External drains versus no drains after burr-hole evacuation for the treatment of chronic subdural haematoma in adults
Abstract Background Chronic subdural haematoma (CSDH) is one of the most common types of intracranial haematoma, and often occurs in older people. Burr-hole craniostomy, which is an evacuation through one or two burr holes drilled over the site of the haematoma, has been widely accepted as the most effective way to manage CSDH. Recurrences are […]
Rapamycin and rapalogs for tuberous sclerosis complex
Abstract Background Previous studies have shown potential benefits of rapamycin or rapalogs for treating people with tuberous sclerosis complex. Although everolimus (a rapalog) is currently approved by the FDA (U.S. Food and Drug Administration) and the EMA (European Medicines Agency) for tuberous sclerosis complex-associated renal angiomyolipoma and subependymal giant cell astrocytoma, applications for other manifestations […]
Intraoperative mild hypothermia for postoperative neurological deficits in intracranial aneurysm patients
Abstract Background Rupture of an intracranial aneurysm causes aneurysmal subarachnoid haemorrhage, which is one of the most devastating clinical conditions. It can be classified into five Grades using the Hunt-Hess or World Federation of Neurological Surgeons (WFNS) scale. Grades 4 and 5 predict poor prognosis and are known as ‘poor grade’, while grade 1, 2, […]
Surgical versus non-surgical treatment for lumbar spinal stenosis
Abstract Background Lumbar spinal stenosis (LSS) is a debilitating condition associated with degeneration of the spine with aging. Objectives To evaluate the effectiveness of different types of surgery compared with different types of non-surgical interventions in adults with symptomatic LSS. Primary outcomes included quality of life, disability, function and pain. Also, to consider complication rates […]
Routine intracranial pressure monitoring in acute coma
Abstract Background We know that the brain damage resulting from traumatic and other insults is not due solely to the direct consequences of the primary injury. A significant and potentially preventable contribution to the overall morbidity arises from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) prevents adequate cerebral perfusion with well-oxygenated […]
Interventions for the treatment of metastatic extradural spinal cord compression in adults
Abstract Background Metastatic extradural spinal cord compression (MESCC) is treated with radiotherapy, corticosteroids, and surgery, but there is uncertainty regarding their comparative effects. This is an updated version of the original Cochrane review published in theCochrane Database of Systematic Reviews (Issue 4, 2008). Objectives To determine the efficacy and safety of radiotherapy, surgery and corticosteroids […]
Interventions for idiopathic intracranial hypertension
Abstract Background Idiopathic intracranial hypertension (IIH) has an estimated incidence of one to three people per 100,000 people per year, and occurs most commonly in obese, young women. IIH is associated with severe morbidity, notably due to a significant threat to sight and severe headache. Several different management options have been proposed. Conservative measures centre […]
Endoscopic third ventriculostomy (ETV) for idiopathic normal pressure hydrocephalus (iNPH)
Abstract Background Idiopathic normal pressure hydrocephalus (iNPH) is a type of communicating hydrocephalus also known as non-obstructive hydrocephalus. This type of hydrocephalus is caused by impaired cerebrospinal fluid reabsorption without any obstruction in the ventricular system and is associated with normal cerebrospinal fluid pressure. It is characterised clinically by gait disturbance, cognitive dysfunction, and urinary […]
Prothrombin complex concentrate for reversal of vitamin K antagonist treatment in bleeding and non-bleeding patients
Abstract Background Treatment with vitamin K antagonists is associated with increased morbidity and mortality. Reversal therapy with prothrombin complex concentrate (PCC) is used increasingly and is recommended in the treatment of patients with bleeding complications undertaking surgical interventions, as well as patients at high risk of bleeding. Evidence is lacking regarding indication, dosing, efficacy and […]
Antifibrinolytic drugs for acute traumatic injury
Abstract Background Uncontrolled bleeding is an important cause of death in trauma victims. Antifibrinolytic treatment has been shown to reduce blood loss following surgery and may also be effective in reducing blood loss following trauma. Objectives To assess the effect of antifibrinolytic drugs in patients with acute traumatic injury. Search methods We ran the most […]