Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jul 2003
Meta AnalysisHead injury as a risk factor for Alzheimer's disease: the evidence 10 years on; a partial replication.
To determine, using a systematic review of case-control studies, whether head injury is a significant risk factor for Alzheimer's disease. We sought to replicate the findings of the meta-analysis of Mortimer et al (1991). ⋯ This study provides support for an association between a history of previous head injury and the risk of developing Alzheimer's disease.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2003
ReviewEffects of decompressive craniectomy on brain tissue oxygen in patients with intracranial hypertension.
This report examined the intraoperative course of partial pressure of brain tissue oxygen (P(ti)O(2)) and intracranial pressure (ICP) during surgical decompressive craniectomy for medically intractable intracranial hypertension due to diffuse brain swelling in three patients after severe subarachnoid haemorrhage and aneurysm coiling. The mean ICP decreased from 59 mm Hg to 10 mm Hg in a two step fashion, relating to bone flap removal and dural opening. ⋯ P(ti)O(2) and ICP remained at non-critical ranges postoperatively. Despite these beneficial effects on ICP and P(ti)O(2), the patients' clinical status remained poor with two in a persistent vegetative state and one dead.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2003
ReviewSurgery for Parkinson's disease: lack of reliable clinical trial evidence.
There has been a striking resurgence of interest in surgery for Parkinson's disease (PD) with new targets identified and new procedures developed. This systematic review identified over 500 studies of surgery for PD published since 1990, including over 10 000 patients. ⋯ Studies of surgery for PD have generally been of poor quality with too few patients, too short follow up, inappropriate choice of outcome measures, and lack of control groups. Much larger, randomised, controlled trials are needed to assess the longer term effects of surgery on patient rated quality of life and cost effectiveness.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2003
ReviewSurgery for Parkinson's disease: lack of reliable clinical trial evidence.
There has been a striking resurgence of interest in surgery for Parkinson's disease (PD) with new targets identified and new procedures developed. This systematic review identified over 500 studies of surgery for PD published since 1990, including over 10 000 patients. ⋯ Studies of surgery for PD have generally been of poor quality with too few patients, too short follow up, inappropriate choice of outcome measures, and lack of control groups. Much larger, randomised, controlled trials are needed to assess the longer term effects of surgery on patient rated quality of life and cost effectiveness.