Neurosurgery

Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery

Abstract Background Postoperative pain is a common consequence of surgery and can have deleterious effects. It has been suggested that the administration of opioid analgesia before a painful stimulus may improve pain control. This can be done in two ways. We defined ‘preventive opioids‘ as opioids administered before incision and continued postoperatively, and ‘pre‐emptive opioids‘ […]

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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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Endovascular coiling versus neurosurgical clipping for patients with aneurysmal subarachnoid haemorrhage

Abstract Background Around 30% of people who are admitted to hospital with aneurysmal subarachnoid haemorrhage (SAH) will rebleed in the initial month after the haemorrhage if the aneurysm is not treated. The two most commonly used methods to occlude the aneurysm for prevention of rebleeding are microsurgical clipping of the neck of the aneurysm and […]

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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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Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases

Abstract Background This is an update to the review published in the Cochrane Library (2012, Issue 4). It is estimated that 20% to 40% of people with cancer will develop brain metastases during the course of their illness. The burden of brain metastases impacts quality and length of survival. Objectives To assess the effectiveness and […]

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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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