normalities, basal cistern effacement, compliance to ICP monitoring guidelines and type of surgical approach (craniotomy and pre-emptive DC are associated with better outcome). Patients with an intermediate or worse risk of unfavourable outcome according to their baseline characteristics might achieve better than expected outcome if they undergo pre-emptive DC.
 When differences in patient's baseline characteristics are balanced by PS, the variables associated with long-term outcome are year, age, falls from patient´s own height, hypoxia, early deterioration, pupillary abnormalities, basal cistern effacement, compliance to ICP monitoring guidelines and type of surgical approach (craniotomy and pre-emptive DC are associated with better outcome). Patients with an intermediate or worse risk of unfavourable outcome according to their baseline characteristics might achieve better than expected outcome if they undergo pre-emptive DC.
  Malignant ependymomas are rare cancerous tumors that are associated with increased morbidity and mortality in the affected patients. Lately, there has been a lot of controversy about the correct way to manage and predict the survival outcome of these patients. We aim in this retrospective cohort study to develop novel nomograms that can better predict the overall survival (OS) and cancer-specific survival (CSS) of these patients.
 
  This is a retrospective cohort study that was conducted through the Surveillance, Epidemiology, and End Results databases (SEER) between 1998 and 2016. Patients were excluded if they had an unknown diagnosis, unknown cause of death or those with survival duration less than a month. We used penalized regression models with the highest timedependent area under the ROC curve (AUC) and most stable calibrations to construct the nomograms. By searching the SEER database and applying the eligibility criteria, we identified 3391 patients for the final analysis.
 
  Nine penalized regression models were developed of which two models including adaptive elastic-net was selected for both OS and CSS. The model incorporated age, sex, year of diagnosis, site, race, radiation, chemotherapy, surgery, and type for the construction of nomograms. We aimed in this population-based cohort study to develop novel prediction tools that can help physicians estimate the survival of malignant ependymoma patients and provide better care.
 
  Our nomograms appear to have high accuracy and applicability, which we hope that can predict the survival and improve the treatment and prognosis of these patients.
 Our nomograms appear to have high accuracy and applicability, which we hope that can predict the survival and improve the treatment and prognosis of these patients.
  This population study aims to assess the impact of the implementation of the original Stupp protocol on overall survival in patients with new-diagnosed supratentorial primary GBM.
 
  The Surveillance, Epidemiology, and End Results (SEER) database was used to study the survival of histologically confirmed adult supratentorial GBM patients diagnosed between 1998 and 2016. Kaplan-Meier, and a univariate and propensity-score weighted multivariate Cox proportional hazard model adjusted for age at diagnosis, sex, race, marital status and extent of resection was used to assess the survival of patients prior to implementation of the Stupp protocol in 2005 (Pre-Stupp) and following implementation of the Stupp Protocol until 2016 (Post Stupp).
 
  6,390 patients satisfied inclusion exclusion criteria. Median survival times were 13 months for the Pre-Stupp and 15 months for Post-Stupp groups (p<0.001). The 1-,2-, 5- and 10- year survival rates for the Pre-Stupp group were 51, 18, 5 and 2% respectively compared to 59, 27, 8 and 4% on the Post-Stupp group. Propensity-score weighted analysis showed a lower mortality risk for patients who underwent concomitant chemoradiation during the Post-Stupp era [HR 0.77, 95% CI 0.62-0.94]. There was a 42 percent relative reduction in the risk of death for patients treated during the Post-Stupp era.
 
  This population-based propensity-score study with long-term follow-up suggests that the implementation of the Stupp protocol in 2005 had a positive impact on the survival of patients with supratentorial GBM. This "real-world" analysis validates the results of the original randomized control trial on which this protocol is based.
 This population-based propensity-score study with long-term follow-up suggests that the implementation of the Stupp protocol in 2005 had a positive impact on the survival of patients with supratentorial GBM. This "real-world" analysis validates the results of the original randomized control trial on which this protocol is based.
  Lesions of the craniovertebral junction are difficult to access, which is due to the anatomical features and high concentration of vital structures in the area. The transoral access has been most commonly used for anterior approach to treat craniovertebral junction pathology. This method has consistently shown a high complication rate and difficulties in-patient rehabilitation. In this study we analyzed the benefits of surgical treatment of the craniovertebral junction area pathology with the transnasal approach.
 
  Four patients with C2 odontoid process invagination and brain stem compression were treated with the transnasal endoscopic resection of the pathological process combined with simultaneous occipital-cervical stabilization (OCS). Surgical procedure, anatomical findings, complications and rehabilitation period were assessed.
 
  Transnasal treatment of C2 odontoid process lesions was applied successfully in all four cases. An modified extended transnasal approach was used. This approach is characterizC2 odontoid process invagination, a combination of transnasal resection and OCS shows excellent preliminary results. This method should be favorable over the transoral approach in certain cases, as it provides a better direct access to lesion of the craniovertebral junction and allows for more complex combined procedures.
  C2 vertebral body fractures are relatively rare fractures with no defined management protocol and outcomes. The aim of the study is to evaluate the clinical and radiological outcomes of C2 body fratecures.
 
  The study was conducted at the Department of Neurosurgery, Nizam's Iinstitute of Medical Sciences, Hyderabad, India, following clearance from the Institutional Ethical Committee. The data of all patients with traumatic C2 body fracture who were managed in our department between Jan'2008 to Jan'2019 was retrieved from the database. Functional status of the patients was assessed by Neck disability index while pain was assessed by VAS at follow up after at least 6 months. Fusion and regional kyphotic angles (O-C2 and C2-C7) were assessed for radiological outcome.
 
  There were a total of 16 patients with isolated C2 body fractures in the defined time period. The male (n=11) female (n=5) distribution was 2.21. Ten patients had road traffic accidents while the remaining 6 had history of fall from height.  https://www.selleckchem.com/products/jib-04.html  Only 3 patients presented with neurological deficits.