None of the methods is unequivocally superior. Considering its inefficiency, stent-assisted coiling should be undertaken with caution. A time-delimited systematic review is needed to establish the most accurate treatment for ruptured BBAs.

YouTube is the world's most popular video-sharing site ("Top 15 Most Popular Video Websites | January 2020," n.d.). It is not only used for entertainment purposes but in recent years YouTube has expanded to become a platform for education. Formerly, patients would rely solely on their physician as a source of information, whereas current data shows that the internet is becoming an increasingly credible database. Studies show that patients and their families use internet sites such as YouTube to provide educational information about their disease, possible treatment options and management of daily life

Background: Previous studies on the novel Coronavirus (COVID-19) have found strong correlations between online searches and the epidemiology of the disease. Aim: Our aim was to determine if online searches for COVID-19 related to international media announcements or national epidemiology. Methods: Searches for "coronavirus" were made on Google Trends from December 31, 2019 to April 13, 2020 for 40 European countries. The online COVID-19 searches for all countries were correlated with each other. COVID-10 epidemiology (i.e. incidence and mortality) was correlated with the national online searches. Major announcements by the World Health Organization (WHO) were taken into consideration with peaks in online searches. Correlations were made using Spearman's rank correlation coefficient. Results: Overall, the online searches for COVID-19 were not correlated with the actual incidence and mortality of COVID-19. The mean Spearman correlation for incidence was 0.20 (range À0.66 to 0.76) and for mortality was 0.35 (range À0.75 to 0.85). Online searches in Europe were all strongly synchronized with each other; a mean Spearman correlation of 0.93 (range 0.62 to 0.99). Conclusions: Online searches for COVID-19 in Europe are not correlated with epidemiology but strongly correlated with international WHO announcements. Our study challenges previous Google Trends studies and emphasizes the role of the WHO in raising awareness of a new disease.

Background: Frontal aslant tract (FAT) is a white matter bundle connecting the pre-supplementary motor area (pre-SMA) and the supplementary motor area (SMA) with the inferior frontal gyrus (IFG). The purpose of the present study was to evaluate the anatomical variability of FAT. Materials and methods: Total number of fibres and the lateralisation index (LI) were calculated. We attempted to find factors contributing to the diversity of FAT regarding IFG terminations to the pars opercularis (IFG-Op) and to the pars triangularis (IFG-Tr). Magnetic resonance imaging of adult patients with diffusion tensor imaging (DTI) with total number of 98 hemispheres composed a cohort. V-shaped operculum was the most common (60.5%). Results: Total number of FAT fibres had widespread and unimodal distribution (6 to 1765; median: 160). Left lateralisation was noted in 64.3% of cases and was positively correlated with total number of FAT fibres and the bundle projecting to IFG-Op (p < 0.01). LI correlated with total number of FAT fibres (r = 0.43, p < 0.01). FAT projected predominantly to IFG-Op (88.9%; 88 of 99). Only in 3 (3.1%) cases more fibres terminated in IFG-Tr than in IFG-Op. Total number of FAT fibres and number of fibres terminating at IFG-Op did not correlate with the ratio of fibre numbers: FAT/IFG-Op, FAT/IFG . The greater total number of fibres to IFG-Tr was, the higher were the ratios of p = 0.04 (Folia Morphol 2017; 76, 4: 574-581)

