World Neurosurg
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Review Meta Analysis
Outcomes in Lesion Surgery versus Deep Brain Stimulation in Patients with Tremor: A Systematic Review and Meta-Analysis.
Optimal surgical strategy for patients with tremor remains uncertain. We conducted a systematic review and meta-analysis evaluating randomized controlled trials of deep brain stimulation (DBS) and lesion surgery (LS) in the treatment of tremor. ⋯ Although the main analysis showed that LS and DBS were equally effective in the treatment of patients with tremor, an exploratory subgroup analysis indicated an improvement in quality of life with noninvasive focused-ultrasound surgery.
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Review Meta Analysis
Effect of tranexamic acid in patients with traumatic brain injury: a systematic review and meta-analysis.
Tranexamic acid (TXA) reduces hemorrhage volume and consequently the need for operative intervention. However, its effectiveness and safety in patients with traumatic brain injury (TBI) is unclear. We conducted this systematic review and meta-analysis to evaluate the safety and efficacy of TXA in patients with TBI. ⋯ TXA demonstrates significant effect in reducing the risk of hematoma expansion by lowering the mortality rate and improving favorable neurologic outcomes in patients with TBI while not affecting thrombosis event rates. In addition, early TXA treatment is more effective in decreasing hematomas.
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Review Meta Analysis
The efficacy of gamma knife radiosurgery for cavernous malformation: a meta-analysis and review.
This meta-analysis is to evaluate the clinical efficacy of gamma knife radiosurgery (GKRS) for treating cavernous malformations. ⋯ Patients with cerebral cavernous malformations, especially ones that were deep seated and surgically inaccessible, seem to benefit from GKRS owing to a reduction of annual hemorrhage rate in the first 2 years and 2 years after, despite several cases that suffer from negative side effects of radiation.
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Review Meta Analysis
Anterior Thoracic Spinal Cord Herniation: Surgical Treatment and Postoperative Course. An Individual Participant Data Meta-Analysis of 246 Cases.
Anterior thoracic spinal cord herniation (ATSCH) is a rare cause of progressive myelopathy. Early surgery is essential, but there is no agreement about the best surgical approach. ⋯ In general, postoperative results after surgery for ATSCH are favorable, with a high percentage of patients experiencing postoperative improvement. Postoperative motor function improvement is more likely to occur in patients with a Brown-Séquard-like neurologic deficit. The WDD should be favored above the application of a patch as the technique of choice in surgical treatment of ATSCH.
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Review Meta Analysis
The Effect of Intrawound Vancomycin on Surgical Site Infections in Non-spinal Neurosurgical Procedures: A Systematic Review and Meta-Analysis.
Applying vancomycin into the surgical site has been well-described in spinal neurosurgery, with extensive institutional experience and systematic reviews describing its effectiveness in reducing surgical site infections (SSIs). Its use in nonspinal neurosurgical procedures is a logical extension of those findings; however, recent studies have described varying degrees of success. We have summarized the effect of local vancomycin application on SSIs in nonspinal neurosurgical procedures and describe the quality of the supporting evidence. ⋯ Vancomycin use in nonspinal neurosurgery is not supported by high-quality evidence, limiting the strength of the conclusions that can be drawn on the topic. Nonetheless, we found an overall favorable effect on SSIs (except in the context of cranioplasty), which should be reproduced in a randomized controlled fashion.