Neurosurgery
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Meta Analysis
Long-term follow-up of Chiari-related syringomyelia in adults: analysis of 157 surgically treated cases.
To determine the long-term outcome of surgically treated Chiari-related syringomyelia. ⋯ Our results confirmed that surgery is an effective and safe treatment of Chiari-related syringomyelia, with a 90% chance of long-term stabilization or improvement on average. Surgery should be proposed as soon as possible in patients with clearly progressing clinical features.
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Review Meta Analysis
Glioma extent of resection and its impact on patient outcome.
There is still no general consensus in the literature regarding the role of extent of glioma resection in improving patient outcome. Although the importance of resection in obtaining tissue diagnosis and alleviating symptoms is clear, a lack of Class I evidence prevents similar certainty in assessing the influence of extent of resection. ⋯ Despite persistent limitations in the quality of data, mounting evidence suggests that more extensive surgical resection is associated with longer life expectancy for both low- and high-grade gliomas.
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Meta Analysis Controlled Clinical Trial
Risk of shunt-dependent hydrocephalus after occlusion of ruptured intracranial aneurysms by surgical clipping or endovascular coiling: a single-institution series and meta-analysis.
To compare the risk of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by clipping versus coiling. ⋯ Clipping of a ruptured aneurysm may be associated with a lower risk for developing shunt dependency, possibly by clot removal. This might influence long-term outcome and surgical decision making.
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Meta Analysis Comparative Study
Efficacy of prophylactic antibiotics against meningitis after craniotomy: a meta-analysis.
Although prophylactic antibiotics have been shown by randomized clinical trials (RCTs) to help prevent deep infection after craniotomies, recent reports have suggested that antibiotics are not effective in preventing postcraniotomy meningitis. ⋯ Prophylactic antibiotics administered before craniotomy reduce rates of postoperative meningitis by approximately one-half, a statistically and clinically significant benefit.
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Review Meta Analysis
Treatment of ruptured intracranial aneurysms: looking to the past to register the future.
The outcomes reported in the International Subarachnoid Aneurysm Trial (ISAT), a multicenter, prospective, randomized trial to directly compare surgical clipping with endovascular coiling as treatments for ruptured intracranial aneurysms, have been misinterpreted by many to indicate the superiority of coiling to surgical clipping in all instances. To better understand the results of ISAT and their implications for practice patterns, we compared the ISAT results with the results of other published studies regarding the treatment of ruptured intracranial aneurysms. ⋯ Discrepancies with the results of other published studies, procedural limitations in study design, and lack of some data endpoints and subgroup analysis raise concerns regarding extracting generalizations from the conclusions of ISAT. We think that the creation of a national registry would further the study of treatment of ruptured intracranial aneurysms.