract:OBJECTIVE:To determine the optimal proximal fusion level after long instrumented fusion to the sacrum for lumbar degenerative flat back. METHODS:Data from 70 patients with lumbar degenerative flat back were reviewed retrospectively. Three groups were designated according to the upper instrumented vertebrae (UIV): grou...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.03.051
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:With only 4 active certified neurosurgeons for a population of 50 million, neurosurgical care was seriously underdeveloped in Myanmar in 2012. Together with the local neurosurgical community, Swiss Neurosurgeons International started a program of assisted education with the aim of increasing the neurosurgica...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.018
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Surgical treatment of giant vestibular schwannomas (GVS) is challenging. The philosophy of incomplete tumor resection may balance the preservation of facial nerve function and long-term tumor control. OBJECTIVE:We aimed to evaluate the outcome of facial nerve function and tumor control in treating GVS via o...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.119
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To assess and compare clinical outcomes and sagittal balance after unstable hangman fracture between C2-C3 anterior discectomy and fusion (ACDF) and posterior C2-C3 short-segment fixation and fusion. METHODS:A total of 45 patients underwent ACDF (20 patients) and posterior C2-C3 short-segment fixation and fu...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.03.070
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Intrathecal disc herniation is a rare but serious condition that has the potential to generate devastating neurologic deficits. We present a case of a 56-year-old man who developed cauda equina syndrome after several episodes of severe Valsalva maneuver. CASE DESCRIPTION:The patient was found to have develo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.06.024
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Percutaneous endoscopic lumbar discectomy (PELD) is regarded as an alternative treatment for lumbar disc herniation. Although the indication for PELD has expanded with remarkable evolution of the technique, sometimes unexpected complications have occurred during PELD. We report 3 cases of de novo disc prolap...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.216
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The effect of frailty on outcomes after angiogram-negative subarachnoid hemorrhages (ANSAH) is currently unknown. We investigated frailty's effects on ANSAH outcomes, including mortality and in-hospital complications. METHODS:Patients from 2014 to 2018 with non-traumatic subarachnoid hemorrhage and cerebral...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.003
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Surgical treatment of meningiomas next to venous sinuses is difficult because of their irregular growth patterns and infiltration into the venous sinuses, making gross total resection impossible in some patients. We evaluated the postoperative clinical and neurologic course of this tumor subgroup. METHODS:T...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.05.025
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:The concept of enhanced recovery after surgery (ERAS) spread to different surgical specialties to minimize surgical stress response and to reduce length of hospital stay (LOS) and cost. Recently, several studies have reported experience with the ERAS program for spine surgery. The aim of this study is to introd...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.139
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s), which could result in more extensive revision surgery. Traditional electrosurgery devices ar...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2018.01.007
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Trigeminal neuralgia is usually caused by microvascular conflict with the fifth cranial nerve in the pontocerebellar angle. Rarely is it secondary to other extra-axial or intra-axial lesions. Few cases of trigeminal neuralgia due to cavernous angiomas have been reported in the literature. This is the first r...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.03.035
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Fungal infection is a rare pathology in the sphenoid sinus, and extension into the pituitary fossa with visual loss has only been described in a few reports in the literature. Following publication of a recent report of pituitary abscess by Candida glabrata, we describe our own experience with a similar path...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.054
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Dissection of brain surface adhesions during recurrent glioma surgery carries a risk of injury to cortical vessels and important surface vessels. We present our experience with the use of BioD film, a biocompatible amniotic membrane implant, to help prevent postoperative adhesions. We describe a novel method...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.143
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Calcified hypertrophic ligamentum flavum is a known entity that causes myeloradiculopathy of the cervical, thoracic, and lumbar spine and is seen more commonly in Asian populations. Noncalcified hypertrophic changes are less common and may mimic other epidural space-occupying lesions. CASE DESCRIPTION:A 59-...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.08.035
更新日期:2016-11-01 00:00:00
abstract::Recent advances in neuroimaging demonstrated many markedly improved images hitherto unavailable, specifically the areas that lie deep in the brain. The anatomic images of the deep brain structure taken in vivo using 7.0 T magnetic resonance imaging (MRI) and the molecular images using high resolution research tomograp...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.10.020
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Gorham-Stout disease (GSD) or "vanishing bone" disease is characterized by progressive osteolysis with intraosseous lymphangiomatosis (hemangiomatosis). Given its rarity, with about 300 reported cases, its pathophysiology, etiology, and treatment guidelines are not established yet. CASE DESCRIPTION:A 22-yea...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.05.235
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Vasospasm developing after subarachnoid hemorrhage (SAH) is an important cause of mortality and morbidity. Lutein is a carotenoid with antioxidant and anti-inflammatory properties. The aim of present study was to investigate effects of lutein on the basilar artery and nerve tissues. METHODS:Wistar rats were ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.186
更新日期:2020-11-01 00:00:00