Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jan 2016
Review Meta Analysis Comparative StudyLaparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: A systematic review and meta-analysis.
Ventriculoperitoneal shunt (VPS) surgery is the most commonly used method for the treatment of hydrocephalus. Traditionally, distal catheters in the VPS surgery have been placed either through a standard small open laparotomy or via a laparoscopic technique. Although there are many studies demonstrating the benefits of a minimally invasive approach, limited research has directly compared the two techniques used in VPS surgery. ⋯ There was no difference between the laparotomic and laparoscopic approaches in the length of hospital stay, complication rate, proximal shunt failure or infection rate. The present systematic review and meta-analysis demonstrated that the laparoscopic technique in VPS surgery is associated with reduced shunt failure and abdominal malposition compared to the open laparotomy technique, with no significant difference in rates of infection or other complications. The lack of studies with high levels of evidence may contribute to bias in our conclusions and the long-term relative merits require validation by further prospective, randomized studies.
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Clin Neurol Neurosurg · Jan 2016
Difference in white matter microstructure in differential diagnosis of normal pressure hydrocephalus and Alzheimer's disease.
Alzheimer's disease (AD) and normal pressure hydrocephalus (NPH) are both associated with cognitive decline and ventriculomegaly. While promising approach in differentiating between the two diseases, only a few diffusion tensor imaging (DTI) studies compared directly NPH and AD patients. The current study compares global whitematter (WM) alterations in AD and NPH addressing some of the methodological issues of previous studies. ⋯ Our analysis identified a pattern of WM diffusion alterations that can differentiate NPH patients from controls and AD patients.
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Clin Neurol Neurosurg · Jan 2016
Use of anti-platelet agents after traumatic intracranial hemorrhage.
To evaluate the risk of hemorrhagic complications associated with starting anti-platelet therapy (APT) after acute traumatic intracranial hemorrhage (tICH) and to examine the frequency of thrombotic complications. ⋯ The risk of immediate and delayed intracranial hemorrhages from initiating APT after tICH must be weighed against the morbidity of delaying indicated thrombotic prophylaxis. Our initial data indicates that hemorrhagic complications are infrequent, and thrombotic complications can have significant clinical consequences. Our retrospective review provides the first rates of complications for this patient population.
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Clin Neurol Neurosurg · Jan 2016
Posterior distraction reduction and occipitocervical fixation for the treatment of basilar invagination and atlantoaxial dislocation.
To introduce a novel distraction technique for the treatment of basilar invagination (BI) and atlantoaxial dislocation (AAD) via a posterior-only approach. ⋯ This novel distraction technique may provide satisfactory reduction via a posterior-only approach without exposure of the C1/2 facet joint. Therefore, it is a safe and effective method for the treatment of BI with AAD.
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Clin Neurol Neurosurg · Jan 2016
Surgical complications following malignant brain tumor surgery: An analysis of 2002-2011 data.
To estimate the incidence of surgical complications and associated in-hospital morbidity and mortality following surgery for malignant brain tumors. ⋯ In this study of an administrative database, patients undergoing surgery for a malignant brain tumor who suffered from a surgical complication had significantly longer lengths of stay, total hospital charges, and complication rates. Having a surgical complication was also an independent risk factor for in-hospital mortality. Nonetheless, it is unclear whether all surgical complications were clinically relevant, and further research is encouraged.