Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02877-0
Aizaz Ali, Umar T Ayub, Khaled Gharaibeh, Rahul Rao, Naveed Akhtar, Mouhammad Jumaa, Ashfaq Shuaib
Multiple prognostic scores have been developed to predict morbidity and mortality in patients with spontaneous intracerebral hemorrhage(sICH). Since the advent of machine learning(ML), different ML models have also been developed for sICH prognostication. There is however a need to verify the validity of these ML models in diverse patient populations. We aim to create machine learning models for prognostication purposes in the Qatari population. By incorporating inpatient variables into model development, we aim to leverage more information. 1501 consecutive patients with acute sICH admitted to Hamad General Hospital(HGH) between 2013 and 2023 were included. We trained, evaluated, and compared several ML models to predict 90-day mortality and functional outcomes. For our dataset, we randomly selected 80% patients for model training and 20% for validation and used k-fold cross validation to train our models. The ML workflow included imbalanced class correction and dimensionality reduction in order to evaluate the effect of each. Evaluation metrics such as sensitivity, specificity, F-1 score were calculated for each prognostic model. Mean age was 50.8(SD 13.1) years and 1257(83.7%) were male. Median ICH volume was 7.5 ml(IQR 12.6). 222(14.8%) died while 897(59.7%) achieved good functional outcome at 90 days. For 90-day mortality, random forest(RF) achieved highest AUC(0.906) whereas for 90-day functional outcomes, logistic regression(LR) achieved highest AUC(0.888). Ensembling provided similar results to the best performing models, namely RF and LR, obtaining an AUC of 0.904 for mortality and 0.883 for functional outcomes. Random Forest achieved the highest AUC for 90-day mortality, and LR achieved the highest AUC for 90-day functional outcomes. Comparing ML models, there is minimal difference between their performance. By creating an ensemble of our best performing individual models we maintained maximum accuracy and decreased variance of functional outcome and mortality prediction when compared with individual models.
目前已开发出多种预后评分来预测自发性脑出血(sICH)患者的发病率和死亡率。自机器学习(ML)问世以来,人们也开发出了不同的 ML 模型来预测 sICH 的预后。然而,还需要在不同的患者群体中验证这些 ML 模型的有效性。我们的目标是在卡塔尔人群中创建用于预后的机器学习模型。通过将住院患者变量纳入模型开发,我们旨在利用更多信息。2013年至2023年期间,哈马德总医院(HGH)连续收治了1501名急性sICH患者。我们训练、评估并比较了多个 ML 模型,以预测 90 天死亡率和功能预后。对于我们的数据集,我们随机选择了 80% 的患者进行模型训练,20% 的患者进行验证,并使用 k 倍交叉验证来训练模型。ML 工作流程包括不平衡类校正和降维,以评估每种方法的效果。每个预后模型都计算了灵敏度、特异性、F-1 评分等评价指标。平均年龄为 50.8(SD 13.1)岁,1257 人(83.7%)为男性。ICH 容量中位数为 7.5 毫升(IQR 12.6)。222例(14.8%)患者死亡,897例(59.7%)患者在90天后功能恢复良好。对于 90 天死亡率,随机森林(RF)的 AUC 最高(0.906),而对于 90 天功能预后,逻辑回归(LR)的 AUC 最高(0.888)。集合模型的结果与表现最好的模型(即 RF 和 LR)相似,死亡率的 AUC 为 0.904,功能性结果的 AUC 为 0.883。随机森林模型在 90 天死亡率方面获得了最高的 AUC,而 LR 模型在 90 天功能结果方面获得了最高的 AUC。比较 ML 模型,它们之间的性能差异很小。通过对表现最好的单个模型进行组合,我们保持了最高的准确性,并且与单个模型相比,降低了功能性结果和死亡率预测的方差。
{"title":"A comprehensive comparison of machine learning models for ICH prognostication: Retrospective review of 1501 intra-cerebral hemorrhage patients from the Qatar stroke database.","authors":"Aizaz Ali, Umar T Ayub, Khaled Gharaibeh, Rahul Rao, Naveed Akhtar, Mouhammad Jumaa, Ashfaq Shuaib","doi":"10.1007/s10143-024-02877-0","DOIUrl":"10.1007/s10143-024-02877-0","url":null,"abstract":"<p><p>Multiple prognostic scores have been developed to predict morbidity and mortality in patients with spontaneous intracerebral hemorrhage(sICH). Since the advent of machine learning(ML), different ML models have also been developed for sICH prognostication. There is however a need to verify the validity of these ML models in diverse patient populations. We aim to create machine learning models for prognostication purposes in the Qatari population. By incorporating inpatient variables into model development, we aim to leverage more information. 