Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
ASH 2024 Annual Meeting 2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

Published: Thursday 12th December 2024
ADVANCED SEARCH
Log in
Top
Neurosurgical Review
Published in:

01-12-2024 | Deep Brain Stimulation | Review

Efficacy and safety of deep brain stimulation in drug resistance epilepsy: A systematic review and meta-analysis

Authors: Amir Reza Bahadori, Parisa Javadnia, Afshan Davari, Mehrdad Sheikhvatan, Sara Ranji, Sajad Shafiee, Abbas Tafakhori

Published in: Neurosurgical Review | Issue 1/2024

Login to get access

Abstract

In the context of drug-resistant epilepsy, deep brain stimulation (DBS) has received FDA approval. However, there have been reports of potential adverse effects, such as depression and memory impairment associated with DBS.This systematic review and meta-analysis aimed to investigate the impact of DBS on the quality of life (QoL), and seizure frequency of patients who had DRE, and assess its potential adverse events. The study followed PRISMA guidelines and thoroughly assessed databases, including Pubmed, Scopus, Embase, Web of Science, and the Cochrane Library, up to 31 July. Statistical analysis, fixed effect model analysis, performed by the Comprehensive Meta-analysis software (CMA) version 3.0. Additionally, Cochran’s Q test was conducted to determine the statistical heterogeneity. The systematic review encompassed 54 studies, with 38 studies included in the subsequent meta-analysis. The total number of patients included in the studies was 999. The findings indicated a significant decrease in the mean seizure frequency of subjects following DBS (SMD: 0.609, 95% CI: 0.519 to 0.700, p-value < 0.001). Moreover, patients' QoL significantly improved after DBS (SMD: -0.442, 95% CI: -0.576 to -0.308, p-value < 0.001). The hippocampus displayed the most notable effect size among the different DBS targets. Subgroup analysis based on follow-up duration revealed increased DBS efficacy after two years. There are few reports of adverse events, such as insertional-related complications, infection, and neuropsychiatric complications, but the majority of these were temporary and non-fatal. DBS emerged as an effective and safe procedure for reducing seizure frequency and enhancing the quality of life in DRE patients, with minimal adverse events. Furthermore, the efficacy of DBS was observed to improve over time.
Appendix
Available only for authorised users
Literature
1.
Global, regional, and national burden of epilepsy (2019) 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 18(4):357–75CrossRef
2.
Kalilani L, Sun X, Pelgrims B, Noack-Rink M, Villanueva V (2018) The epidemiology of drug-resistant epilepsy: a systematic review and meta-analysis. Epilepsia 59(12):2179–2193PubMedCrossRef
3.
4.
Luciano AL, Shorvon SD (2007) Results of treatment changes in patients with apparently drug-resistant chronic epilepsy. Ann Neurol 62(4):375–381PubMedCrossRef
5.
Bien CG, Raabe AL, Schramm J, Becker A, Urbach H, Elger CE (2013) Trends in presurgical evaluation and surgical treatment of epilepsy at one centre from 1988–2009. J Neurol Neurosurg Psychiatry 84(1):54–61PubMedCrossRef
6.
Hesdorffer DC, Tomson T, Benn E, Sander JW, Nilsson L, Langan Y et al (2011) Combined analysis of risk factors for SUDEP. Epilepsia 52(6):1150–1159PubMedCrossRef
7.
Mula M, Cock HR (2015) More than seizures: improving the lives of people with refractory epilepsy. Eur J Neurol 22(1):24–30PubMedCrossRef
8.
