Research Article
Efficacy and Safety of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunting for the Treatment of Hydrocephalus: A Meta-Analysis
Issue:
Volume 8, Issue 2, June 2024
Pages:
19-25
Received:
29 March 2024
Accepted:
13 April 2024
Published:
28 April 2024
DOI:
10.11648/j.cnn.20240802.11
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Abstract: Introduction: Hydrocephalus, characterized by abnormal cerebrospinal fluid (CSF) accumulation, presents significant challenges requiring timely intervention to prevent neurological complications. Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) are primary surgical options, yet their relative efficacy and safety remain debated. This meta-analysis aims to compare ETV and VPS for hydrocephalus treatment, providing evidence-based insights to guide clinical decision-making. Objectives: To compare the efficacy of ETV and VPS in achieving symptom relief and radiological resolution of hydrocephalus. To evaluate the safety profiles of ETV and VPS by assessing perioperative and postoperative complication rates. To examine long-term outcomes following ETV or VPS placement. To conduct subgroup analyses based on patient characteristics influencing treatment effectiveness and safety. Methods: A comprehensive literature search was conducted in PubMed and Scopus databases to identify relevant studies comparing ETV and VPS for hydrocephalus treatment. Inclusion criteria encompassed comparative studies reporting efficacy and safety outcomes in pediatric and adult populations. Data extraction and quality assessment were performed using standardized protocols. Meta-analysis was conducted using appropriate statistical methods, with sensitivity and subgroup analyses conducted to assess robustness and variability. Results: Symptom improvement was comparable between ETV and VPS, with lower major complications associated with ETV. Mortality and postoperative complications favored ETV, although VPS exhibited lower CSF leakage risk. Overall success rates were similar, but ETV demonstrated superior safety profiles. Subgroup analyses revealed variations based on patient characteristics. Conclusion: ETV and VPS are effective in achieving symptomatic relief and radiological resolution of hydrocephalus, with ETV demonstrating superior safety profiles. Shared decision-making considering patient factors is crucial in selecting the most appropriate treatment approach. Further research is warranted to refine treatment algorithms and optimize outcomes for hydrocephalus patients.
Abstract: Introduction: Hydrocephalus, characterized by abnormal cerebrospinal fluid (CSF) accumulation, presents significant challenges requiring timely intervention to prevent neurological complications. Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) are primary surgical options, yet their relative efficacy and safety remain...
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Research Article
Proposal of Music Therapy Protocol for Ataxic Patients
Yuri Giffoni*
,
Rita de Cassia Moura
Issue:
Volume 8, Issue 2, June 2024
Pages:
26-31
Received:
14 August 2024
Accepted:
20 September 2024
Published:
29 September 2024
Abstract: Neurologic music therapy has been studied as an alternative methodology to stimulate neurological patients in a motor rehabilitation process. It uses music and its elements in a feedback-feedforward system, promoting an environment for neuroplasticity and re-learning of movements. Research to evaluate the use of neurologic music therapy in patients with ataxia due to Parkinson's and Stroke diseases has shown positive impacts on function rehabilitation, resulting in improvements in activities of daily living and life quality self-perception. The main goals for patients with ataxia described in available research are related to the positive impact on gait function, limb movements, speech, and postural impairment. The most commonly used techniques in neurologic music therapy research are Therapeutical Instrumental Music Performance (TIMP) and Rhythmic Auditory Stimulation (RAS). Literature indicates that both techniques are typically studied independently. Research on the application of neurologic music therapy to ataxic patients, whether due to genetic factors or acquired cerebellar damage, as well as protocols to assist music therapists in implementing these methodologies, are not available. The objective of this study is to propose a music therapy protocol for patients with ataxia from any disease or acquired, using neurologic music therapy and its techniques (TIMP and RAS), to measure the contribution in reducing impacts of ataxia in motor functions, improving patients’ autonomy in daily living activities and as a consequence higher life quality self-perception, also contributing to increasing literature availability regarding this theme. For protocol application feasibility and considering ataxia prevalence in the total population, an experimental group of 15 patients diagnosed with ataxia without impairment on auditory systems will be designed.
Abstract: Neurologic music therapy has been studied as an alternative methodology to stimulate neurological patients in a motor rehabilitation process. It uses music and its elements in a feedback-feedforward system, promoting an environment for neuroplasticity and re-learning of movements. Research to evaluate the use of neurologic music therapy in patients...
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