Neurosurgery
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Randomized Controlled Trial Multicenter Study
High-dose simvastatin for aneurysmal subarachnoid hemorrhage: a multicenter, randomized, controlled, double-blind clinical trial protocol.
Experimental evidence has indicated the benefit of simvastatin in the treatment of subarachnoid hemorrhage. However, no clinical data are available to answer whether a high-dose regimen is more effective than a normal-dose regimen, even though the biochemical actions and related neuroprotective mechanisms are thought to be dose related. ⋯ In the present trial, we compare high-dose and normal-dose simvastatin; we know that another ongoing phase III multicenter trial (Simvastatin in Aneurysmal Subarachnoid Haemorrhage; http://www.stashtrial.com/home.html) is comparing normal-dose and no simvastatin. When the results are interpreted together, the research question of a possible beneficial effect of high-dose simvastatin in acute aneurysmal subarachnoid hemorrhage could be answered.
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Randomized Controlled Trial
A prospective study comparing single and double fascicular transfer to restore elbow flexion after brachial plexus injury.
The recovery of elbow flexion in upper brachial plexus injury can be achieved by the reinnervation of the biceps muscle (single reinnervation), but concomitant restoration of brachialis and biceps function (double reinnervation) has been recommended to improve elbow flexion strength. ⋯ The strength of elbow flexion did not differ significantly between the groups treated with single or double muscle reinnervation. Deterioration of handgrip, lateral pinch strength, and sensibility measured by using Semmes-Weinstein monofilaments, was temporary, resulting in low morbidity for both techniques.
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Randomized Controlled Trial
Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial.
Currently, the most common treatment for idiopathic normal pressure hydrocephalus (INPH) is a ventriculoperitoneal shunt (VPS), generally with programmable valve implantation. Endoscopic third ventriculostomy (ETV) is another treatment option, and it does not require prosthesis implantation. ⋯ Compared with ETV, VPS is a superior method because it had better functional neurological outcomes 12 months after surgery.
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Randomized Controlled Trial
Noninvasive language mapping in patients with epilepsy or brain tumors.
Functional magnetic resonance imaging (fMRI) has become part of routine brain mapping in patients with epilepsy or tumor undergoing resective surgery. However, robust localization of crucial functional areas is required. ⋯ The proposed fast fMRI language protocol reliably localized the most relevant language areas in individual subjects. It appears to be a valuable complementary tool for surgical planning of epileptogenic foci and of brain tumors.
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Randomized Controlled Trial
Autologous iliac bone graft with anterior plating is advantageous over the stand-alone cage for segmental lordosis in single-level cervical disc disease.
Anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft and plating has been a standard surgical method for single-level cervical disc disease. The stand-alone cage was introduced to reduce graft-related morbidity. However, problems due to focal kyphosis at the operated level have been on the rise. It has been difficult to derive a conclusive answer from previous studies for the indications of each method. ⋯ The stand-alone cage and autologous bone graft with plating had similar clinical outcomes, but stand-alone cage fusion may be disadvantageous from a radiological viewpoint.