Journal of neurosurgery
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Journal of neurosurgery · Apr 2013
Review Meta AnalysisImpact of particular antiepileptic drugs on the survival of patients with glioblastoma multiforme.
Glioblastoma multiforme (GBM) is the most common astrocytic brain tumor and carries a dire prognosis. Despite current therapeutic options--surgery, radiotherapy, and chemotherapy--survival varies from 11.3 to 14.6 months. A group of drugs known as histone deacetylase inhibitors (HDIs) has demonstrated a potentially beneficial role in cancer treatment, particularly in combination with other therapies. A drug that exhibits potential as an HDI is sodium valproate (VPA), which is frequently used to treat seizures in patients with cerebral neoplasms. The present study was undertaken to investigate the role of VPA as an antitumor agent in the management of patients with GBM. ⋯ Authors of this study demonstrated evidence supporting the theory that VPA may benefit patients with GBM in terms of survival.
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Journal of neurosurgery · Apr 2013
Comparative StudyIn-hospital mortality after traumatic brain injury surgery: a nationwide population-based comparison of mortality predictors used in artificial neural network and logistic regression models.
Most reports compare artificial neural network (ANN) models and logistic regression models in only a single data set, and the essential issue of internal validity (reproducibility) of the models has not been adequately addressed. This study proposes to validate the use of the ANN model for predicting in-hospital mortality after traumatic brain injury (TBI) surgery and to compare the predictive accuracy of ANN with that of the logistic regression model. ⋯ This work supports the continued use of ANNs for predictive modeling of neurosurgery outcomes. However, further studies are needed to confirm the clinical efficacy of the proposed model.
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Journal of neurosurgery · Apr 2013
Comparative StudyPostoperative ischemic changes following resection of newly diagnosed and recurrent gliomas and their clinical relevance.
The aim of surgical treatment of glioma is the complete resection of tumor tissue with preservation of neurological function. Inclusion of diffusion-weighted imaging (DWI) in the postoperative MRI protocol could improve the delineation of ischemia-associated postoperative neurological deficits. The present study aims to assess the incidence of infarctions following resection of newly diagnosed gliomas in comparison with recurrent gliomas and the influence on neurological function. ⋯ Postoperative infarctions occur frequently in patients with newly diagnosed and recurrent gliomas and do have an impact on postoperative neurological function. In this patient cohort there was a higher risk for ischemic lesions and for deterioration of neurological function after resection of recurrent tumors. Radiogenic and postoperative tissue changes could contribute to the higher risk of an ischemic infarction in patients with recurrent tumors.
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Journal of neurosurgery · Apr 2013
Long-term ongoing cortical remodeling after contralateral C-7 nerve transfer.
Contralateral C-7 nerve transfer was developed for the treatment of patients with brachial plexus avulsion injury (BPAI). In the surgical procedure the affected recipient nerve is connected to the ipsilateral motor cortex, and the dramatic peripheral alteration may trigger extensive cortical reorganization. However, little is known about the long-term results after such specific nerve transfers. The purpose of this study was to investigate the long-term cortical adaptive plasticity after BPAI and contralateral C-7 nerve transfer. ⋯ The authors believe that the cortical remodeling may last for a long period after peripheral rearrangement and that the successful cortical transfer is the foundation of the independent motor recovery.