Bazil CW (2004) Comprehensive care of the epilepsy patient–control, comorbidity, and cost. Epilepsia 45(Suppl 6):3–12PubMedCrossRef
9.
Nair DR, Laxer KD, Weber PB, Murro AM, Park YD, Barkley GL et al (2020) Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy. Neurology 95(9):e1244–e56PubMedPubMedCentralCrossRef
10.
11.
Alcala-Zermeno JL, Gregg NM, Starnes K, Mandrekar JN, Van Gompel JJ, Miller K et al (2022) Invasive neuromodulation for epilepsy: comparison of multiple approaches from a single center. Epilepsy Behav 137:108951 (Pt A))PubMedPubMedCentralCrossRef
12.
13.
Velasco AL, Velasco F, Velasco M, Jiménez F, Carrillo-Ruiz J, Castro G (2007) The role of neuromodulation of the hippocampus in the treatment of intractable complex partial seizures of the temporal lobe. Operative Neuromodulation. volume 2. Neural Networks Surgery, pp 329–32https://​doi.​org/​10.​1007/​978-3-211-33081-4_​36
14.
Middlebrooks EH, Lin C, Okromelidze L, Lu C-Q, Tatum WO, Wharen RE Jr, Grewal SS (2020) Functional activation patterns of deep brain stimulation of the anterior nucleus of the thalamus. World Neurosurg 136:357–363.e2PubMedCrossRef
15.
Salanova V, Sperling MR, Gross RE, Irwin CP, Vollhaber JA, Giftakis JE, Fisher RS (2021) The SANTÉ study at 10 years of follow-up: effectiveness, safety, and sudden unexpected death in epilepsy. Epilepsia 62(6):1306–1317PubMedCrossRef
16.
Alcala-Zermeno JL, Gregg NM, Wirrell EC, Stead M, Worrell GA, Van Gompel JJ, Lundstrom BN (2021) Centromedian thalamic nucleus with or without anterior thalamic nucleus deep brain stimulation for epilepsy in children and adults: a retrospective case series. Seizure 84:101–107PubMedCrossRef
17.
Fisher R, Salanova V, Witt T, Worth R, Henry T, Gross R et al (2010) Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia 51(5):899–908PubMedCrossRef
18.
van der Bouwens TAM, Schijns O, Schaper F, Hoogland G, Kubben P, Wagner L et al (2019) Deep brain stimulation of the anterior nucleus of the thalamus for drug-resistant epilepsy. Neurosurg Rev 42(2):287–296CrossRef
19.
Salanova V, Witt T, Worth R, Henry TR, Gross RE, Nazzaro JM et al (2015) Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy. Neurology 84(10):1017–1025PubMedPubMedCentralCrossRef
20.
Oh Y-S, Kim HJ, Lee KJ, Kim YI, Lim S-C, Shon Y-M (2012) Cognitive improvement after long-term electrical stimulation of bilateral anterior thalamic nucleus in refractory epilepsy patients. Seizure 21(3):183–187PubMedCrossRef
21.
Ilyas A, Pizarro D, Romeo AK, Riley KO, Pati S (2019) The centromedian nucleus: anatomy, physiology, and clinical implications. J Clin Neurosci 63:1–7PubMedCrossRef
22.
Cohen-Gadol AA, Wilhelmi BG, Collignon F, White JB, Britton JW, Cambier DM et al (2006) Long-term outcome of epilepsy surgery among 399 patients with nonlesional seizure foci including mesial temporal lobe sclerosis. J Neurosurg 104(4):513–524PubMedCrossRef
23.
Martin RC, Kretzmer T, Palmer C, Sawrie S, Knowlton R, Faught E et al (2002) Risk to verbal memory following anterior temporal lobectomy in patients with severe left-sided hippocampal sclerosis. Arch Neurol 59(12):1895–1901PubMedCrossRef
24.
Chabardès S, Kahane P, Minotti L, Koudsie A, Hirsch E, Benabid AL (2002) Deep brain stimulation in epilepsy with particular reference to the subthalamic nucleus. Epileptic Disord 4(Suppl 3):S83–93PubMed
25.
Cui Z, Wang J, Mao Z, Ling Z, Zhang J, Chen T (2023) Long-term efficacy of deep brain stimulation of the subthalamic nucleus in patients with pharmacologically intractable epilepsy: a case series of six patients. Epileptic Disord 25(5):712–723PubMedCrossRef
26.
