Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Mar 2017
Review Meta AnalysisCalcitonin gene-related peptide monoclonal antibody for preventive treatment of episodic migraine: A meta analysis.
Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) have shown promise in the preventive treatment of migraine. Therefore, we performed a meta-analysis to evaluate the efficacy and safety of CGRP mAbs for preventive treatment of migraine. Database including Ovid-SP, Cochrane Library, Pubmed and Web of Science (ISI) were systematically searched up to April 2, 2016 for randomized controlled trials(RCTs) which were dealing with the efficacy and safety of CGRP mAbs for preventive treatment of episodic migraine. ⋯ And CGRP mAbs improved the decrease of monthly migraine days from baseline to week 9-12, no matter in single dose subgroup (WMD=1.83, 95%CI=[0.06,3.60], I2=69%,P=0.04) or in multiple doses subgroup (WMD=1.77, 95%CI=[0.40,3.14], I2=61%,P=0.01). And there were no difference in incidence of adverse events between CGRP mAb group and placebo group. In conclusion, CGRP mAbs was a safety and effective preventive treatment for episodic migraine.
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Clin Neurol Neurosurg · Mar 2017
Which one is more effective for analgesia in infratentorial craniotomy? The scalp block or local anesthetic infiltration.
The most painful stages of craniotomy are the placement of the pin head holder and the skin incision. The primary aim of the present study is to compare the effects of the scalp block and the local anesthetic infiltration with bupivacaine 0.5% on the hemodynamic response during the pin head holder application and the skin incision in infratentorial craniotomies. The secondary aims are the effects on pain scores and morphine consumption during the postoperative 24h. ⋯ The scalp block may provide better analgesia in infratentorial craniotomies than local anesthetic infiltration.
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Clin Neurol Neurosurg · Mar 2017
Analysis the causes of radiosurgical failure in intracranial meningiomas treated with radiosurgery.
Surgical resection is a primary indication for intracranial meningioma. Radiosurgery is also an excellent treatment modality for postoperative residual tumors, or tumors in high-risk locations, such as the skull base. Despite multimodality treatments, there are some cases in which radiosurgery fails and surgical resection or re-radiosurgery is required. However, there has not been a comprehensive study focusing on the causes of secondary treatment for local recurrence or a new mass that develops outside the target area after radiosurgery. Hence, we analyzed the causes of radiosurgical failure in patients with meningioma. ⋯ We analyzed the causes of radiosurgical failure in meningioma patients and observed that microsurgery before radiosurgery was significantly associated with a high local recurrence rate compared with primary radiosurgery. Furthermore, the percentage of local recurrence cases that required secondary radiosurgery was as low as 2.98%. This result is comparable with that of microsurgical resection, which is the mainstay of treatment for meningioma.