Abstract:
BACKGROUND:Therapeutic hypothermia (TH) offers cerebral protection following ischemic stroke and may improve outcomes in conjunction with decompressive hemicraniectomy (DHC). We aimed to assess the effectiveness of TH in patients with malignant ischemic stroke and DHC. METHODS:We performed a meta-analysis in patients with malignant ischemic stroke undergoing DHC comparing TH versus normothermia in studies published up to August 2019. Included studies had ≥10 adults with acute ischemic stroke. Primary outcome was functional independence, and secondary outcomes included complications. Effect size was pooled and described by relative risk (RR) ratios and 95% confidence intervals (CIs). RESULTS:Five studies (n = 269 patients; n = 130 TH, n = 139 controls) were included, 4 of which were prospective (n = 2 randomized controlled trials). Median achieved body temperature of TH was 33.6°C (range 33°C-35°C). Median modified Rankin Scale at the study completion was similar between TH and controls (RR 1.08, 95% CI 0.56-2.07, P = 0.8). Three studies reported individual patient modified Rankin Scale outcomes demonstrated a shift toward worse outcomes with TH (unadjusted common odds ratio 1.74; 95% CI 1.05-2.88, P = 0.01). Overall complications were similar between groups (RR 1.20, 95% CI 0.70-2.05, random effects P = 0.5). A suggestion of higher mortality was seen in TH (RR 1.50, 95% CI 0.97-2.32, P = 0.07). CONCLUSIONS:Clinical and functional outcomes were not overall different between patients undergoing systemic TH and controls following DHC despite the shift toward worse outcomes with TH observed in some studies.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Kuczynski AM,Ospel JM,Demchuk AM,Goyal M,Mitha AP,Almekhlafi MAdoi
10.1016/j.wneu.2020.05.277subject
Has Abstractpub_date
2020-09-01 00:00:00pages
e677-e685eissn
1878-8750issn
1878-8769pii
S1878-8750(20)31256-0journal_volume
141pub_type
杂志文章,meta分析abstract:OBJECTIVE:Flow diversion has emerged as a promising strategy for management of intracranial aneurysms. The purpose of this study was to determine whether treatment of large and giant aneurysms with the pipeline embolization device (PED) is more economical than traditional embolization strategies. METHODS:We identified...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.02.089
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Symptomatic cerebral vasospasm may occur in the setting of aneurysmal subarachnoid hemorrhage, traumatic brain injury, or after anterior skull base surgery, but its occurrence is extremely rare in the background of glioma surgical resection. CASE DESCRIPTION:We present a rare case of symptomatic diffuse vas...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.08.239
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:The effect of frailty on outcomes after angiogram-negative subarachnoid hemorrhages (ANSAH) is currently unknown. We investigated frailty's effects on ANSAH outcomes, including mortality and in-hospital complications. METHODS:Patients from 2014 to 2018 with non-traumatic subarachnoid hemorrhage and cerebral...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.003
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To correlate the presence of objectively measured wall enhancement on high-resolution vessel wall imaging (HR-VWI) with the clinical predictive scales PHASES, ELAPSS, and UIATS. METHODS:Patients with unruptured intracranial aneurysm (UIAs) prospectively underwent HR-VWI on a 3-T magnetic resonance imaging sc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.123
更新日期:2020-12-31 00:00:00
abstract:BACKGROUND:Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain. METHODS:This study aimed to investigate the occurrence and course of psychological sequelae following awake craniotomy (AC) for brain tumors in a series of 20 patients using a broad, validated psych...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.156
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVES:Temporary placement of an internal distraction rod is one of the surgical options in the treatment of severe scoliosis to avoid preoperative halo traction or vertebral column resection. This technique can be applied in a single session or staged. The aim of our study was to report the outcomes of less-invasi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.183
更新日期:2020-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.053
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To analyze a consecutive series of patients with middle cerebral artery (MCA) aneurysms who needed an adjunctive cerebral revascularization procedure to achieve aneurysm occlusion with preservation of flow through all MCA branches. METHODS:A total of 42 patients with 43 MCA aneurysms underwent 52 bypass proc...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.059
更新日期:2019-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.207
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Older patients are increasingly presenting for surgery with intracranial meningioma because of progress with diagnostic imaging and longer life expectancy. However, older patients have many problems, such as comorbidities and reduced physiological capacity reflected in the frailty index. This study examines ...
journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2018-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.128
更新日期:2021-01-04 00:00:00
abstract:BACKGROUND:Meningocele manqué (MM) is characterized by tethering of the spinal cord, nerve roots, or filum terminale by fibrous attachments formed by atrophic or incomplete meningoceles. Patients with MM can present with symptoms of tethered cord syndrome (TCS). CASE DESCRIPTION:We present the case of an MM discovered...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.016
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformations; they frequently cause progressive myelopathy including gait disturbances and sensory disorders. CASE DESCRIPTION:We report a rare case of a middle-aged man who experienced right-sided chest pain and ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.03.138
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Stereotactic biopsy is an everyday procedure implemented in numerous neurosurgical departments. The procedure is performed to obtain tumor tissue of unclear diagnosis. Going in hand with low complication rates and high diagnostic yield, stereotactic biopsies can be performed in adults and children likewise fo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.03.059
更新日期:2017-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.138
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Microvascular anastomosis is an essential procedure in neurosurgery, but the opportunity to perform the surgery has gradually decreased for neurosurgeons. Therefore, training is necessary for obtaining and maintaining the skills required for the procedure. We describe the detailed anatomy of cervical and fem...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.071
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Every aspect of the medical field has been heavily affected by the coronavirus disease 2019 (COVID-19) pandemic, and neurosurgical services are no exception. Several departments have reported their experiences and protocols to provide insights for others impacted. The goals of this study are to report the lo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.083
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Multiple biopsy samples are warranted for the histomolecular diagnosis of diffuse gliomas in the current molecular era, which possibly increases morbidity. OBJECTIVE:We assessed diagnostic yield, safety, and risk factors of postoperative morbidity after robot-assisted serial stereotactic biopsy sampling alo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.127
更新日期:2021-01-04 00:00:00
abstract:BACKGROUND:Novel audiovisual feedback methods were developed to improve image guidance during skull base surgery by providing audiovisual warnings when the drill tip enters a protective perimeter set at a distance around anatomic structures ("distance control") and visualizing bone drilling ("virtual drilling"). OBJEC...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.142
更新日期:2018-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.070
更新日期:2019-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.082
更新日期:2019-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.01.017
更新日期:2019-01-21 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.027
更新日期:2016-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.wneu.2019.01.066
更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.106
更新日期:2019-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wneu.2019.02.102
更新日期:2019-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.150
更新日期:2021-01-05 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.167
更新日期:2020-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.002
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The angioarchitecture and presentation of arteriovenous malformations (AVMs) associated with AVM hemorrhage may vary with patient age. Our aim was to determine the influence of patient age at diagnosis on hemorrhage patterns and outcomes. METHODS:A consecutive case series of 267 cases of ruptured AVMs was r...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.020
更新日期:2015-10-01 00:00:00