1501 consecutive patients with acute sICH admitted to Hamad General Hospital(HGH) between 2013 and 2023 were included. We trained, evaluated, and compared several ML models to predict 90-day mortality and functional outcomes. For our dataset, we randomly selected 80% patients for model training and 20% for validation and used k-fold cross validation to train our models. The ML workflow included imbalanced class correction and dimensionality reduction in order to evaluate the effect of each. Evaluation metrics such as sensitivity, specificity, F-1 score were calculated for each prognostic model. Mean age was 50.8(SD 13.1) years and 1257(83.7%) were male. Median ICH volume was 7.5 ml(IQR 12.6). 222(14.8%) died while 897(59.7%) achieved good functional outcome at 90 days. For 90-day mortality, random forest(RF) achieved highest AUC(0.906) whereas for 90-day functional outcomes, logistic regression(LR) achieved highest AUC(0.888). Ensembling provided similar results to the best performing models, namely RF and LR, obtaining an AUC of 0.904 for mortality and 0.883 for functional outcomes. Random Forest achieved the highest AUC for 90-day mortality, and LR achieved the highest AUC for 90-day functional outcomes. Comparing ML models, there is minimal difference between their performance. By creating an ensemble of our best performing individual models we maintained maximum accuracy and decreased variance of functional outcome and mortality prediction when compared with individual models.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02947-3
Akankshya Dash, Chinnasamy Ragavendran
{"title":"Letter to editor: Comments on \"Superb microvascular ultrasound is a promising non-invasive diagnostic tool to assess a ventriculoperitoneal shunt system function: a feasibility study\".","authors":"Akankshya Dash, Chinnasamy Ragavendran","doi":"10.1007/s10143-024-02947-3","DOIUrl":"10.1007/s10143-024-02947-3","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02873-4
Akshaya Viswanathan, Neha Brahma, Vimal S
The treatment of brain tumors is significantly hindered by the Blood-Brain Barrier (BBB), a selective barrier that restricts the passage of therapeutic agents to the brain. Recent advancements in BBB-targeting therapies offer promising strategies to overcome this challenge, providing new avenues for the effective treatment of brain cancer. This article reviews innovative approaches, including Convection-Enhanced Delivery (CED) and RNA-based therapeutics, which enhance drug delivery directly to tumor sites, bypassing the BBB and reducing systemic toxicity. Additionally, the use of theranostic nanoparticles and CRISPR-Cas9 gene editing presents novel opportunities for real-time monitoring and precision-targeted therapy, respectively. Techniques such as magnetic nanoparticles, intranasal drug administration, and focused ultrasound with microbubbles are also being refined to improve drug penetration across the BBB. Furthermore, peptide-based delivery systems and small molecules designed to mimic endogenous transport pathways are accelerating the discovery of more effective therapies. The exploration of combination therapies that synergize BBB-penetrant drugs with conventional chemotherapeutic agents or immunotherapies holds the potential to enhance treatment efficacy and patient outcomes. Continued research and interdisciplinary collaboration are essential to develop predictive models, personalized treatment strategies, and alternative delivery methods that ensure the long-term safety and effectiveness of these novel therapies. Advancements in BBB-targeting therapeutics are poised to transform the landscape of brain cancer treatment, offering renewed hope for improved survival rates and quality of life for patients.
