Browsing by Author "Rowe, Scott E."

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    Comparison of Blister Aneurysm Treatment Techniques: A Systematic Review and Meta-Analysis
    (Elsevier, 2021-10) Sanchez, Victoria E.; Haider, Ali S.; Rowe, Scott E.; Wahood, Waseem; Sagoo, Navraj S.; Ozair, Ahmad; El Ahmadieh, Tarek Y.; Kan, Peter; Johnson, Jeremiah N.; Neurological Surgery, School of Medicine
    Objective Blood blister aneurysms are small, thin-walled, rapidly growing side-wall aneurysms that have proven particularly difficult to treat, and evidence-based guidance for treatment strategies is lacking. A systematic review and meta-analysis was performed to aggregate the available data and compare the three primary treatment modalities. Methods We performed a comprehensive literature search according to PRISMA guidelines followed by an indirect meta-analysis that compares the safety and efficacy of surgical, flow-diverting stents (FDS), and other endovascular approaches for the treatment of ruptured blood blister aneurysms. Results A total of 102 studies were included for quantitative synthesis with sample sizes of 687 treated surgically, 704 treated endovascularly without FDS, and 125 treated via flow-diversion. Comparatively, FDS achieved significantly reduced rates of perioperative retreatment compared to both surgical (P=0.025) and non-FDS endovascular (P<0.001). The FDS subgroup also achieved a significantly lower incidence of perioperative rebleed (P<0.001), perioperative hydrocephalus (P=0.012), postoperative infarction (P=0.002), postoperative hydrocephalus (P<0.001), and postoperative vasospasm (P=0.002) when compared to those patients in the open surgical subgroup. While no significant differences were found between groups on the basis of functional outcomes, angiographic outcomes detailed by rates of radiographic complete occlusion were highest for surgical (90.7%, 262/289) and FDS (89.1%, 98/110) subgroups versus the non-FDS endovascular subgroup at (82.7%, 268/324). Conclusion Flow-diversion appears to be an effective treatment strategy for ruptured BBAs with lower rates of perioperative complications when compared to surgical and other endovascular techniques but studies investigating long-term outcomes following flow-diversion warrant further study.
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    Pineal Region Gliomas: A Systematic Review of Clinical Features and Treatment Outcomes
    (International Institute of Anticancer Research, 2022) Bin Alamer, Othman; Palmisciano, Paolo; Rowe, Scott E.; Gupta, Aditya Dutta; Haider, Maryam; Alduhaymi, Mohammed; Cohen-Gadol, Aaron A.; Yu, Kenny; El-Ahmadieh, Tarek Y.; Haider, Ali S.; Neurological Surgery, School of Medicine
    Background/aim: To review the current literature on pineal region gliomas, summarizing the clinical characteristics and treatment outcomes. Materials and methods: PubMed, Scopus, and Cochrane databases were used to identify relevant articles. Comprehensive clinical characteristic review and survival analysis were conducted. Results: Twelve studies describing 81 patients were included. The median age was 39 years (male=54.3%). Fifty patients (61.7%) had obstructive hydrocephalus requiring cerebrospinal fluid diversion with either ventriculoperitoneal shunt (VPS) (40.0%) or endoscopic third ventriculostomy (ETV) (24.0%). Patients who underwent VPS had significant survival benefits compared to ETV (p<0.05). All patients in our review underwent surgery, and gross-total resection (≥98%) was achieved in 34.6%. The supracerebellar infratentorial approach was the most employed surgical approach (62.3%). Chemotherapy was administered in 32.1% of cases, and radiotherapy in 40.7%. The median overall survival (OS) was 12 months, and the overall one-year survival rate was 60%. Conclusion: This study could not establish a correlation between the extent of tumor resection and positive treatment outcomes. However, among cases with hydrocephalus, patients who underwent VPS placement had better survival as compared to ETV.