Egyptian journal of neurosurgery最新文献_第9页

Recurrent artery of Heubner infarction: a complication after clipping of anterior communicating artery aneurysm Heubner梗死复发动脉:前交通动脉瘤夹闭后的并发症

Egyptian journal of neurosurgery Pub Date : 2023-11-09 DOI: 10.1186/s41984-023-00228-7

Oday Atallah, Yasser F. Almealawy, Omar Wawi, Ved Maurya, Md Moshiur Rahman, Amit Agrawal

{"title":"Recurrent artery of Heubner infarction: a complication after clipping of anterior communicating artery aneurysm","authors":"Oday Atallah, Yasser F. Almealawy, Omar Wawi, Ved Maurya, Md Moshiur Rahman, Amit Agrawal","doi":"10.1186/s41984-023-00228-7","DOIUrl":"https://doi.org/10.1186/s41984-023-00228-7","url":null,"abstract":"Abstract Recurrent artery of Heubner (RAH) infarction is a potential complication following the surgical clipping of anterior communicating artery (A-comm) aneurysms. RAH plays a crucial role in supplying blood to the basal ganglia and anterior limb of the internal capsule. Understanding the pathogenesis, prognosis, and surgical result of RAH infarction is critical for providing the best care for patients. The literature study produced case reports and retrospective research on topics including the RAH infarct and A-comm aneurysm clipping. The importance of recognizing and controlling the risk of a RAH infarction in relation to A-comm aneurysm clipping is emphasized in this research. RAH infarction following clipping of an A-comm aneurysm has a complex pathophysiology, and by learning more about its causes, prognosis, and surgical results, medical personnel may better assist their patients. While further study is needed to overcome the obstacles highlighted here, the information presented here lays the groundwork for future research and adds to what is already known about the topic.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135242545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical students’ perception toward neurosurgery as a career: a cross-sectional study 医学生对神经外科职业的看法:一项横断面研究

Egyptian journal of neurosurgery Pub Date : 2023-11-02 DOI: 10.1186/s41984-023-00227-8

Misbah Kaleem, Musaddiq Kaleem, Alishba Anwar, Sarah Anis, Yumna Zafar, Muhammad Tanveer Alam

{"title":"Medical students’ perception toward neurosurgery as a career: a cross-sectional study","authors":"Misbah Kaleem, Musaddiq Kaleem, Alishba Anwar, Sarah Anis, Yumna Zafar, Muhammad Tanveer Alam","doi":"10.1186/s41984-023-00227-8","DOIUrl":"https://doi.org/10.1186/s41984-023-00227-8","url":null,"abstract":"Abstract Background This study aims to access the perspective of medical students toward practicing neurosurgery after MBBS and also to identify factors responsible for low affinity among medical students in pursuing neurosurgery as a career. In this cross-sectional study, medical students were surveyed via pre-tested questionnaire, with a four-point Likert scale to determine their influence on student’s consideration of neurosurgery as a career. Data analysis was performed using SPSS software. Results The survey was completed by 185 students out of which 56.2% students considered neurosurgery as a career. Although more than 90% students acknowledged that neurosurgery training is too prolonged and it can also impede family life but huge prestige and income is attached to neurosurgery, 35.7% students shared that neurosurgery exposure and teaching is not adequate enough for them in order to have a positive influence toward neurosurgery as a career. Conclusion Additional studies are required to further explore how participation in a formal neurosurgery experience can alter medical students’ perceptions and influences their consideration of neurosurgery as career choice.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review and meta-analysis of Surpass flow diverter for the treatment of intracranial aneurysms 超流分流器治疗颅内动脉瘤的系统回顾和荟萃分析

Egyptian journal of neurosurgery Pub Date : 2023-11-02 DOI: 10.1186/s41984-023-00236-7

William A. Florez-Perdomo, Tariq Janjua, Luis Rafael Moscote-Salazar, Adesh Shrivastava, Sumit Raj, Amit Agrawal