{"title":"Transforming brain cancer therapeutics: unlocking the power of blood-brain barrier-targeting strategies for superior treatment outcomes and precision medicine.","authors":"Akshaya Viswanathan, Neha Brahma, Vimal S","doi":"10.1007/s10143-024-02873-4","DOIUrl":"10.1007/s10143-024-02873-4","url":null,"abstract":"<p><p>The treatment of brain tumors is significantly hindered by the Blood-Brain Barrier (BBB), a selective barrier that restricts the passage of therapeutic agents to the brain. Recent advancements in BBB-targeting therapies offer promising strategies to overcome this challenge, providing new avenues for the effective treatment of brain cancer. This article reviews innovative approaches, including Convection-Enhanced Delivery (CED) and RNA-based therapeutics, which enhance drug delivery directly to tumor sites, bypassing the BBB and reducing systemic toxicity. Additionally, the use of theranostic nanoparticles and CRISPR-Cas9 gene editing presents novel opportunities for real-time monitoring and precision-targeted therapy, respectively. Techniques such as magnetic nanoparticles, intranasal drug administration, and focused ultrasound with microbubbles are also being refined to improve drug penetration across the BBB. Furthermore, peptide-based delivery systems and small molecules designed to mimic endogenous transport pathways are accelerating the discovery of more effective therapies. The exploration of combination therapies that synergize BBB-penetrant drugs with conventional chemotherapeutic agents or immunotherapies holds the potential to enhance treatment efficacy and patient outcomes. Continued research and interdisciplinary collaboration are essential to develop predictive models, personalized treatment strategies, and alternative delivery methods that ensure the long-term safety and effectiveness of these novel therapies. Advancements in BBB-targeting therapeutics are poised to transform the landscape of brain cancer treatment, offering renewed hope for improved survival rates and quality of life for patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02904-0
Tong Wang, Jiahui Hao, Jialei Zhou, Gang Chen, Haitao Shen, Qing Sun
Pneumonia is a common postoperative complication in patients with aneurysmal subarachnoid hemorrhage (aSAH), which is associated with poor prognosis and increased mortality. The aim of this study was to develop a predictive model for postoperative pneumonia (POP) in patients with aSAH. A retrospective analysis was conducted on 308 patients with aSAH who underwent surgery at the Neurosurgery Department of the First Affiliated Hospital of Soochow University. Univariate and multivariate logistic regression and lasso regression analysis were used to analyze the risk factors for POP. Receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the constructed model. Finally, the effectiveness of modeling these six variables in different machine learning methods was investigated. In our patient cohort, 23.4% (n = 72/308) of patients experienced POP. Univariate, multivariate logistic regression analysis and lasso regression analysis revealed age, Hunt-Hess grade, mechanical ventilation, leukocyte count, lymphocyte count, and platelet count as independent risk factors for POP. Subsequently, these six factors were used to build the final model. We found that age, Hunt-Hess grade, mechanical ventilation, leukocyte count, lymphocyte count, and platelet count were independent risk factors for POP in patients with aSAH. Through validation and comparison with other studies and machine learning models, our novel predictive model has demonstrated high efficacy in effectively predicting the likelihood of pneumonia during the hospitalization of aSAH patients.
肺炎是动脉瘤性蛛网膜下腔出血(aSAH)患者常见的术后并发症,与预后不良和死亡率升高有关。本研究的目的是建立一个蛛网膜下腔出血患者术后肺炎(POP)的预测模型。研究人员对在苏州大学附属第一医院神经外科接受手术的 308 名 aSAH 患者进行了回顾性分析。采用单变量、多变量逻辑回归和拉索回归分析来分析 POP 的风险因素。利用接收者操作特征曲线(ROC)、校准曲线和决策曲线分析(DCA)对所建模型进行评估。最后,研究了用不同的机器学习方法对这六个变量建模的有效性。在我们的患者队列中,23.4%(n = 72/308)的患者经历过 POP。单变量、多变量逻辑回归分析和套索回归分析显示,年龄、Hunt-Hess 分级、机械通气、白细胞计数、淋巴细胞计数和血小板计数是 POP 的独立风险因素。随后,这六个因素被用于建立最终模型。我们发现,年龄、Hunt-Hess 分级、机械通气、白细胞计数、淋巴细胞计数和血小板计数是 aSAH 患者 POP 的独立危险因素。通过与其他研究和机器学习模型的验证和比较,我们的新型预测模型在有效预测 aSAH 患者住院期间发生肺炎的可能性方面表现出了很高的效率。
