Acta neurochirurgica
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Acta neurochirurgica · Sep 2014
Surgical treatment of intraparenchymal hemorrhage during mechanical circulatory support for heart-failure--a single-centre experience.
Cranial intraparenchymal hemorrhage represents a critical complication of mechanical circulatory support requiring constant antithrombotic treatment. Surgery of intraparenchymal hemorrhage under anticoagulation represents a challenge and imposes significant risks for patients. It was the aim to analyse surgical and clinical outcome of patients requiring surgical treatment due to intraparenchymal hemorrhage. ⋯ Surgical treatment of life threatening, space-occupying intraparenchymal hemorrhage under mechanical circulation support is of limited efficacy with high rates of recurrent hemorrhage and in-hospital mortality. We provide additional data that postponing anticoagulation is feasible and may lead to improved clinical outcome and survival.
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Acta neurochirurgica · Sep 2014
No exacerbation of perihematomal edema with intraclot urokinase in patients with spontaneous intracerebral hemorrhage.
Perihematomal edema (PHE) can worsen patient outcomes after spontaneous intracerebral hemorrhage (ICH). Minimally invasive surgery (MIS) in combination with thrombolytic removal of hematoma has been proven to be a promising treatment strategy. However, preclinical studies have suggested that intraclot thrombolysis may exacerbate PHE after ICH. Herein, we investigated the effects of MIS and urokinase on PHE. ⋯ Hematoma evacuation using MIS leads to a significant reduction in PHE. Furthermore, the use of urokinase does not exacerbate PHE, making its hypothesized proedematous effects unlikely when the thrombolytic is administered directly into the clot.
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Acta neurochirurgica · Sep 2014
Comparative StudyMid-term outcome of intracranial aneurysms treated with HydroSoft coils compared to historical controls treated with bare platinum coils: a single-center experience.
HydroSoft (MicroVention, Aliso Viejo, CA), a hydrogel-platinum coil hybrid device, is one of various efforts to overcome recanalization of coiled intracranial aneurysms. The purpose of this study was to evaluate the efficacy and safety of the HydroSoft coils in patients with intracranial aneurysms, and to compare the 12-month outcomes with that of bare platinum coils. ⋯ Coil embolization using HydroSoft coils achieves higher volumetric packing density. Twelve-month follow-up data favors HydroSoft coils, with lower retreatment rates.
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Acta neurochirurgica · Sep 2014
Critical age affecting 1-year functional outcome in elderly patients aged ≥ 70 years with aneurysmal subarachnoid hemorrhage.
While advanced age is already recognized as an independent risk factor for a poor functional outcome following an aneurysmal subarachnoid hemorrhage (SAH), it is also important to investigate the critical age for defining a higher risk population among elderly patients and the clinical grade at admission in order to provide a prognostic description and help guide the management of patients aged ≥ 70 years. ⋯ The long-term outcome for elderly patients with an aneurysmal SAH is affected primarily by the clinical condition at admission and the patient's age in relation to the critical age (> 75 years), regardless of the treatment modalities, including surgical clipping and endovascular coiling.