Review

Types of stent retrievers used in mechanical thrombectomy for acute ischaemic stroke: A scoping review

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In a scoping review Song et al.from: – Austin Health, Melbourne (Radiology) – St Vincent’s Health, Melbourne (Interventional Neuroradiology) – Monash Health, Melbourne (Neurosurgery & Imaging) – Eastern Health/MU, Melbourne – Northern Health/Univ. of Melbourne, Melbourne – SAHMRI, Adelaide – Deakin Univ., Geelong published in the Journal of Clinical Neuroscience with the purpose to map the landscape of stent retriever devices used in mechanical thrombectomy for acute ischemic stroke, stratified by device type and occlusion location. They concluded that Solitaire and Trevo dominate clinical use (~57 % of cases), primarily in M1 and ICA occlusions. Many devices remain under‑studied, especially in distal (ACA, M3+) occlusions. There is a notable evidence gap for newer stent retrievers in medium/distal vessel territory 1).

This review, while comprehensive in device enumeration, falls short in critical appraisal. By pooling data from 133 heterogeneous studies without quality stratification or bias assessment, it gives an inflated sense of evidence. The emphasis on device frequency—rather than outcomes or head‑to‑head efficacy—renders the conclusions superficial. The assertion of a “strong evidence base” for conventional devices is misleading; no meta‑analysis or performance metrics are provided. The claim that distal occlusions are understudied is unsurprising, but the authors offer no actionable framework or proposals for future targeted trials. The review reads more like a registry report than a scoping synthesis intended to inform practice. Novelty is minimal, relevance limited.

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Oncolytic virus‑mediated immunomodulation in glioblastoma: Insights from clinical trials and challenges

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In a Review Raziye Piranlioglu *et al.* from

Affiliations Harvey Cushing Neuro‑oncology Laboratories, Dept. Neurosurgery, Brigham and Women’s Hospital, Boston, MA, USA; Dana‑Farber Cancer Institute, Boston, MA, USA

published in *Seminars in Immunology* with the Purpose to synthesize data from clinical trials of oncolytic viruses (OVs) in glioblastoma, evaluating immunomodulatory effects, delivery strategies, and challenges in assessing immune responses. They concluded that Oncolytic virus therapy is well tolerated in GBM trials and can convert the immunosuppressive microenvironment into an immunologically active state. However, limitations in post‑treatment sampling and delivery methods impede full understanding of biological mechanisms.

This review is a rehash of well‑known take‑home messages, offering little in the way of novel synthesis or incisive critique. The authors lean heavily on canonical trials (e.g., oHSV, adenovirus) but fail to integrate preclinical correlates from myeloid-targeting strategies, such as macrophage polarization dynamics or MDSC modulation. There’s no fresh mechanism, no meta‑analysis of response rates, and no exploration of why most trials remain phase I with limited impact. Sample‑scarcity is once again highlighted as a blocker—but no alternative trial designs (e.g., neoadjuvant window cohorts, liquid biopsy) are proposed. In short, the review scratches the surface of challenges without pushing the field forward.

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Fluids, Electrolytes, and Nutrition in the Critically Ill Patient with Neurotrauma

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* Type of Study: Narrative Review * Authors: Thomas et al. * Institution and City: University of Pennsylvania, Philadelphia, PA, USA * Journal: Neurosurgical Clinics of North America*, July 2025 * Purpose: To synthesize current clinical practices and considerations for fluid, electrolyte, and Nutritional Management in Critically Ill Neurotrauma Patients. * Conclusions: Isotonic saline remains the fluid of choice for resuscitation in TBI. Hypertonic saline is increasingly favored over mannitol for hyperosmolar therapy. Electrolyte imbalances are prevalent and necessitate close management. Nutritional optimization requires multidisciplinary coordination due to the elevated metabolic demands in TBI 1).

Critical Peer Review

1. Scientific Rigor & Methodology:

This narrative review lacks systematic methodology, which limits reproducibility and objectivity. There is no explicit discussion of inclusion/exclusion criteria for literature cited, nor a transparency framework for evaluating evidence quality. Future iterations would benefit from at least a semi-structured approach or alignment with PRISMA-ScR guidelines for scoping reviews.

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Challenges in Pulmonary Management after Traumatic Brain and Spinal Cord Injury

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In a review Zhou et al. published in Neurosurgery clinics of North America the most common pulmonary complications following traumatic brain injury (TBI) and spinal cord injury (SCI) — such as neurogenic pulmonary edema, Acute Respiratory Distress Syndrome, Ventilator-Associated Pneumonia, and thromboembolic events — and summarize current understanding of their pathophysiology and treatment, with the goal of guiding early recognition and management to improve outcomes in neurotrauma patients 3)

🧨 Verdict: ❝A clinically themed PowerPoint stretched into ten pages. No risk. No depth. No new thought.❞

⚠️ Fundamental Flaws No Original Contribution → This is not a review — it’s a recitation. The article contributes zero new data, no expert algorithm, and no provocative insight into managing a leading cause of secondary injury in neurotrauma.

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Fever in the Neurocritically Ill Patient

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In a review Kitagawa et al. from McGovern Medical School at the University of Texas Health Science Center at Houston published in Neurosurgical Clinics of North America to review fever etiology in neurocritically ill patients, assessed current pharmacologic and mechanical strategies for temperature control, and evaluated the existing evidence on whether these interventions improve clinical outcomes. The goal was to inform clinical decision-making in the neuro ICU setting. They concuded that fever is common in neuro ICU patients and is associated with worse outcomes. While several interventions effectively reduce body temperature, the literature remains inconclusive regarding their impact on prognosis. Management should be individualized, weighing the potential benefits against adverse effects. Further research is needed to clarify the clinical value of temperature control in this population 4)

Another polished yet pointless review, safely orbiting the surface of a real clinical problem without offering a single actionable insight. If you’ve spent time in a Neuro-ICU, you already know everything this article says. And if you haven’t — reading it won’t help you survive your next febrile crisis.

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