Neurosurgery

Interventions to reduce body temperature to 35 ⁰C to 37 ⁰C in adults and children with traumatic brain injury

Abstract Background Traumatic brain injury (TBI) is a major cause of death and disability, with an estimated 5.5 million people experiencing severe TBI worldwide every year. Observational clinical studies of people with TBI suggest an association between raised body temperature and unfavourable outcome, although this relationship is inconsistent. Additionally, preclinical models suggest that reducing temperature […]

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Carotid endarterectomy for symptomatic carotid stenosis

Abstract Background Stroke is the third leading cause of death and the most common cause of long‐term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of a Cochrane […]

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Ventriculo-peritoneal shunting devices for hydrocephalus

Abstract Background Hydrocephalus is a common neurological disorder, caused by a progressive accumulation of cerebrospinal fluid (CSF) within the intracranial space that can lead to increased intracranial pressure, enlargement of the ventricles (ventriculomegaly) and, consequently, to brain damage. Ventriculo‐peritoneal shunt systems are the mainstay therapy for this condition, however there are different types of shunt […]

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Antiepileptic drugs as prophylaxis for postcraniotomy seizures

Abstract Background This is an updated version of the Cochrane Review previously published in 2018. The incidence of seizures following supratentorial craniotomy for non‐traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five‐year period. Postoperative seizures can […]

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Carotid artery stenting versus endarterectomy for treatment of carotid artery stenosis

Abstract Background Carotid artery stenting is an alternative to carotid endarterectomy for the treatment of atherosclerotic carotid artery stenosis. This review updates a previous version first published in 1997 and subsequently updated in 2004, 2007, and 2012. Objectives To assess the benefits and risks of stenting compared with endarterectomy in people with symptomatic or asymptomatic […]

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Interval brain imaging for adults with cerebral glioma

Abstract Background Clinical practice guidelines suggest that magnetic resonance imaging (MRI) of the brain should be performed at certain time points or intervals distant from diagnosis (interval or surveillance imaging) of cerebral glioma, to monitor or follow up the disease; it is not known, however, whether these imaging strategies lead to better outcomes among patients […]

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Pharmacological interventions for the prevention of acute postoperative pain in adults following brain surgery

Abstract Background Pain following brain surgery can compromise recovery. Several pharmacological interventions have been used to prevent pain after craniotomy; however, there is currently a lack of evidence regarding which interventions are most effective. Objectives The objectives are to assess the effectiveness of pharmacological interventions for prevention of acute postoperative pain in adults undergoing brain […]

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Route of antibiotic prophylaxis for prevention of cerebrospinal fluid-shunt infection

Abstract Background The main complication of cerebrospinal fluid (CSF) shunt surgery is shunt infection. Prevention of these shunt infections consists of the perioperative use of antibiotics that can be administered in five different ways: orally; intravenously; intrathecally; topically; and via the implantation of antibiotic‐impregnated shunt catheters. Objectives To determine the effect of different routes of […]

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Decompressive craniectomy for the treatment of high intracranial pressure in closed traumatic brain injury

Abstract Background High intracranial pressure (ICP) is the most frequent cause of death and disability after severe traumatic brain injury (TBI). It is usually treated with general maneuvers (normothermia, sedation, etc.) and a set of first‐line therapeutic measures (moderate hypocapnia, mannitol, etc.). When these measures fail, second‐line therapies are initiated, which include: barbiturates, hyperventilation, moderate hypothermia, […]

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Postoperative epidural analgesia versus systemic analgesia for thoraco-lumbar spine surgery in children

Abstract Background Spine surgery may be associated with severe acute postoperative pain. Compared with systemic analgesia alone, epidural analgesia may offer better pain control. However, epidural analgesia has sometimes been associated with rare but serious complications. Therefore, it is critical to quantify the real benefits of epidural analgesia over other modes of pain treatment. Objectives […]

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