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BACKGROUND: Chronic subdural hematoma (CSDH) has significant patient morbidity and recurrence that drives the management towards less invasive procedures. We describe the different indications of middle meningeal artery embolization (MME) in management of CSDH. OBJECTIVE: We aimed to report and evaluate our institutional experience using MME in management of CSDH. PATIENTS AND METHODS: Retrospective analysis was conducted between 2020 and 2023, we reviewed the different indications of MME using different embolization material. Clinical and radiological outcomes were described 6 months and 1 year postoperatively. RESULTS: Twenty one CSDHs were treated in 16 patients (5 patients had bilateral CSDH). In patients with bilateral CSDH each hematoma was considered separately. Of the 21 hematomas, 7 (33.3%) were treated upfront without prior surgical treatment, 4 (19.1%) were treated for recurrence after prior surgical evacuation, and 10 (47.6%) were treated prophylactically following surgical evacuation. Post embolization, one hematoma needed to be evacuated due to failure of hematoma volume reduction. By the end of one year follow up, 50% reduction in hematoma size was achieved in 13 hematomas (62%), while total disappearance was evident in 7 hematomas (33.3%). Recurrence was noted in one patient on renal dialysis which was managed conservatively. The modified Rankin scale (mRS) improved after 6 months in comparison to the admission time from 3 ± 1.2 to 1.6 ± 0.63 with p value of 0.003. CONCLUSION: The MME is a safe and effective technique that should be considered in management of CSDH in patients with multiple morbidities and patients who have high risk of recurrence. [ABSTRACT FROM AUTHOR]

This article, titled "Management of Brain Stem Cavernomas in the Setting of Multiple Intracranial Cavernomas: A Retrospective Analysis of Single Institutional Experience," explores the impact of multiple cerebral cavernomas on the management of brain stem cavernomas. The study analyzed electronic records from 2007 to 2023 and selected patients with multiple intracranial cavernomas, dividing them into two groups: those with only brain stem cavernomas and those with both brain stem and non-brain stem cavernomas. The study found that the risk of brain stem cavernoma bleeding was higher in the group with multiple cavernomas compared to the group with only brain stem cavernomas. However, there was no significant difference in outcomes between the two groups after a two-year follow-up period. [Extracted from the article]

The focus of this paper was to review and summarise the current issues and recent trends within the framework of locally advanced (LA) non-small cell lung cancer (NSCLC). The recently proposed 8th tumour–node–metastases (TNM) staging system exhibited significant amendments in the distribution of the T and M descriptors. Every revision to the TNM classification should contribute to clinical improvement. This is particularly necessary regarding LA NSCLC stratification, therapy and outcomes. While several studies reported the superiority of the 8th TNM edition in comparison to the previous 7th TNM edition, in terms of both the discrimination ability among the various T subgroups and clinical outcomes, others argued against this interpretation. Synergistic cytotoxic chemotherapy with radiotherapy is most prevalent in treating LA NSCLC. Clinical trial experience from multiple references has reported that the risk of locoregional relapse and distant metastasis was less evident for patients treated with concomitant radiochemotherapy than radiotherapy alone. Nevertheless, concern persists as to whether major incidences of toxicity may occur due to the addition of chemotherapy. Cutting-edge technologies such as four-dimensional computed tomography (4D-CT) and volumetric modulated arc therapy (VMAT) should yield therapeutic gains due to their capability to conform radiation doses to tumours. On the basis of the preceding notion, the optimum radiotherapy technique for LA NSCLC has been a controversial and much-disputed subject within the field of radiation oncology. Notably, no single-perspective research has been undertaken to determine the optimum radiotherapy modality for LA NSCLC. The landscape of immunotherapy in lung cancer is rapidly expanding. Currently, the standard of care for patients with inoperable LA NSCLC is concurrent chemoradiotherapy followed by maintenance durvalumab according to clinical outcomes from the PACIFIC trial. An estimated 42.9% of patients randomly assigned to durvalumab remained alive at five years, and free of disease progression, thereby establishing a new benchmark for the standard of care in this setting. [ABSTRACT FROM AUTHOR]