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Chronic subdural haematoma (CSDH) is a common neurosurgical condition. Burr-hole for drainage is an effective treatment. However, recurrence can be up to 8–33% and is associated with morbidities and mortalities. The underlying pathogenesis was postulated to be localised inflammation and pathological aberrant vessels formation. Atorvastatin, an HMG-CoA reductase inhibitor, is a type of lipid-lowering medication. In animal studies and a preliminary clinical trial, Atorvastatin was shown to be effective in the treatment of CSDH. It was found to inhibit inflammation and promote vascular maturation at the neomembrane of CSDH. Our study aimed to investigate the efficacy of Atorvastatin in CSDH. During the study period from January to December 2014, Atorvastatin was used in 12 CSDH patients with Glasgow Coma Scale (GCS) 13–15 or Markwalder’s Grading Scale (MGS) Grade 0–2. They were retrospectively compared with GCS- and MGS-matched controls who had not used statin. Improvement with haematoma resolution at 3 months was 75% (9/12) for the Atorvastatin group, versus 42% (5/12) for the Control group (p = 0.0977). The risk of deterioration requiring burr-hole drainage was 16.7% (2/12) in the Atorvastatin group, versus 58.3% (7/12) in the Control group (p = 0.0447). The Odds Ratio (OR) of deterioration requiring burr-hole drainage with Atorvastatin was 0.143 (95%CI: 0.021–0.958), which favours the use of Atorvastatin in CSDH (p = 0.0451). The Number needed to treat (NNT) was 2.4 (p = 0.0447; 95%CI: 1.31–14.93). In conclusion, this retrospective cohort comparison study has shown that CSDH with Atorvastatin had a lower rate of deterioration and burr-hole drainage. [ABSTRACT FROM PUBLISHER]

Introduction. It has been theorised that the relationship between smaller body size and smaller ruptured intracranial aneurysms in Asians indirectly supports the treatment of small, unruptured intracranial aneurysms. There has also been uncertainty regarding whether the progress that has been made in neuroimaging allows for better detection of smaller ruptured intracranial saccular aneurysms. Therefore, we conducted this systemic review of ruptured intracranial saccular aneurysm sizes according to region and time. Material and Methods. Computerised MEDLINE and PubMed searches of the literature for population-based studies of ruptured intracranial saccular aneurysms were carried out from 1 January 1980 to 1 March 2011. Statistical analyses were generated using SPSS for Windows, Version 15.0 (SPSS Inc., Chicago, IL) and Comprehensive MetaAnalysis 2.0 for Windows (Biostat, Englewood, NJ). The results of the meta-analyses are presented with 95% confidence intervals (CIs). Results. Six eligible population- or hospital-based studies were analysed. The percentage of ruptured intracranial aneurysms measuring less than 5 mm was 28.4% (95% CI: 18.1% to 41.6%, I2 = 98%). The percentage of ruptured intracranial aneurysms measuring less than 10 mm was 76.7% (95% CI: 69.2% to 82.9%, I2 = 89%). A higher proportion of patients with ruptured intracranial aneurysms of less than 5 mm was found in Asia compared to other regions. Similarly, a higher proportion of patients with ruptured intracranial aneurysms of less than 10 mm was found in Asia compared to other regions. Conclusions. The present findings suggest that ruptured intracranial aneurysms are smaller in Asians and should be confirmed in future prospective international multi-centre registries to assess ethnicity. Whether these findings support treating smaller unruptured intracranial aneurysms in Asians should be investigated. [ABSTRACT FROM AUTHOR]

Background: Ocular dominance is the superiority or preference of one eye over the other in terms of sighting, sensory function (for example, visual acuity) or persistence in binocular rivalry. There is poor agreement between sighting and sensory dominance and findings are equivocal on the possible neural basis of ocular dominance and its significance. Thus, there are questions on the meaning and importance of ocular dominance. Despite the lack of clarity in this area, ocular dominance is used clinically, for example, as the basis for decisions on monovision in contact lens wear and on treatment of anomalies of binocular vision. Methods: Sighting dominance and three types of sensory dominance (based on resolution acuity, contrast sensitivity and alignment sensitivity) were compared within individuals, with the main aim of determining whether sensory dominance is consistent across spatial visual functions. Results: Our findings indicate that each type of sensory dominance is insignificant in most individuals and in agreement with previous work that sensory and sighting dominance do not generally agree. Conclusion: These results demonstrate not only that different types of ocular dominance are not in agreement but also that in the normal visual system sensory dominance as measured here is insignificant in most individuals with normal vision. [ABSTRACT FROM AUTHOR]