{"title":"Development and validation of a machine-learning model for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage.","authors":"Tong Wang, Jiahui Hao, Jialei Zhou, Gang Chen, Haitao Shen, Qing Sun","doi":"10.1007/s10143-024-02904-0","DOIUrl":"10.1007/s10143-024-02904-0","url":null,"abstract":"<p><p>Pneumonia is a common postoperative complication in patients with aneurysmal subarachnoid hemorrhage (aSAH), which is associated with poor prognosis and increased mortality. The aim of this study was to develop a predictive model for postoperative pneumonia (POP) in patients with aSAH. A retrospective analysis was conducted on 308 patients with aSAH who underwent surgery at the Neurosurgery Department of the First Affiliated Hospital of Soochow University. Univariate and multivariate logistic regression and lasso regression analysis were used to analyze the risk factors for POP. Receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the constructed model. Finally, the effectiveness of modeling these six variables in different machine learning methods was investigated. In our patient cohort, 23.4% (n = 72/308) of patients experienced POP. Univariate, multivariate logistic regression analysis and lasso regression analysis revealed age, Hunt-Hess grade, mechanical ventilation, leukocyte count, lymphocyte count, and platelet count as independent risk factors for POP. Subsequently, these six factors were used to build the final model. We found that age, Hunt-Hess grade, mechanical ventilation, leukocyte count, lymphocyte count, and platelet count were independent risk factors for POP in patients with aSAH. Through validation and comparison with other studies and machine learning models, our novel predictive model has demonstrated high efficacy in effectively predicting the likelihood of pneumonia during the hospitalization of aSAH patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02820-3
Muhammad Farhan, Sudhair Alam
This letter recognizes the authors' commendable work in examining the role of social media in promoting neurosurgical research. It also underscores the necessity for more robust methodologies in future studies to clearly assess the impact of social media promotion and to ensure that findings are generalizable, addressing the limitations of the current study.
{"title":"Letter to editor: A randomized controlled trial of social media promotion in neurosurgical publishing.","authors":"Muhammad Farhan, Sudhair Alam","doi":"10.1007/s10143-024-02820-3","DOIUrl":"10.1007/s10143-024-02820-3","url":null,"abstract":"<p><p>This letter recognizes the authors' commendable work in examining the role of social media in promoting neurosurgical research. It also underscores the necessity for more robust methodologies in future studies to clearly assess the impact of social media promotion and to ensure that findings are generalizable, addressing the limitations of the current study.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02929-5
Sarah Shaheen, Ume Aiman, Zainab Azad
Idiopathic normal pressure hydrocephalus (iNPH) affects approximately 1.5% of the population, with a higher prevalence in men than women. Ventriculoperitoneal shunting (VPS) is the standard treatment for iNPH, but it poses a notable risk of infection, occurring in 8-10% of cases. Recent advancements in non-invasive diagnostic techniques, such as superb microvascular ultrasound (SMI), have demonstrated potential in evaluating cerebrospinal fluid (CSF) flow within VPS systems. A single-center feasibility study involving 19 asymptomatic patients with VPS systems showed that SMI reliably detected CSF flow in the proximal catheter in all patients and in the distal catheter in 89.5%, while reductions in optic nerve sheath diameter (ONSD) indicated lowered intracranial pressure after shunt activation. These findings suggest that SMI could serve as a safer alternative to invasive methods for assessing shunt function. Additionally, artificial intelligence (AI)-based approaches are being explored to reduce infection risk and enhance shunt efficacy. An artificial neural network (ANN) model achieved an 83.1% accuracy in predicting infection risk, surpassing traditional logistic regression models. However, the study's limitations, including its retrospective design, small sample size, and single-center nature, underscore the need for larger multi-center studies to confirm the generalizability of these findings. Further research is essential to validate the effectiveness of these innovations and their potential to improve patient outcomes in hydrocephalus management.