{"title":"A systematic review and meta-analysis of Surpass flow diverter for the treatment of intracranial aneurysms","authors":"William A. Florez-Perdomo, Tariq Janjua, Luis Rafael Moscote-Salazar, Adesh Shrivastava, Sumit Raj, Amit Agrawal","doi":"10.1186/s41984-023-00236-7","DOIUrl":"https://doi.org/10.1186/s41984-023-00236-7","url":null,"abstract":"Abstract Objective Systematically review and analyze the published literature on the safety and efficacy of Surpass flow diverter in terms of mortality, functional outcome, complication rate, and aneurysm occlusion rate. Methods The literature was searched in PubMed, MEDLINE, Embase, and Scopus using the terms Surpass for the treatment of Intracranial aneurysms, Intracranial aneurysms, Complication with no constraints applied. Two review authors independently conducted the study selection. Two review authors independently extracted study data. Data were pooled using a random effect model, results were abstracted as odds ratios and 95% CI, and heterogeneity was reported as I 2 . Results Five studies were included, which involved retrospectively and prospectively collected data on 464 patients. The use of Surpass flow diverter was associated with a rate of occlusion of 73.4% (95% confidence interval [CI] 62.48–83.077%). Low rate of thromboembolic complication was 6.6% (95% CI 3.0–10.1%), the rate of hemorrhagic complication was 2.9% (95% CI 1.6–4.6%), and low vasospasm rate was 4.38% (95% confidence interval [CI] 1.8–7.7%). The mortality rate was 4.6% (95% CI 1.4–1.4%). An overall of good outcome was 86.6% (95% CI 75.9–94.5%), and poor outcome was 7.8% (95% CI 5.0–11.2%). Conclusions Based on the studies available in the literature, Surpass flow diverter offers high aneurysm occlusion rates with adequate safety and low rate of complications.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135934856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Traffic light alarming signs are indispensable prerequisites for fruitful endoscopic third ventriculostomy 交通灯警示标志是内镜下第三脑室造瘘术成功的必要前提

Egyptian journal of neurosurgery Pub Date : 2023-10-30 DOI: 10.1186/s41984-023-00225-w

Alhusain Nagm

{"title":"Traffic light alarming signs are indispensable prerequisites for fruitful endoscopic third ventriculostomy","authors":"Alhusain Nagm","doi":"10.1186/s41984-023-00225-w","DOIUrl":"https://doi.org/10.1186/s41984-023-00225-w","url":null,"abstract":"Abstract Background Endoscopic third ventriculostomy (ETV) is a satisfying neuro-endoscopic journey in candidates with preoperatively predicted higher success rates. Alarming cases require extra care to avoid serious complications, predict/identify failure and offer reasonable intra-/postoperative decisions. Purpose To create easily interpretable traffic light alarming signs to increase the awareness level for neurosurgeons regarding ETV difficulty/failure. Methods A 3-year-retrospective study of postoperative ETV infants of both sexes with obstructive hydrocephalus and preoperative ETV success score ≤ 70, age ≤ 12 months, and follow-up for ≥ 6 months with a postoperative radiological evaluation of the ETV patency and cerebrospinal fluid dynamics. The ETV difficulty scale (ETV-DS) was designed as an intraoperative monitor for surgical/anatomical difficulties. And the ETV failure threshold (ETV-FT) was offered for postoperative evaluation to identify cases that are mistakenly interpreted as failure. Results Among our 159 case series, 54 infants were involved. Patients’ demographics, age: ≤ 28 days, > 28 days to 6 months, and >6 to 12 months, were 5.5%, 70.3%, and 24.2%, respectively. Postoperatively, the outcome based on ETV-FT color scale was dark green (ETV-FT=0), light green (ETV-FT=1), yellow (ETV-FT=2), orange (ETV-FT=3), red (ETV-FT=4) in 29%, 14%, 20%, 10.3%, and 26.7%, respectively. Actual failure is identified as ETV-FT=4 based on clinical/radiological data. The failure rate was significantly attributed to inadequate communication with the basal cistern due to difficult/unsafe perforation of the thick/dense Liliequist membrane (87%) ( P = 0.001). Conclusion The traffic light alarming signs (ETV-DS and ETV-FT) can warn neurosurgeons to recognize critical cases that necessitate ultra-precautions to navigate safely through landmines for worthy outcomes.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Computer-guided cranioplasty using ultra-high molecular weight polyethylene patient-specific implants: a case series 使用超高分子量聚乙烯患者特异性植入物的计算机引导颅骨成形术:一个案例系列

