World Neurosurg
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Randomized Controlled Trial
Effect of Sevoflurane Postconditioning on the Incidence of Symptomatic Cerebral Hyperperfusion after Revascularization Surgery in Adult Patients with Moyamoya Disease.
Various experimental studies have reported neuroprotective effects of sevoflurane postconditioning against cerebral ischemia-reperfusion injury. We therefore investigated its neuroprotective effects on hyperperfusion-related transient neurologic deterioration, called symptomatic cerebral hyperperfusion (SCH), and also identified predictive factors for SCH in patients with moyamoya disease after revascularization surgery. ⋯ Sevoflurane postconditioning did not reduce the incidence of SCH after revascularization surgery in patients with moyamoya disease. Rather, a decreased vascular reserve, operation on the dominant hemisphere, increased temporal occlusion time, and decreased intraoperative minimum PaCO2 were associated with SCH in these patients.
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Review Meta Analysis
Intravenous Acetaminophen (Paracetamol) for Post-Craniotomy Pain; Systematic Review and Meta-analysis of Randomized Clinical Trials.
Acute pain control after supratentorial craniotomy is considered among the most important indicators of postoperative recovery. The aim of this study was to determine the effects of intravenous acetaminophen on postcraniotomy pain. ⋯ The results of this systematic review and meta-analysis indicate that preoperative intravenous administration of acetaminophen is associated with decreased postoperative pain, need for rescue analgesics, and dosages of analgesics after craniotomy surgery.
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Comparative Study
Is it necessary to perform the second surgery stage of anterior debridement in the treatment of spinal tuberculosis?
In this retrospective comparative study, the efficacy and clinical outcomes of long posterior instrumentation, with or without laminectomy, were evaluated and the necessity of the second stage of anterior debridement in the treatment of spinal tuberculosis (TB) was discussed. ⋯ Single-stage long posterior instrumentation, with or without laminectomy, is a safe, effective, and feasible method for the treatment of spinal TB. The second stage of anterior debridement surgery may not be necessary for every spinal TB treatment.
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Clinical Trial
Efficacy of Laminoplasty in Improving Sensory Disturbances in Patients with Cervical Spondylotic Myelopathy: A Prospective Study.
Upper extremity sensory disturbances are primary symptoms that affect the quality of life (QOL) of patients with cervical spondylotic myelopathy. Although laminoplasty is 1 of the surgical options, its effects on sensory disturbances have remained unclear. We aimed to determine whether surgical intervention would improve the sensory disturbances of patients with cervical spondylotic myelopathy. ⋯ Our findings have indicated that improvement in postoperative subjective sensory disturbances will occur relatively earlier and will be significantly greater than the improvement in objective sensory disturbances. Furthermore, improvement in the subjective sensory disturbances contributes to functional spinal cord recovery and patients' health-related QOL.
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The preventable shunt revision rate (PSRR) was recently introduced in pediatric hydrocephalus as a quality metric for shunt surgery. We evaluated the PSRR in an adult hydrocephalus population. ⋯ The 90-day PSRR can be applied to an adult population and serve as a quality metric.