Journal of neurosurgery
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Journal of neurosurgery · Jun 2017
Randomized Controlled TrialEffect of functional MRI-guided navigation on surgical outcomes: a prospective controlled trial in patients with arteriovenous malformations.
OBJECTIVE The impact of functional MRI (fMRI)-guided navigation on the surgical outcome of patients with arteriovenous malformations (AVMs) is undetermined. This large, randomized controlled trial (RCT) was designed to determine the safety and efficacy of fMRI-guided microsurgery of AVMs. This paper reports the preliminary results of the interim analysis. ⋯ The preliminary data indicated that the additional intervention of fMRI navigation is not associated with a more favorable surgical outcome in patients with AVMs. The results indicated that eloquent adjacent brain tissue and a low preoperative mRS score are independent risk factors for S-PFD. Clinical trial registration no.: NCT01758211 ( clinicaltrials.gov ).
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Journal of neurosurgery · Jun 2017
Randomized Controlled TrialA prospective randomized trial of the optimal dose of mannitol for intraoperative brain relaxation in patients undergoing craniotomy for supratentorial brain tumor resection.
OBJECTIVE Mannitol is used intraoperatively to induce brain relaxation in patients undergoing supratentorial brain tumor resection. The authors sought to determine the dose of mannitol that provides adequate brain relaxation with the fewest adverse effects. METHODS A total of 124 patients were randomized to receive mannitol at 0.25 g/kg (Group A), 0.5 g/kg (Group B), 1.0 g/kg (Group C), and 1.5 g/kg (Group D). ⋯ CONCLUSIONS The higher doses of mannitol provided better brain relaxation but were associated with more adverse effects. Considering the balance between the benefits and risks of mannitol, the authors suggest the use of 1.0 g/kg of intraoperative mannitol for satisfactory brain relaxation with the fewest adverse effects. Clinical trial registration no.: NCT02168075 ( clinicaltrials.gov ).