J Neurosurg Sci
-
Decompressive craniectomy (DC) to control refractory intracranial hypertension in patients with traumatic brain injury (TBI), has been listed as possible but controversial therapeutic approach in the latest version of TBI management guidelines. This study aimed to perform a systematic review and meta-analysis on efficacy and safety of DC compared to standard care in TBI patients. ⋯ It seems that, in TBI patients with intracranial hypertension, the use of DC is associated with survival benefit when compared to medical therapy alone, but with no clear improvement of functional outcome. Yet no definite conclusion can be drawn due to limited quantity and considerable heterogeneity of available data.
-
Awake craniotomies (AC) could reduce neurological deficits compared with patients under general anesthesia, however, intraoperative seizure (IOS) is a major reason causing awake surgery failure. The purpose of the study was to give a comprehensive overview the published articles focused on seizure incidence in AC. ⋯ This systematic review and meta-analysis shows that AC is a safe technique with relatively low IOS occurrence. However, few RCTs were available, and the acquisition of further evidence through high-quality RCTs is highly recommended.
-
Meta Analysis
Prognostic implications of resection extent for patients with glioblastoma multiforme: a meta-analysis.
Surgery is the primary treatment of glioblastoma multiforme (GBM), and a greater extent of resection (EOR) has been shown to be associated with improved survival. Our objective was to perform a meta-analysis comparing the 1-year overall survival (OS) and 1-year progression-free survival (PFS) of GBM patients who receive total resection, incomplete resection, or biopsy only. ⋯ Total resection of GBM is associated with improved OS and PFS as compared to incomplete resection or biopsy.
-
Review Meta Analysis
Repetitive transcranial magnetic stimulation for pain after spinal cord injury: a systematic review and meta-analysis.
The evidence regarding efficiency of repetitive transcranial magnetic stimulation (rTMS) on relief of neuropathic pain (NP) in patients with prior spinal cord injury (SCI) is controversial. The current meta-analysis aimed to assess the efficacy of rTMS in pain relieve in patients suffering from SCI associated NP. ⋯ rTMS might reduce SCI associated neuropathic pain; however, further studies are required to support our conclusions.