Schmitt FC, Voges J, Heinze HJ, Zaehle T, Holtkamp M, Kowski AB (2014) Safety and feasibility of nucleus accumbens stimulation in five patients with epilepsy. J Neurol 261(8):1477–1484PubMedPubMedCentralCrossRef
27.
Benedetti-Isaac JC, Torres‐Zambrano M, Vargas‐Toscano A, Perea‐Castro E, Alcalá‐Cerra G, Furlanetti LL et al (2015) Seizure frequency reduction after posteromedial hypothalamus deep brain stimulation in drug‐resistant epilepsy associated with intractable aggressive behavior. Epilepsia 56(7):1152–1161PubMedCrossRef
28.
29.
Boëx C, Seeck M, Vulliémoz S, Rossetti AO, Staedler C, Spinelli L et al (2011) Chronic deep brain stimulation in mesial temporal lobe epilepsy. Seizure 20(6):485–490PubMedCrossRef
30.
Boon P, Vonck K, De Herdt V, Van Dycke A, Goethals M, Goossens L et al (2007) Deep brain stimulation in patients with refractory temporal lobe epilepsy. Epilepsia 48(8):1551–1560PubMedCrossRef
31.
Cukiert A, Burattini JA, Cukiert CM, Argentoni-Baldochi M, Baise-Zung C, Forster CR, Mello VA (2009) Centro-median stimulation yields additional seizure frequency and attention improvement in patients previously submitted to callosotomy. Seizure 18(8):588–592PubMedCrossRef
32.
Cukiert A, Cukiert CM, Burattini JA, Lima AM (2014) Seizure outcome after hippocampal deep brain stimulation in a prospective cohort of patients with refractory temporal lobe epilepsy. Seizure 23(1):6–9PubMedCrossRef
33.
Cukiert A, Cukiert CM, Burattini JA, Mariani PP (2020) Seizure outcome during bilateral, continuous, thalamic centromedian nuclei deep brain stimulation in patients with generalized epilepsy: a prospective, open-label study. Seizure 81:304–309PubMedCrossRef
34.
Cukiert A, Cukiert CM, Burattini JA, Mariani PP (2021) Long-term seizure outcome during continuous bipolar hippocampal deep brain stimulation in patients with temporal lobe epilepsy with or without mesial temporal sclerosis: an observational, open-label study. Epilepsia 62(1):190–197PubMedCrossRef
35.
Herrman H, Egge A, Konglund AE, Ramm-Pettersen J, Dietrichs E, Taubøll E (2019) Anterior thalamic deep brain stimulation in refractory epilepsy: a randomized, double-blinded study. Acta Neurol Scand 139(3):294–304PubMed
36.
Hodaie M, Wennberg RA, Dostrovsky JO, Lozano AM (2002) Chronic anterior thalamus stimulation for intractable epilepsy. Epilepsia 43(6):603–608PubMedCrossRef
37.
Kaufmann E, Peltola J, Colon AJ, Lehtimäki K, Majtanik M, Mai JK, et al (2024) Long-term evaluation of anterior thalamic deep brain stimulation for epilepsy in the European MORE registry. Epilepsia 65:2438–2458. https://​doi.​org/​10.​1111/​epi.​18003
38.
Kerrigan JF, Litt B, Fisher RS, Cranstoun S, French JA, Blum DE et al (2004) Electrical stimulation of the anterior nucleus of the thalamus for the treatment of intractable epilepsy. Epilepsia 45(4):346–354PubMedCrossRef
39.
Kim SH, Lim SC, Kim J, Son B-C, Lee KJ, Shon Y-M (2017) Long-term follow-up of anterior thalamic deep brain stimulation in epilepsy: a 11-year, single center experience. Seizure 52:154–161PubMedCrossRef
40.
Koubeissi MZ, Joshi S, Eid A, Emami M, Jaafar N, Syed T et al (2022) Low-frequency stimulation of a fiber tract in bilateral temporal lobe epilepsy. Epilepsy Behav 130:108667PubMedCrossRef
41.
Kulju T, Haapasalo J, Lehtimäki K, Rainesalo S, Peltola J (2018) Similarities between the responses to ANT-DBS and prior VNS in refractory epilepsy. Brain Behav 8(6):e00983PubMedPubMedCentralCrossRef
42.