Egyptian journal of neurosurgery Pub Date : 2023-10-25 DOI: 10.1186/s41984-023-00239-4

Mariam S. K. Abdelwahed, Mamdouh S. Ahmed, Ahmed S. Kamel Abdelwahed, Mohamed M. Aziz

{"title":"Computer-guided cranioplasty using ultra-high molecular weight polyethylene patient-specific implants: a case series","authors":"Mariam S. K. Abdelwahed, Mamdouh S. Ahmed, Ahmed S. Kamel Abdelwahed, Mohamed M. Aziz","doi":"10.1186/s41984-023-00239-4","DOIUrl":"https://doi.org/10.1186/s41984-023-00239-4","url":null,"abstract":"Abstract Introduction Cranioplasty is the surgical correction of a cranial defect. Three-dimensional software designs have allowed patient-specific single-step cranial reconstruction for neuroprotection and cosmesis. Ultra-high molecular weight polyethylene for partial or total bone replacement has been recently introduced as a promising material for cranioplasty. The objectives of this study are to evaluate the complications and esthetic results concerning the use of ultra-high molecular weight polyethylene patient-specific implants in craniectomy patients. Methods We report a series of nine patients with cranial defects from a previous craniectomy, or patients eligible for simultaneous craniectomy and cranioplasty via computer designed ultra-high molecular weight polyethylene patient-specific implants. We have analyzed the complications and cosmetic outcomes over a course of six months. Results None of the cases developed infection, extra/subdural hematoma, cerebrospinal fluid leak, or implant failure. Three cases had postoperative sequalae: The first patient had mild postoperative seroma which subsided after medical therapy and compression, the second showed wound breakdown due to tumor metastasis and recurrence but did not necessitate implant removal, while the third sequela was a subgaleal hematoma which was aspirated, and the patient healed uneventfully afterward. Esthetic results were highly satisfactory in 75% of the patients (good patient acceptance without touch-ups). Conclusion Ultra-high molecular weight polyethylene is in all respects suitable for primary and secondary cranioplasty, combined with computer-aided manufacturing–computer-aided design techniques, excellent esthetic and functional results were achieved. However, proper preoperative planning is important, and we recommend further prospective studies with larger number of patients followed up for longer periods for better assessment.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An arachnoid cyst rupture complicated with subdural hygroma in a middle-aged woman: a case report and review of the literature 中年妇女蛛网膜囊肿破裂并发硬膜下积液1例报告及文献复习

Egyptian journal of neurosurgery Pub Date : 2023-10-23 DOI: 10.1186/s41984-023-00224-x

Fakhreddin Sabooniha, Ghasem Baghershahi

{"title":"An arachnoid cyst rupture complicated with subdural hygroma in a middle-aged woman: a case report and review of the literature","authors":"Fakhreddin Sabooniha, Ghasem Baghershahi","doi":"10.1186/s41984-023-00224-x","DOIUrl":"https://doi.org/10.1186/s41984-023-00224-x","url":null,"abstract":"Abstract Background Arachnoid cysts (ACs) account for about 1% of all intracranial mass lesions. The Sylvian fissure is the most common site of ACs which are usually asymptomatic. Traumatic rupture of arachnoid cysts complicated with subdural hygroma is a relatively rare entity in adults especially in females. There is no consensus on their management and each case could add to previous experiences leading to more uniform therapeutic measurements. This case encompasses a combination of watchful strategy, limited surgery and ultimately successful cyst fenestration which highlights a good outcome without complications by adopting a stepwise procedure. Case presentation Here, the case of a 51-year-old Persian woman being presented with a 2-month history of a localized headache which had begun 4 days after a minor head trauma. Early brain computed tomography (CT) obtained in another center at 4th day of post-injury which misinterpreted as an old infarct. Repeated CT in our center revealed a large AC of Sylvian fissure complicated with subdural hygroma. Initially a conservative management pursued but due to worsening of the symptoms, a burr-hole craniotomy performed for hygroma evacuation that subsequently followed by cyst fenestration about 1-month later. Conclusion Previous awareness about radiographic characteristics of ACs as well as employing appropriate imaging modality are necessary for correct and timely diagnosis of symptomatic patients after minor head trauma because incidentally found ACs might be the underpinning causes of symptoms. Also, following a multistage therapeutic process along with the involvement of patients in decision-making are of paramount importance.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135366146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulsed radiofrequency in the management of lumbar radicular pain: initial experience 脉冲射频治疗腰神经根性疼痛:初步经验

