World Neurosurg
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Traumatic brain injury (TBI) represents a major public health concern worldwide, with no significant change in its epidemiology over the last 30 years. After TBI, the primary injury induces irreversible brain damage, which is untreatable. The subsequent secondary injury plays a critical role in the clinical prognosis because without effective treatment it will provide additional tissue damage. ⋯ Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies among which is decompressive hemicraniectomy. With the advent of technology, research in the glymphatic pathways, and advances in microscopic surgery, a novel surgical technique-the cisternostomy-has emerged that holds promise in managing rising ICP in TBI-affected patients. In this article we describe the rationale for cisternostomy, an emerging microneurosurgical approach for the management of moderate to severe TBI.
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Review Meta Analysis
Waves of Pain Relief: A Systematic Review of Clinical Trials in Spinal Cord Stimulation Waveforms for the Treatment of Chronic Neuropathic Low-Back and Leg Pain.
In the United States, chronic low back pain affects up to 37% of adults and is a multibillion dollar health care expenditure. Spinal cord simulation (SCS) has been established as an effective treatment alternative for chronic neuropathic low back and leg pain, especially for patients with failed back surgery syndrome or chronic regional pain syndrome. The field of SCS has rapidly advanced such that analgesia can now be achieved through numerous different waveforms, each claiming to offer improved outcomes. ⋯ Of 38 eligible studies reviewed, 13 randomized controlled trials were finally included in our systematic review. We reviewed evidence from randomized controlled trials in the field of SCS that have established paresthesia-based SCS, paresthesia-free high-frequency SCS, burst SCS, and subperception SCS as viable treatment options for chronic neuropathic low back and leg pain. We critically evaluated evidence that claims to support the use of one waveform over another and reviewed the literature on patient preference for different waveforms.
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Review Meta Analysis
Therapeutic Targeting of the Notch Pathway in Glioblastoma.
Glioblastoma (GBM) is the most common and deadly form of brain tumor. After standard treatment of resection, radiotherapy, and chemotherapy, the 5-year survival is <5%. In recent years, research has uncovered several potential targets within the Notch signaling pathway, which may lead to improved patient outcomes. ⋯ Recent literature suggests targeting the Notch pathway has great potential for future therapies for GBM.