Lee KJ, Jang KS, Shon YM (2006) Chronic deep brain stimulation of subthalamic and anterior thalamic nuclei for controlling refractory partial epilepsy. In Chang JW, Katayama Y, Yamamoto T (eds) Advances in functional and reparative neurosurgery. Acta Neurochirurgica Supplementum, vol 99. Springer, Vienna. https://​doi.​org/​10.​1007/​978-3-211-35205-2_​17
43.
Lee KJ, Shon YM, Cho CB (2012) Long-term outcome of anterior thalamic nucleus stimulation for intractable epilepsy. Stereotact Funct Neurosurg 90(6):379–385PubMedCrossRef
44.
Lim SN, Lee CY, Lee ST, Tu PH, Chang BL, Lee CH et al (2016) Low and high frequency hippocampal stimulation for drug-resistant mesial temporal lobe Epilepsy. Neuromodulation 19(4):365–372PubMedPubMedCentralCrossRef
45.
Park HR, Choi SJ, Joo EY, Seo DW, Hong SB, Lee JI et al (2019) The role of Anterior Thalamic Deep Brain Stimulation as an alternative therapy in patients with previously failed vagus nerve stimulation for Refractory Epilepsy. Stereotact Funct Neurosurg 97(3):176–182PubMedCrossRef
46.
Peltola J, Colon AJ, Pimentel J, Coenen VA, Gil-Nagel A, Goncalves Ferreira A et al (2023) Deep brain stimulation of the anterior nucleus of the thalamus in drug-resistant epilepsy in the MORE multicenter patient registry. Neurology 100(18):e1852–e1865PubMedPubMedCentralCrossRef
47.
Piacentino M, Durisotti C, Garofalo PG, Bonanni P, Volzone A, Ranzato F, Beggio G (2015) Anterior thalamic nucleus deep brain stimulation (DBS) for drug-resistant complex partial seizures (CPS) with or without generalization: long-term evaluation and predictive outcome. Acta Neurochir 157(9):1525–1532PubMedCrossRef
48.
Poulen G, Rolland A, Chan-Seng E, Sanrey E, Gélisse P, Crespel A, Coubes P (2022) Microendoscopic transventricular deep brain stimulation of the anterior nucleus of the thalamus as a safe treatment in intractable epilepsy: a feasibility study. Rev Neurol (Paris) 178(9):886–895PubMedCrossRef
49.
Sitnikov AR, Grigoryan YA, Mishnyakova LP (2018) Bilateral stereotactic lesions and chronic stimulation of the anterior thalamic nuclei for treatment of pharmacoresistant epilepsy. Surg Neurol Int 9:137PubMedPubMedCentralCrossRef
50.
Valentín A, García Navarrete E, Chelvarajah R, Torres C, Navas M, Vico L et al (2013) Deep brain stimulation of the centromedian thalamic nucleus for the treatment of generalized and frontal epilepsies. Epilepsia 54(10):1823–1833PubMedCrossRef
51.
Velasco AL, Velasco F, Jiménez F, Velasco M, Castro G, Carrillo-Ruiz JD et al (2006) Neuromodulation of the centromedian thalamic nuclei in the treatment of generalized seizures and the improvement of the quality of life in patients with Lennox–Gastaut syndrome. Epilepsia 47(7):1203–1212PubMedCrossRef
52.
Velasco F, Velasco M, Ogarrio C, Fanghanel G (1987) Electrical stimulation of the centromedian thalamic nucleus in the treatment of convulsive seizures: a preliminary report. Epilepsia 28(4):421–430PubMedCrossRef
53.
Wang S, Zhao M, Li T, Zhang C, Zhou J, Wang M et al (2021) Long-term efficacy and cognitive effects of bilateral hippocampal deep brain stimulation in patients with drug-resistant temporal lobe epilepsy. Neurol Sci 42(1):225–233PubMedCrossRef
54.
55.
Velasco AL, Velasco F, Velasco M, Trejo D, Castro G, Carrillo-Ruiz JD (2007) Electrical stimulation of the hippocampal epileptic foci for seizure control: a double-blind, long-term follow-up study. Epilepsia 48(10):1895–1903PubMedCrossRef
56.
Bondallaz P, Boëx C, Rossetti AO, Foletti G, Spinelli L, Vulliemoz S et al (2013) Electrode location and clinical outcome in hippocampal electrical stimulation for mesial temporal lobe epilepsy. Seizure. 22(5):390–5PubMedCrossRef
57.
