期刊,World neurosurgery 2022年162卷期_国家学术搜索

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World neurosurgery

Elsevier

主办单位：Elsevier

国际刊号：1878-8750

World neurosurgery/Journal World neurosurgeryAHCISCIISTP

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Early Stages Management of Traumatic Spinal Cord Injury in Latin America: A Scoping Review

Marchesini N.Fernandez Londono L.L.Griswold D.Rubiano A.M....

12页

查看更多>>摘要：? 2022 Elsevier Inc.Objective: To understand the extent and type of evidence on diagnosis, clinical presentation, management, outcomes, and costs of traumatic spinal cord injury (TSCI) in the early stages in Latin America. Methods: The Joanna Briggs Institute methodology for scoping reviews was followed. Extracted data included study aim, country, methodology, population characteristics, and outcome measures. Results: Thirteen studies met the inclusion criteria. Studies were grouped into 5 categories: associated lesions and intensive care unit (ICU); treatment; complications; neurologic outcomes; length of hospital stay (LOS), costs, and mortality. Studies were from Brazil, Mexico, Argentina, Colombia, Chile, and one included several countries. A significant number of patients had associated injuries, little information was found about ICU management. A high variability existed in the surgical and conservative management rate. Some medical therapies were found to be used that could partially alleviate the neurologic symptoms. Most complications were preventable, not always directly related to the event, and could be associated with increased mortality. LOS could be related to complications and to the type of interventions required, which, in turn, could increase the in-hospital costs. Conclusions: Information about the management of traumatic spinal cord injury in the early stages in Latin America is not exhaustive and high variability exists among the studies in all the examined sections. Nevertheless, many patients are polytraumatized, and little is known about ICU requirement. Treatment is heterogeneous and the complications are in many cases preventable conditions that can increase LOS, costs, and mortality.

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NSTL
Elsevier

Growth Factor Gene-Modified Cells in Spinal Cord Injury Recovery: A Systematic Review

Babahajian A.Rafiei Alavi S.N.Madani Neishaboori A.Vaccaro A.R....

13页

查看更多>>摘要：? 2022Background: Numerous preclinical studies have been performed in recent years on the effects of the administration of growth factor gene-modified cells in spinal cord injury (SCI). However, findings of these studies are contradictory. Objective: The present study aims to conduct a systematic review and meta-analysis of animal studies evaluating the effects of administration of growth factor gene-modified cells on locomotion recovery after SCI. Methods: A search of the MEDLINE, Embase, Scopus, and Web of Science databases was conducted, including all animal studies until the end of 2020. Two researchers screened search results, summarized relevant studies and assessed risk of bias, independently. Results: Thirty-three studies were included in the final analysis. Transplantation of growth factor gene-modified cells in the injured spinal cord resulted in a significant improvement in locomotion of animals compared with nontreated animals (standardized mean difference = 1.86; 95% confidence interval, 1.39–2.33; P < 0.0001)] and non-genetically modified cell–treated animals (standardized mean difference = 1.30; 95% confidence interval, 0.80–1.79; P < 0.0001). Transplantation efficacy of these cells failed to achieve significance in moderate lesions (P = 0.091), when using modified neural stem/progenitor cells (P = 0.164), when using synthetic neurotrophins (P = 0.086) and when the number of transplanted cells was less than 1.0 × 105 cells per animal (P = 0.119). Conclusions: The results showed that transplantation of growth factor gene– modified cells significantly improved locomotion in SCI animal models. However, there is a major concern regarding the safety of transplantation of genetically modified cells, in terms of overexpressing growth factors. Further studies are needed before any effort to perform a translational and clinical study.

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NSTL
Elsevier

Diagnostic and Prognostic Utility of Optical Coherence Tomography in Patients With Sellar/Suprasellar Lesions with Chiasm Impingement: A Systematic Review/ Meta-Analyses

Jeong S.S.Funari A.Agarwal V.