Egyptian journal of neurosurgery Pub Date : 2023-10-16 DOI: 10.1186/s41984-023-00223-y

Hosam Eldin Abdel Azim Habib, Sameh Fathy Abdo, Ahmed Gabry El Nagar

引用次数: 0

Post-operative cerebrospinal fluid leak: single-continuous versus double-breasted dural repair of myelomeningocele 术后脑脊液泄漏:单排扣与双排扣硬脊膜修复脊髓脊膜膨出

Egyptian journal of neurosurgery Pub Date : 2023-10-16 DOI: 10.1186/s41984-023-00240-x

Usman Daibu, Aliyu Muhammad Koko, Babagana Usman

{"title":"Post-operative cerebrospinal fluid leak: single-continuous versus double-breasted dural repair of myelomeningocele","authors":"Usman Daibu, Aliyu Muhammad Koko, Babagana Usman","doi":"10.1186/s41984-023-00240-x","DOIUrl":"https://doi.org/10.1186/s41984-023-00240-x","url":null,"abstract":"Abstract Background Myelomeningocele is the most common neural tube defect in our environment. Initial surgical management involves untethering and water-tight dural closure. Single-continuous dural repair is more straightforward and faster than the double-breasted repair, even though the latter offers more strength to the reconstructed dura as the repair is in two layers. Preference was given to single-continuous repair even though the two techniques were not compared in terms of post-operative cerebrospinal fluid leak. The aim of this study was to compare the frequency of cerebrospinal fluid (CSF) leak following single-continuous versus double-breasted dural repair of myelomeningocele. Patients and methods This was a randomized prospective study that reviewed all patients that presented to Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria, with myelomeningocele who met the inclusion criteria. Fifty-four patients were enrolled into the study randomized into two groups of 27 patients each. Group 1 had single-continuous repair, while group 2 had double-breasted technique. Post-operatively, patients were assessed for post-operative cerebrospinal fluid leak and pseudomeningocele. Data collected were analysed using the statistical package for social sciences version 22.0. The value for significance was set at 0.05. Results The median age at presentation for both groups was 5 months. Both groups showed female preponderance with a female-to-male ratio of 1.3:1 and 1.7:1. Post-operative CSF leak occurred in 2(7.4%) patients in the single-continuous group compared to 3(11.1%) patients in the double-breasted group. Only 1(3.7%) patient in the single-continuous group developed pseudomeningocele and none in the double-breasted. Conclusion Dural repair technique of myelomeningocele does not influence the occurrence of post-operative cerebrospinal fluid leak.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136114218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical profile, histopathological, immunohistochemical, and molecular analyses and treatment of pilocytic astrocytoma: an eight year study from a tertiary health care centre in North East India 毛细胞星形细胞瘤的临床概况、组织病理学、免疫组织化学和分子分析和治疗:一项来自印度东北部三级卫生保健中心的8年研究

Egyptian journal of neurosurgery Pub Date : 2023-10-09 DOI: 10.1186/s41984-023-00222-z

Shabnam Akhtar Ahmed, Navanil Barua, Nabajyoti Borah, Inamul Haque, Ananya Barman, Iman Dandapath

