World Neurosurg
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Review Meta Analysis
Cell salvage used in scoliosis surgery: is it really effective?
Scoliosis surgery usually is associated with large volume of intraoperative blood loss, and cell salvage is used commonly to filter and retranfusion autologous blood to patients. The efficacy of using cell salvage in scoliosis surgery, however, is still controversial. ⋯ Cell salvage significantly reduced the volumes of perioperative and postoperative allogenic RBC transfusion in scoliosis surgery and increased the hemoglobin and hematocrit levels on the first day postoperatively. In addition, it seemed not to increase the rate of transfusion complications during the surgery.
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Review Meta Analysis Comparative Study
Craniotomy versus decompressive craniectomy for acute subdural hematoma: systematic review and meta-analysis.
Acute subdural hematoma (SDH) is a major cause of morbidity after severe traumatic brain injury. Surgical evacuation of the hematoma, either via craniotomy or craniectomy, is the mainstay of treatment in patients with progressive neurologic deficits or significant mass effect. However, the decision to perform either procedure remains controversial. ⋯ The safety and efficacy of craniotomy versus decompressive craniectomy in treatment of acute SDH remain controversial. In this study, craniectomy was associated with worse clinical presentation and postoperative outcome compared with craniotomy. However, craniectomy was associated with lower rate of residual SDH after treatment.
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Review Meta Analysis Comparative Study
Endoscopic endonasal versus microscopic transsphenoidal surgery for recurrent and/or residual pituitary adenomas.
Surgery for recurrent/residual pituitary adenomas is increasingly being performed through endoscopic surgery. Whether this new technology has altered the indications and outcomes of surgery is unknown. We conducted a systematic review and meta-analysis of published studies to compare the indications and outcomes between microscopic and endoscopic approaches. ⋯ This meta-analysis indicates that the use of the endoscope to reoperate on residual or recurrent adenomas has only led to modest increases in resection rates. However, larger more complex cases are being tackled, so direct comparisons are misleading. The most dramatic change has been in visual improvement along with modest increases in risk. Reoperation for recurrent or residual adenomas is a safe and effective treatment option.
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Review Meta Analysis
Cholesterol-reducing agents for treatment of aneurysmal subarachnoid haemorrhage: systematic review and meta-analyses of randomized controlled trials.
Aneurysmal hemorrhage induced cerebral vasospasm; delayed ischemic neurologic deficit (DIND), poor neurologic outcome, and mortality are major causes of mortality and morbidity. The effects of cholesterol-lowering agents in these patients remain controversial. This up-to-date systematic review and meta-analysis aimed to evaluate the efficacy of statin use in patients with aneurysmal subarachnoid hemorrhage. ⋯ The outcome of this meta-analysis showed that use of statins in aneurysmal subarachnoid hemorrhage might have the potential to decrease occurrence of vasospasm and DIND. However, there was no benefit in the reduction of mortality and poor neurologic outcome. This is a call for further research.
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Review Case Reports
Recurrent abortion and tethered cord syndrome due to anterior sacral meningocele: a report of rare case with review of literature.
Anterior sacral meningocele is a rare congenital anomaly. ⋯ The various radiologic features, associations such as presacral dermoid as a part of incomplete Currarino syndrome, and the management options available are also discussed.