OBJECTIVE A review article assessing all the risk factors reported in the literature for postoperative cerebellar mutism syndrome (pCMS) among children remains absent. The authors sought to perform a systematic review and meta-analysis to evaluate this issue. METHODS PubMed, Embase, and Web of Science were queried to systematically extract potential references. The articles relating to pCMS were required to be written in the English language, involve pediatric patients (≤ 18 years of age), and provide extractable data, which included a comparison group of patients who did not develop pCMS. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale. Data were pooled using RevMan 5.4, and publication bias was assessed by visual inspection for funnel plot asymmetry. The study protocol was registered through PROSPERO (ID: CRD42021256177). RESULTS Overall, 28 studies involving 2276 patients were included. Statistically significant risk factors identified from univariate analysis were brainstem invasion (OR 4.28, 95% CI 2.23–8.23; p < 0.0001), fourth ventricle invasion (OR 12.84, 95% CI 4.29–38.44; p < 0.00001), superior cerebellar peduncle invasion (OR 6.77, 95% CI 2.35–19.48; p = 0.0004), diagnosis of medulloblastoma (OR 3.26, 95% CI 1.93–5.52; p < 0.0001), medulloblastoma > 50 mm (OR 8.85, 95% CI 1.30–60.16; p = 0.03), left-handedness (OR 6.57, 95% CI 1.25–34.44; p = 0.03), and a vermis incision (OR 5.44, 95% CI 2.09–14.16; p = 0.0005). On the other hand, a tumor located in the cerebellar hemisphere (OR 0.23, 95% CI 0.06–0.92; p = 0.04), cerebellar hemisphere compression (OR 0.23, 95% CI 0.11–0.45; p < 0.0001), and intraoperative imaging (OR 0.36, 95% CI 0.18–0.72; p = 0.004) reduced the risk of pCMS. CONCLUSIONS This study provides the largest and most reliable review of risk factors associated with pCMS. Although some risk factors may be dependent on one another, the data may be used by surgeons to better identify patients at risk for pCMS and for intervention planning.

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The qualitative RAE provides an interim estimate of the clinical relevance of quickly developing diagnostic methods. Based on the critical appraisal of current knowledge, adding the DTI sequence to the standard MRI protocol may be clinically beneficial in selected patient groups with childhood temporal lobe epilepsy or as a part of planning for an epilepsy surgery.

Aim of the study. This study aimed to verify the accuracy of preoperative visualisation of the facial nerve (FN) by magnetic resonance-based (MR) diffusion tensor imaging-fibre tracking (DTI-FT) with neuronavigation system integration in patients with cerebello-pontine angle (CPA) tumours.Clinical rationale for the study. Complete excision with preservation of the FN remains the critical goal of today's vestibular schwannoma (VS) surgery. DTI-FT of the FN with neuronavigation is yet to be fully evaluated, and could make surgery safer. Materials and methods.This was a prospective cohort study in which 38 consecutive patients with a CPA tumour (32 VSs, five meningiomas and one epidermoid cyst) were operated on via the retrosigmoid route from 2013 to 2019. The course of the FN was simulated before surgery using StealthViz and the images were transferred to the Medtronic S7 neuronavigation system. The FN location reconstructed by DTI-FT was verified during the surgery.Results. MR acquisition was inappropriate in three patients (7.9%). DTI-FT correctly predicted the course of the FN in 31 of the 38 patients; the discordance rate was 18.4%. The accuracy of DTI-FT was 81.6% (95% CI: 65.67-92.26), sensitivity 88.57% (95% CI: 73.26-96.80) and positive predictive value was 91.18% (95% CI: 90.17-92.09). The reliability of the neuronavigation-integrated visualisation of the FN did not depend on the tumour size (p = 0.85), but the method was more accurate when the nerve was compact in shape (p = 0.03, area under curve (AUC) 0.87, 95% CI: 0.60-1.00) and in females (p = 0.04, AUC 0.78, 95% CI: 0.56-1.00). Following surgery, 86.5% of the patients presented with useful facial function (House-Brackmann grades I-III). Correct simulation of the FN did not prevent postoperative facial palsy (p = 0.35). Conclusions.The accuracy of DTI-FT of the FN integrated with neuronavigation remains unsatisfactory. This method does not provide any clinical benefit over non-integrated DTI-FT in terms of nerve function preservation.Clinical implications. Due to the low reliability of the predictions, further technical advances in predicting the course of the FN are awaited by clinicians. However, DTI-FT images in the operating theatre would make tumour excision more comfortable for the surgeon.