14页

查看更多>>摘要：? 2022 Elsevier Inc.Background: In this review, we appraised the current literature on the utility of optical coherence tomography (OCT) as a diagnostic and predictive factor for postoperative visual function outcomes in patients with sellar/suprasellar lesions with chiasmal impingement. Methods: A systematic search of PubMed, CINAHL, Scopus, and Cochrane Library was conducted following PRISMA guidelines. Included studies described diagnostic or prognostic utility of OCT in patients with sellar/suprasellar lesions with chiasmal impingement. Meta-analysis was represented as mean difference (MD) with 95% confidence intervals. Meta-regression was performed to determine predictive factors of visual outcomes. Results: Forty-eight articles were identified for final pooled analysis, representing a total of 2435 patients with compressive sellar/suprasellar lesions and 952 healthy controls. Mean age was 43.3 (11.4) years, with 1494 (48.8%) male and 1566 (51.2%) female patients. Mean retinal nerve fiber layer (RNFL) was significantly different in the study population compared with healthy controls (75.8 μ [13.2] vs. 91.4 μ [10.8], P < 0.00001). The nasal segment of RNFL had the largest mean difference (MD –9.76 [–12.39, –7.13], P < 0.0001). Visual acuity, visual field mean deviation, and visual field pattern standard deviation all showed significant differences between the study population and healthy controls as well (P < 0.0001). Meta-regressions showed significant predictive capability of preoperative RNFL in determining visual function outcome (P < 0.05). Conclusions: Our findings provide promising support for the growing evidence that OCT parameters can be utilized as both a diagnostic and prognostic tool for patients with compression of the optic apparatus. There is a need for further studies to gain a better understanding of OCTs and to improve patient outcomes.

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NSTL
Elsevier

Evolution of Intracranial-Intracranial Bypass Surgery: A Bibliometric Analysis

Reddy V.P.Seas A.Sood N.Srinivasan V.M....

6页

查看更多>>摘要：? 2022 Elsevier Inc.Objective: Modern cerebrovascular bypass surgery uses either extracranial-intracranial (EC-IC) or intracranial-intracranial (IC-IC) approaches. Compared with EC-IC bypasses, IC-IC bypasses allow neurosurgeons to safely address tumors, aneurysms, and other lesions using shorter grafts that are well matched to the size of recipient vessels. Fewer than 100 articles have been published on IC-IC bypasses compared with more than 1000 on EC-IC bypasses. This study examined the increase of interest and innovation in IC-IC bypass. Methods: PubMed and Web of Science were searched using keywords specific to IC-IC bypass, yielding 717 articles supplemented with 36 reports from other databases and gray literature. The articles were reviewed, and 98 articles were selected for further evaluation. Final articles were categorized as innovations or retrospective studies. Publication metrics were passed through an analytic program to assess statistical measures of growth. Results: The number of publications describing innovations (n = 52) and retrospective studies (n = 46) in IC-IC surgical techniques increased exponentially (R2 = 0.983 and R2 = 0.993, respectively), with both interest and research in the field increasing. The rate of publications in each group also increased. In recent years, increasing numbers of global institutions have researched and published on IC-IC bypasses. Conclusions: As more work is undertaken on IC-IC bypasses, it is critical for knowledge to be shared through research, collaboration, publication, and early teaching within residency training programs. This field has increased exponentially in the past 2 decades and has yet to reach an inflection point, indicating possible additional interest and growth over time.

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NSTL
Elsevier

Flow Diverter Devices for Treatment of Intracranial Aneurysms in Small Parent Vessels—A Systematic Review of Literature

Dabhi N.Sarathy D.Snyder M.H.Kellogg R.T....

12页

查看更多>>摘要：? 2022 Elsevier Inc.Background: The overall safety and efficacy of flow diverting stents (FDSs) deployed in small caliber parent arteries (≤2.5 mm) for the treatment of intracranial aneurysms remains unclear. Recent studies have provided additional outcomes data to assess the use of FDSs for such arteries. In the present review, we have summarized the reported clinical and angiographic outcomes of FDS-treated brain aneurysms in small parent arteries. Methods: A systematic literature review was performed for outcomes data related to FDS-treated intracranial aneurysms using PubMed, Ovid Medline, and Web of Science. Procedural data, angiographic outcomes, and clinical outcomes at various time points were collected and summarized. Results: The 19 studies included 580 patients with 604 aneurysms, of which 6.1% had been acutely ruptured and 28.3% had been previously treated. The procedural complication rate and symptomatic stroke rate was 9.8% and 7.5%. The complete occlusion rate at the last radiographic follow-up (mean, 12.1 months) was 73.6%. At the last clinical follow-up (mean, 10.6 months), the FDS-associated mortality was 2.5%. Conclusions: FDSs for the treatment of intracranial aneurysms located in small caliber arteries was associated with rates of long-term complete aneurysm occlusion, mortality, and permanent neurologic deficit comparable to the rates with FDS-treated aneurysms in larger parent arteries. However, the relatively increased risk of symptomatic stroke of these FDS-treated aneurysms should not be ignored. Direct comparisons with alternative endovascular approaches are necessary to further define the optimal use of FDS for these aneurysms.

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