{"title":"\"Artificial intelligence-driven infection risk prediction in ventriculoperitoneal shunting: a novel approach for normal pressure hydrocephalus treatment\".","authors":"Sarah Shaheen, Ume Aiman, Zainab Azad","doi":"10.1007/s10143-024-02929-5","DOIUrl":"10.1007/s10143-024-02929-5","url":null,"abstract":"<p><p>Idiopathic normal pressure hydrocephalus (iNPH) affects approximately 1.5% of the population, with a higher prevalence in men than women. Ventriculoperitoneal shunting (VPS) is the standard treatment for iNPH, but it poses a notable risk of infection, occurring in 8-10% of cases. Recent advancements in non-invasive diagnostic techniques, such as superb microvascular ultrasound (SMI), have demonstrated potential in evaluating cerebrospinal fluid (CSF) flow within VPS systems. A single-center feasibility study involving 19 asymptomatic patients with VPS systems showed that SMI reliably detected CSF flow in the proximal catheter in all patients and in the distal catheter in 89.5%, while reductions in optic nerve sheath diameter (ONSD) indicated lowered intracranial pressure after shunt activation. These findings suggest that SMI could serve as a safer alternative to invasive methods for assessing shunt function. Additionally, artificial intelligence (AI)-based approaches are being explored to reduce infection risk and enhance shunt efficacy. An artificial neural network (ANN) model achieved an 83.1% accuracy in predicting infection risk, surpassing traditional logistic regression models. However, the study's limitations, including its retrospective design, small sample size, and single-center nature, underscore the need for larger multi-center studies to confirm the generalizability of these findings. Further research is essential to validate the effectiveness of these innovations and their potential to improve patient outcomes in hydrocephalus management.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1007/s10143-024-02937-5
Hethesh Chellapandian, Sivakamavalli Jeyachandran
{"title":"Comment on \"Beyond the scalpel: the role of palliative care in neurosurgery\".","authors":"Hethesh Chellapandian, Sivakamavalli Jeyachandran","doi":"10.1007/s10143-024-02937-5","DOIUrl":"10.1007/s10143-024-02937-5","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10143-024-02893-0
Hethesh Chellapandian, Sivakamavalli Jeyachandran
This study by Aboukais et al. (2024) evaluates postoperative outcomes in patients with unruptured giant middle cerebral artery (MCA) aneurysms associated with intracranial hypertension and midline brain shift. Analyzing data from 2012 to 2022, the authors compare surgical approaches, emphasizing the potential benefits of systematic decompressive hemicraniotomy in improving patient outcomes. While the study's findings are valuable, the small sample size and absence of a control group limit its generalizability. The retrospective nature of the study introduces potential biases, and long-term cognitive outcomes are not fully explored. Future research should involve larger, prospective cohorts with control groups, incorporating advanced imaging and monitoring techniques to enhance surgical precision and long-term recovery assessments. This study provides important insights but underscores the need for further investigation to optimize treatment strategies for this complex condition.
{"title":"Letter to Editor, \"Giant unruptured middle cerebral artery aneurysm revealed by intracranial hypertension: is a systematic decompressive hemicraniotomy mandatory?","authors":"Hethesh Chellapandian, Sivakamavalli Jeyachandran","doi":"10.1007/s10143-024-02893-0","DOIUrl":"https://doi.org/10.1007/s10143-024-02893-0","url":null,"abstract":"<p><p>This study by Aboukais et al. (2024) evaluates postoperative outcomes in patients with unruptured giant middle cerebral artery (MCA) aneurysms associated with intracranial hypertension and midline brain shift. Analyzing data from 2012 to 2022, the authors compare surgical approaches, emphasizing the potential benefits of systematic decompressive hemicraniotomy in improving patient outcomes. While the study's findings are valuable, the small sample size and absence of a control group limit its generalizability. The retrospective nature of the study introduces potential biases, and long-term cognitive outcomes are not fully explored. Future research should involve larger, prospective cohorts with control groups, incorporating advanced imaging and monitoring techniques to enhance surgical precision and long-term recovery assessments. This study provides important insights but underscores the need for further investigation to optimize treatment strategies for this complex condition.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1007/s10143-024-02921-z
Chinnasamy Ragavendran
{"title":"Letter to editor: comment on, \"Imaging manifestations of papillary glioneuronal tumors\".","authors":"Chinnasamy Ragavendran","doi":"10.1007/s10143-024-02921-z","DOIUrl":"https://doi.org/10.1007/s10143-024-02921-z","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}