Neurosurgery
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After a subarachnoid hemorrhage (SAH), the primary cause of mortality is secondary brain injury occurring within the first 48 hours after the initial bleeding. Because of the unknown pathophysiology of these early events, therapeutic approaches are scarce. Because mild hypothermia (33 degrees C) is among the strongest neuroprotectants known so far, the aim of this study was to investigate acute and delayed effects of hypothermia if applied after SAH. ⋯ The current results show that mild hypothermia (33 degrees C) exhibits sustained neuroprotection if applied up to 3 hours after SAH. Overall, mild hypothermia seems to be an effective neuroprotective strategy after SAH and should therefore be evaluated as a treatment option for SAH in patients.
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Comparative Study
Inaccuracy of the administrative database: comparative analysis of two databases for the diagnosis and treatment of intracranial aneurysms.
Administrative databases of hospital admissions are increasingly being used, mostly without validation, for epidemiological and clinical outcomes studies. Although it has been difficult to assess the true accuracy of administrative databases, we have identified an opportunity to directly compare the State of Maryland administrative database against a prospectively maintained departmental database at The Johns Hopkins Hospital. ⋯ We show that this representative administrative database is significantly flawed. Given the exponentially increasing number of research studies based on administrative databases, the pitfalls of research based solely on these need to be recognized. Strong criteria requiring accurate data validation are critical to justify the conclusions of these studies, regardless of their large numbers and complex statistics.