Surgery

Mannitol versus hypertonic saline for brain relaxation in patients undergoing craniotomy

Abstract Background Patients with brain tumour usually suffer from increased pressure in the skull due to swelling of brain tissue. A swollen brain renders surgical removal of the brain tumour difficult. To ease surgical tumour removal, measures are taken to reduce brain swelling, often referred to as brain relaxation. Brain relaxation can be achieved with […]

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Flow-regulated versus differential pressure-regulated shunt valves for adult patients with normal pressure hydrocephalus

Abstract Background Since 1965 many ventriculo-peritoneal shunt systems have been inserted worldwide to treat hydrocephalus. The most frequent indication in adults is normal pressure hydrocephalus (NPH), a condition that can be difficult to diagnose precisely. Surgical intervention with flow-regulated and differential pressure-regulated ventriculo-peritoneal shunts remains controversial. Knowledge about the benefits and harms of these interventions […]

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Surgical resection and whole brain radiation therapy versus whole brain radiation therapy alone for single brain metastases

Abstract Background The treatment of brain metastasis is generally palliative since most patients have uncontrollable systemic cancer. Historically, whole brain radiation therapy (WBRT) has been the treatment of choice, although more recently focused radiation therapy e.g. stereotactic radiosurgery (SRS) has developed a role in selected patients. In certain circumstances, such as single brain metastasis, death […]

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Surgery versus radiosurgery for patients with a solitary brain metastasis from non-small cell lung cancer

Abstract Background Non-small cell lung cancer is one of the leading causes of death in developed countries. Brain metastases are often seen in non-small cell lung cancer patients and although they are frequently multiple, a subset of patients with a solitary brain metastasis is regularly seen. Treatment of solitary brain metastasis has been surgery, when […]

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Shunting for normal pressure hydrocephalus (NPH)

Abstract Background Since the condition was first described in 1965, the syndrome of normal pressure hydrocephalus (NPH) has conventionally been managed by placement of a cerebrospinal fluid (CSF) shunt. Objectives To determine the effectiveness of shunting procedures in promoting stability or improvement in the neurological symptoms and signs of NPH. Search methods The Specialized Register […]

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Angioplasty for intracranial artery stenosis

Abstract Background Intracranial artery stenosis causes up to 10% of all ischaemic strokes. The rate of recurrent vascular ischaemic events is very high. Angioplasty with or without stent placement is a feasible procedure to dilate the vessel affected. However, its safety and efficacy have not been systematically studied. Objectives To determine the efficacy and safety […]

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Eversion versus conventional carotid endarterectomy for preventing stroke

Abstract Background Carotid endarterectomy (CEA) is conventionally undertaken by a longitudinal arteriotomy. Eversion CEA, which employs a transverse arteriotomy and reimplantation of the carotid artery, is reported to be associated with low perioperative stroke and restenosis rates but an increased risk of complications associated with a distal intimal flap. Objectives To determine whether eversion CEA […]

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