Kaufmann E, Bötzel K, Vollmar C, Mehrkens JH, Noachtar S (2021) What have we learned from 8 years of deep brain stimulation of the anterior thalamic nucleus? Experiences and insights of a single center. J Neurosurg 135(2):619–628PubMedCrossRef
58.
Krishna V, King NK, Sammartino F, Strauss I, Andrade DM, Wennberg RA, Lozano AM (2016) Anterior Nucleus Deep Brain Stimulation for Refractory Epilepsy: insights into patterns of Seizure Control and Efficacious Target. Neurosurgery 78(6):802–811PubMedCrossRef
59.
Son BC, Shon YM, Choi JG, Kim J, Ha SW, Kim SH, Lee SH (2016) Clinical Outcome of Patients with Deep Brain Stimulation of the Centromedian Thalamic Nucleus for Refractory Epilepsy and Location of the Active Contacts. Stereotact Funct Neurosurg. 94(3):187–97PubMedCrossRef
60.
Vonck K, Sprengers M, Carrette E, Dauwe I, Miatton M, Meurs A et al (2013) A decade of experience with deep brain stimulation for patients with refractory medial temporal lobe epilepsy. Int J Neural Syst 23(1):1250034PubMedCrossRef
61.
Yang JC, Bullinger KL, Dickey AS, Karakis I, Alwaki A, Cabaniss BT, et al. Anterior nucleus of the thalamus deep brain stimulation vs. temporal lobe responsive neurostimulation for temporal lobe epilepsy. Epilepsia. 2022;63 [9]:2290 − 300
62.
Zhu J, Wang X, Xu C, Zhang X, Qiao L, Zhang X et al (2021) Comparison of efficiency between VNS and ANT-DBS therapy in drug-resistant epilepsy: A one year follow up study. J Clin Neurosci. 90:112–7PubMedCrossRef
63.
Benedetti-Isaac JC, Torres-Zambrano M, Vargas-Toscano A, Perea-Castro E, Alcalá-Cerra G, Furlanetti LL et al (2015) Seizure frequency reduction after posteromedial hypothalamus deep brain stimulation in drug-resistant epilepsy associated with intractable aggressive behavior. Epilepsia. 56(7):1152–61PubMedCrossRef
64.
Dalic LJ, Warren AEL, Malpas CB, Thevathasan W, Roten A, Bulluss KJ, Archer JS (2022) Cognition, adaptive skills and epilepsy disability/severity in patients with Lennox-Gastaut syndrome undergoing deep brain stimulation for epilepsy in the ESTEL trial. Seizure-European Journal of Epilepsy. 101:67–74PubMedCrossRef
65.
Ding P, Zhang S, Zhang J, Hu X, Yu X, Liang S et al (2016) Contralateral Hippocampal Stimulation for Failed Unilateral Anterior Temporal Lobectomy in Patients with Bilateral Temporal Lobe Epilepsy. Stereotact Funct Neurosurg. 94(5):327–35PubMedCrossRef
66.
Hartikainen KM, Sun L, Polvivaara M, Brause M, Lehtimäki K, Haapasalo J et al (2014) Immediate effects of deep brain stimulation of anterior thalamic nuclei on executive functions and emotion-attention interaction in humans. J Clin Exp Neuropsychol. 36(5):540–50PubMedPubMedCentralCrossRef
67.
Koubeissi MZ, Kahriman E, Syed TU, Miller J, Durand DM (2013) Low-frequency electrical stimulation of a fiber tract in temporal lobe epilepsy. Ann Neurol. 74(2):223–31PubMedCrossRef
68.
69.
Miatton M, Van Roost D, Thiery E, Carrette E, Van Dycke A, Vonck K et al (2011) The cognitive effects of amygdalohippocampal deep brain stimulation in patients with temporal lobe epilepsy. Epilepsy Behav 22(4):759–764PubMedCrossRef
70.
Wille C, Steinhoff BJ, Altenmüller DM, Staack AM, Bilic S, Nikkhah G, Vesper J (2011) Chronic high-frequency deep-brain stimulation in progressive myoclonic epilepsy in adulthood–report of five cases. Epilepsia. 52(3):489–96PubMedCrossRef
71.
Parisi V, Gregg NM, Lundstrom BN, Alcala-Zermeno JL, Worrell G, Kerezoudis P et al (2023) Temporo-Parietal Extraventricular Approach for Deep Brain Stimulation Targeting the Anterior Nucleus of the Thalamus: institutional experience. Neurosurgery 93(6):1393–1406PubMedCrossRef
72.
