World Neurosurg
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Review Meta Analysis
Meta-analysis of the efficacy and safety of therapeutic hypothermia in children with acute traumatic brain injury.
To evaluate the efficacy and safety of therapeutic hypothermia in children with acute traumatic brain injury (TBI). ⋯ No benefit of therapeutic hypothermia in children with TBI is shown in this study; therapeutic hypothermia may increase the risk of mortality and arrhythmia. There is no evidence that therapeutic hypothermia improves prognosis of children with TBI; there is also no evidence that therapeutic hypothermia increases the risk of pneumonia and coagulation dysfunction. These results are limited by the quality of the included studies and need to be considered with caution. Further large-scale, well-designed RCTs on this topic are needed.
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Comparative Study
Biomechanical comparison of cervical fixation via transarticular facet screws without rods versus lateral mass screws with rods.
Transarticular facet screws restore biomechanical stability to the cervical spine when posterior cervical anatomy has been compromised. This study compares the more recent, less invasive, and briefer transarticular facet screw system without rods with the lateral mass screw system with rods. ⋯ Transarticular facet screws without rods and lateral mass screws with rods had similar biomechanical stability in single-level insertions. For 2-level insertions, transarticular facet screws without rods are a valid option in cervical spine repair.
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Obsessive-compulsive disorder (OCD) is a psychiatric condition defined by the presence of obsessions, compulsions, or both. It has a lifetime prevalence of 2%-3% and causes significant impairment in social and work functioning, as well as a reduced quality of life. Treatment includes pharmacotherapy and psychotherapy, but a significant number of patients fail to respond to treatment. Deep brain stimulation has shown to be a safe and effective procedure for severe, chronic, treatment-resistant OCD, and several surgical targets have been proposed for treatment, including the nucleus accumbens, the anterior limb of the internal capsule, the subthalamic nucleus, the globus pallidus, and the bed nucleus of stria terminalis. ⋯ DBS of these 2 structures is a safe and effective procedure for the treatment of severe, refractory OCD.
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The cause precipitating intracranial aneurysm rupture remains unknown in many cases. It has been observed that aneurysm ruptures are clustered in time, but the trigger mechanism remains obscure. Because solar activity has been associated with cardiovascular mortality and morbidity, we decided to study its association to aneurysm rupture in the Swiss population. ⋯ We found greater radioflux, SESC sunspot number, and sunspot area to be associated with an increased count of aneurysm rupture. The clinical meaningfulness of this statistical association must be interpreted carefully and future studies are warranted to rule out a type-1 error.