Neurosurgery

Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis

Abstract Background Brain metastases occur when cancer cells spread from their original site to the brain and are a frequent cause of morbidity and death in people with cancer. They occur in 20% to 40% of people during the course of their disease. Brain metastases are also the most frequent type of brain malignancy. Single […]

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Interventions for the treatment of brain radionecrosis after radiotherapy or radiosurgery

Abstract Background Brain radionecrosis (tissue death caused by radiation) can occur following high‐doseradiotherapy to brain tissue and can have a significant impact on a person’s quality of life (QoL) and function. The underlying pathophysiological mechanism remains unclear for this condition, which makes establishing effective treatments challenging. Objectives To assess the effectiveness of interventions used for […]

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Magnetic resonance perfusion for differentiating low-grade from high-grade gliomas at first presentation

Abstract Background Gliomas are the most common primary brain tumour. They are graded using the WHO classification system, with Grade II-IV astrocytomas, oligodendrogliomas and oligoastrocytomas. Low-grade gliomas (LGGs) are WHO Grade II infiltrative brain tumours that typically appear solid and non-enhancing on magnetic resonance imaging (MRI) scans. People with LGG often have little or no […]

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Intraoperative imaging technology to maximise extent of resection for glioma

Abstract Background Extent of resection is considered to be a prognostic factor in neuro-oncology. Intraoperative imaging technologies are designed to help achieve this goal. It is not clear whether any of these sometimes very expensive tools (or their combination) should be recommended as standard care for people with brain tumours. We set out to determine […]

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Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults

Abstract Background Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. Objectives To assess the […]

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Fitness training for cardiorespiratory conditioning after traumatic brain injury

Abstract Background Reduced cardiorespiratory fitness (cardiorespiratory deconditioning) is a common consequence of traumatic brain injury (TBI). Fitness training may be implemented to address this impairment. Objectives The primary objective of this updated review was to evaluate whether fitness training improves cardiorespiratory fitness in people who have sustained a TBI. The secondary objectives were to evaluate […]

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Triage tools for detecting cervical spine injury in pediatric trauma patients

Abstract Background Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate […]

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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 the Cochrane […]

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Progesterone for acute traumatic brain injury

Abstract Background Traumatic brain injury (TBI) is a leading cause of death and disability, and the identification of effective, inexpensive and widely practicable treatments for brain injury is of great public health importance worldwide. Progesterone is a naturally produced hormone that has well‐defined pharmacokinetics, is widely available, inexpensive, and has steroidal, neuroactive and neurosteroidal actions […]

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Surgical options for lumbar spinal stenosis

Abstract Background Hospital charges for lumbar spinal stenosis have increased significantly worldwide in recent times, with great variation in the costs and rates of different surgical procedures. There have also been significant increases in the rate of complex fusion and the use of spinal spacer implants compared to that of traditional decompression surgery, even though […]

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