Tröster AI, Meador KJ, Irwin CP, Fisher RS, Grp SS (2017) Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy. Seizure-European J Epilepsy 45:133–141CrossRef
73.
Klinger NV, Mittal S (2016) Clinical efficacy of deep brain stimulation for the treatment of medically refractory epilepsy. Clin Neurol Neurosurg 140:11–25PubMedCrossRef
74.
Lim SN, Lee ST, Tsai YT, Chen IA, Tu PH, Chen JL et al (2007) Electrical stimulation of the anterior nucleus of the thalamus for intractable epilepsy: a long-term follow-up study. Epilepsia 48(2):342–347PubMedCrossRef
75.
Morrell MJ (2011) Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 77(13):1295–1304PubMedCrossRef
76.
Järvenpää S, Peltola J, Rainesalo S, Leinonen E, Lehtimäki K, Järventausta K (2018) Reversible psychiatric adverse effects related to deep brain stimulation of the anterior thalamus in patients with refractory epilepsy. Epilepsy Behav 88:373–379PubMedCrossRef
77.
Vetkas A, Fomenko A, Germann J, Sarica C, Iorio-Morin C, Samuel N et al (2022) Deep brain stimulation targets in epilepsy: systematic review and meta-analysis of anterior and centromedian thalamic nuclei and hippocampus. Epilepsia 63(3):513–524PubMedCrossRef
78.
Ooi YC, Styliaras JC, Sharan A (2011) Thalamic stimulation for epilepsy. Neurosurg Clin N Am 22(4):457–464 (v-vi)PubMedCrossRef
79.
Sobstyl M, Stapińska-Syniec A, Iwański S, Rylski M (2021) Clinical efficacy and Safety Profile of Anterior thalamic stimulation for Intractable Epilepsy. J Neurol Surg Cent Eur Neurosurg 82(6):568–580CrossRef
80.
Weaver FM, Follett K, Stern M, Hur K, Harris C, Marks WJ Jr et al (2009) Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA 301(1):63–73PubMedPubMedCentralCrossRef
81.
Pompili M, Girardi P, Ruberto A, Tatarelli R (2005) Suicide in the epilepsies: a meta-analytic investigation of 29 cohorts. Epilepsy Behav 7(2):305–310PubMedCrossRef
82.
Wilson SJ, Bladin PF, Saling MM (2007) The burden of normality: a framework for rehabilitation after epilepsy surgery. Epilepsia 48(Suppl 9):13–16PubMedCrossRef
Metadata
Title
Efficacy and safety of deep brain stimulation in drug resistance epilepsy: A systematic review and meta-analysis
Authors
Amir Reza Bahadori
Parisa Javadnia
Afshan Davari
Mehrdad Sheikhvatan
Sara Ranji
Sajad Shafiee
Abbas Tafakhori
Publication date
01-12-2024
Publisher
Springer Berlin Heidelberg
Published in
Neurosurgical Review / Issue 1/2024
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-024-03090-9

Other articles of this Issue 1/2024

Comment on: A novel theory for rapid localization of the transverse-sigmoid sinus junction and “keyhole” in the retrosigmoid keyhole approach: micro-anatomical study, technique nuances, and clinical application

Robot-assisted drainage: A safer and more effective approach to Basal Ganglia Hemorrhage

Neurosurgical simulation models developed in Latin America and the Caribbean: a scoping review

  • Review

Comment on “ultrasoundguided needle aspiration of immediate postoperative symptomatic spinal epidural hematoma after lumbar stenosis surgical decompression in the elderly: a proof-of-concept case”

Prognostic values of combined ratios of white blood cells in glioma: a systematic review and meta-analysis

Letter to Editor “The efficacy of robot-assisted surgery on minor basal ganglia cerebral haemorrhage with neurological dysfunction”

SPONSORED

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

  • Webinar | 06-02-2024 | 20:00 (CET)

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by:
  • Viatris
Developed by: Springer Healthcare
Watch now
Image Credits