{"title":"Clinical profile, histopathological, immunohistochemical, and molecular analyses and treatment of pilocytic astrocytoma: an eight year study from a tertiary health care centre in North East India","authors":"Shabnam Akhtar Ahmed, Navanil Barua, Nabajyoti Borah, Inamul Haque, Ananya Barman, Iman Dandapath","doi":"10.1186/s41984-023-00222-z","DOIUrl":"https://doi.org/10.1186/s41984-023-00222-z","url":null,"abstract":"Abstract Background Pilocytic astrocytoma (PA) is a central nervous system (CNS) World Health Organization (WHO) grade 1 glial tumor that is highly prevalent in children and young adults. The main aim of the study was to assess the frequency, clinicopathological features, and treatment of PAs along with their immunohistochemical and molecular analyses in patients from Northeast India. About 144 glial tumors were diagnosed in patients from 3 to 75 yrs of age from January 2015 to March 2022. Nine pediatric PA patients were identified and their clinical data were analyzed. Immunohistochemistry (IHC), fluorescence in-situ hybridization (FISH), and molecular analysis using the real-time polymerase chain reaction (RT-PCR) were performed. Data analysis was performed using the SPSS software. Results The mean age of the glioma patients was 41.7 yrs ± 18.2 with a male/female ratio of 1.3:1. The most common form of the glial tumor was found to be astrocytoma CNS WHO grade 2 (31.9%). The frequency of PA CNS WHO grade 1 was 6.9%. The pediatric PA cohort had a mean age of 9.2 yrs ± 4.9 with a male/female ratio of 2:1. Glial fibrillary acidic protein (GFAP) positive immunostaining and retention of transcriptional regulator alpha-thalassemia mental retardation X-linked protein (ATRX) expression was seen in all the tested PAs. The KIAA1459-BRAF fusion was detected in four PAs. Surgical intervention with total or radical tumor excision was performed for the PA patients. Eight PA patients exhibited improved condition post-surgery. Conclusion With the advent of healthcare and newer diagnostic facilities there is an increased incidence of glial tumors in developing countries. A combination of histological, immunohistochemical, and molecular analysis is very important for the diagnosis, accurate treatment, and prognosis of PA patients.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135095311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of hypertonic saline and mannitol in patients with traumatic brain injury and cerebral edema: a systematic review and meta-analysis 高渗盐水和甘露醇治疗外伤性脑损伤和脑水肿的疗效:一项系统回顾和荟萃分析

Egyptian journal of neurosurgery Pub Date : 2023-10-02 DOI: 10.1186/s41984-023-00233-w

Umer Iqbal, Aashish Kumar, Syed Ali Arsal, Muhammad Ashir Shafique, Shafin Bin Amin, Adarsh Raja, Rabbia Aqeel, Sameeka Waqas

{"title":"Efficacy of hypertonic saline and mannitol in patients with traumatic brain injury and cerebral edema: a systematic review and meta-analysis","authors":"Umer Iqbal, Aashish Kumar, Syed Ali Arsal, Muhammad Ashir Shafique, Shafin Bin Amin, Adarsh Raja, Rabbia Aqeel, Sameeka Waqas","doi":"10.1186/s41984-023-00233-w","DOIUrl":"https://doi.org/10.1186/s41984-023-00233-w","url":null,"abstract":"Abstract Background Traumatic brain injury has a crippling impact on sufferers’ quality of life, and numerous therapy techniques are being researched to address this problem. In this study, we compared the superiority of HS against mannitol as one such element of treating TBI patients. Objective To compare the efficacy of hypertonic saline and mannitol and demonstrate superiority of one group over the other. Method Our meta-analysis included only randomized controlled trials that compared the efficacy of mannitol and hypertonic saline in the treatment of traumatic brain injury. The literature search was done using a variety of databases, like Google Scholar, PubMed, and the Cochrane Library. From each of the included RCTs, accurate data extraction, bias risk assessment, and statistical analysis were carried out. Result There are 748 patients among the 15 RCTs. Our primary outcomes are mortality and functional outcomes, and our secondary outcomes include treatment failure, osmolality, intracerebral pressure (ICP), cerebral perfusion pressure (CPP), serum sodium (Na), partial pressure of oxygen in brain tissue (PBTO2), duration of elevated ICP, mean arterial pressure, hematocrit level, and central venous pressure. The comparison showed non-significant results for mortality (RR = 0.73, 95% CI 0.49–1.08; p = 0.12) and functional outcome (RR = 1.15, 95% CI = 0.74–1.80; p = 0.53). HS is linked to higher Na levels (RR = 4.55, 95% CI 1.34–7.76, P = 0.005, I2 = 96%). Despite performing a sensitivity analysis due to the heterogeneities in our various outcomes, the findings were still unreliable. Conclusion Our study revealed inconsequential trends for HS and mannitol, and no conclusion was made. We believe the two medications to be equally effective, but there is still opportunity for improvement as more studies are carried out. Eventually, a conclusive decision can be reached in the future.","PeriodicalId":72881,"journal":{"name":"Egyptian journal of neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135790320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1