Biopsy versus resection for high-grade glioma
Abstract Background This is an update of the original review published in the Cochrane Database of Systematic Reviews Issue 1, 2000 and updated in 2003, 2007 and 2010. People with a presumed high‐grade glioma (HGG) identified by clinical evaluation and radiological investigation have two initial surgical options: biopsy or resection. In certain situations, such as severe raised […]
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 […]
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, […]
Stem cell transplantation for ischemic stroke
Abstract Background Stroke is a leading cause of morbidity and mortality worldwide, with very large healthcare and social costs, and a strong demand for alternative therapeutic approaches. Preclinical studies have shown that stem cells transplanted into the brain can lead to functional improvement. However, to date, evidence for the benefits of stem cell transplantation in […]
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 […]
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‘ […]
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 […]
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 […]
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 […]
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 […]