Magnetic resonance perfusion for differentiating low-grade from high-grade gliomas at first presentation
Abstract Background Gliomas are the most common primary brain tumour. They are graded using the WHO classification system, with Grade II-IV astrocytomas, oligodendrogliomas and oligoastrocytomas. Low-grade gliomas (LGGs) are WHO Grade II infiltrative brain tumours that typically appear solid and non-enhancing on magnetic resonance imaging (MRI) scans. People with LGG often have little or no […]
Intraoperative imaging technology to maximise extent of resection for glioma
Abstract Background Extent of resection is considered to be a prognostic factor in neuro-oncology. Intraoperative imaging technologies are designed to help achieve this goal. It is not clear whether any of these sometimes very expensive tools (or their combination) should be recommended as standard care for people with brain tumours. We set out to determine […]
Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults
Abstract Background Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. Objectives To assess the […]
Fitness training for cardiorespiratory conditioning after traumatic brain injury
Abstract Background Reduced cardiorespiratory fitness (cardiorespiratory deconditioning) is a common consequence of traumatic brain injury (TBI). Fitness training may be implemented to address this impairment. Objectives The primary objective of this updated review was to evaluate whether fitness training improves cardiorespiratory fitness in people who have sustained a TBI. The secondary objectives were to evaluate […]
Triage tools for detecting cervical spine injury in pediatric trauma patients
Abstract Background Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate […]
Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases
Abstract Background Historically, whole brain radiation therapy (WBRT) has been the main treatment for brain metastases. Stereotactic radiosurgery (SRS) delivers high‐dose focused radiation and is being increasingly utilized to treat brain metastases. The benefit of adding SRS to WBRT is unclear. This is an updated version of the original Cochrane Review published in Issue 9, […]
Biopsy versus resection for the management of low-grade gliomas
Abstract Background This is an updated version of the original Cochrane review published in 2013, Issue 4. Low‐grade gliomas (LGG) constitute a class of slow‐growing primary brain neoplasms. Patients with clinically and radiographically suspected LGG have two initial surgical options, biopsy or resection. Biopsy can provide a histological diagnosis with minimal risk but does not […]
Progesterone for acute traumatic brain injury
Abstract Background Traumatic brain injury (TBI) is a leading cause of death and disability, and the identification of effective, inexpensive and widely practicable treatments for brain injury is of great public health importance worldwide. Progesterone is a naturally produced hormone that has well‐defined pharmacokinetics, is widely available, inexpensive, and has steroidal, neuroactive and neurosteroidal actions […]
Surgical options for lumbar spinal stenosis
Abstract Background Hospital charges for lumbar spinal stenosis have increased significantly worldwide in recent times, with great variation in the costs and rates of different surgical procedures. There have also been significant increases in the rate of complex fusion and the use of spinal spacer implants compared to that of traditional decompression surgery, even though […]
Intravenous versus inhalational techniques for rapid emergence from anaesthesia in patients undergoing brain tumour surgery
Abstract Background Brain tumour surgery usually is carried out with the patient under general anaesthesia. Over past years, both intravenous and inhalational anaesthetic agents have been used, but the superiority of one agent over the other is a topic of ongoing debate. Early and rapid emergence from anaesthesia is desirable for most neurosurgical patients. With […]