Journal of neurosurgery
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Journal of neurosurgery · Oct 2012
Editorial CommentEditorial: traumatic brain injury and brainstem.
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Journal of neurosurgery · Oct 2012
ReviewThe role of decompressive craniectomy in cerebral venous sinus thrombosis.
Studies on the role of decompressive craniectomy for cerebral venous sinus thrombosis (CVST) in the literature are scanty. Randomized trials face a lot of drawbacks, including ethical issues. In this article the authors discuss their experience with this procedure for CVST and review the available literature. ⋯ Decompressive craniectomy in a selected cohort of patients had a good outcome in a majority of the patients: 26 of 34 in this study had a GOS score of 4 or 5. In this series, which is the largest in the available literature, the authors review their experience and recommend usage of this procedure in selected patients.
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Journal of neurosurgery · Oct 2012
ReviewDecompressive hemicraniectomy for malignant middle cerebral artery territory infarction: is life worth living?
Although decompressive hemicraniectomy has been shown to reduce death and improve functional outcome following malignant middle cerebral artery territory infarction, there is ongoing debate as to whether surgery should be routinely performed, considering the very high rates of disability and functional dependence in survivors. Through a systematic review of the literature, the authors sought to determine the outcome from a patient's perspective. ⋯ Despite high rates of physical disability and depression, the vast majority of patients are satisfied with life and do not regret having undergone surgery.
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Journal of neurosurgery · Oct 2012
Comparative StudyEffects of carotid artery stenosis treatment on blood pressure.
The purpose of this study was to evaluate and compare the long-term effects of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on blood pressure (BP). ⋯ Both CEA and CAS have BP-lowering effects. Carotid artery stenting seems to have a better effect than CEA on BP at the 1-year follow-up.
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Journal of neurosurgery · Oct 2012
Comparative StudyIncreased mortality in patients with severe traumatic brain injury treated without intracranial pressure monitoring.
Evidence-based guidelines recommend intracranial pressure (ICP) monitoring for patients with severe traumatic brain injury (TBI), but there is limited evidence that monitoring and treating intracranial hypertension reduces mortality. This study uses a large, prospectively collected database to examine the effect on 2-week mortality of ICP reduction therapies administered to patients with severe TBI treated either with or without an ICP monitor. ⋯ In patients with severe TBI treated for intracranial hypertension, the use of an ICP monitor is associated with significantly lower mortality when compared with patients treated without an ICP monitor. Based on these findings, the authors conclude that ICP-directed therapy in patients with severe TBI should be guided by ICP monitoring.