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Chronic subdural hematoma (cSDH) is one of the most studied clinical entities in the neurosurgical literature. Management of cSDH is complicated by its propensity to recurrence. Various factors for the development of recurrence of cSDH have been described in various clinical, epidemiological, and observational studies, yet the evidence available is limited. A systematic review and meta-analysis as per PRISMA guidelines to identify clinical and radiological factors which can predict the development of recurrence in cSDH. A total of 14 studies were included for the systematic review and meta-analysis after a comprehensive search of the online databases. Eight studies were of high methodological quality. Age, use of anticoagulants, obesity, seizure, and liver disease were found to be statistically significant clinical risk factors for the development of recurrence in cSDH. Among the radiological parameters, the internal structure of the hematoma and the width of the hematoma was found to be significant risk factor predicting the development of recurrence. Age >75 years, use of anticoagulation therapy, liver disease, and obesity were significant risk factors for cSDH recurrence. Pneumocephalus, internal architecture of hematoma, bilateral cSDH, the width of hematoma, and the presence of bilateral cSDH are important radiological parameters of the development of recurrent cSDH

Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: “SILK”, “Flow Diverter”, “Mortality”, and “Prognosis”. The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00–6.37, P=0.12, I2=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00–5.34, P=0.28, I2=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65–9.38, P

Abstract This article aims to evaluate the safety and effectiveness of Gamma Knife radiosurgery as a treatment modality for pediatric cerebral arteriovenous malformations (AVMs) by assessing mortality rates, the rate of complete AVM obliteration, and the incidence of complications while exploring potential risk factors. A comprehensive search was conducted through multiple databases to identify relevant studies, including randomized controlled trials and observational studies. The studies were assessed for risk of bias using the ROBINS-I tool and methodological quality with the Newcastle–Ottawa Scale. Data on mortality, AVM obliteration rates, and complications were systematically extracted. Pooled rate analysis was performed to assess outcomes, and heterogeneity was evaluated. The analysis included 21 studies involving 2142 pediatric patients with cerebral AVMs. A low mortality rate of 0.75% (95% CI 0.09% to 2.71%) and a high rate of complete obliteration of AVMs was observed, with a rate of 71.64% (95% CI 65.716% to 77.211%). Complications, including new neurological deficits, post-radiosurgery intracranial hemorrhage, and other complications (such as seizures and radiation-related issues), were relatively low, with rates of 2.57%, 2.463%, and 4.784%, respectively. Gamma Knife radiosurgery demonstrates its potential as a safe and effective treatment option for pediatric cerebral AVMs. The low mortality rate and high rate of AVM obliteration suggest that this approach offers significant benefits. While some complications were observed, they were generally non-severe. However, further high-quality studies with extended follow-up periods are needed to better understand long-term efficacy and safety.

Abstract Traumatic spinal cord injury (SCI) or traumatic myelopathy is a devastating neurological condition and a heavy burden on the health system. There are inflammatory and structural biomarkers with well-defined profiles, and useful for determining the management and prognosis of this pathology. Laboratory studies have shown some utility in confirming the existence of a spinal cord injury. Little knowledge about the molecular processes that occur after a SCI is evident, and it is well known that its understanding is dispensable to establish therapeutic targets that improve the outcomes for this type of patient. Many studies have explored the role of structural and inflammatory markers and some structural and inflammatory biomarkers. In the present article, we review the ongoing research in the field of spinal injury and possible role of biomarkers in the management of these patients.