Acta neurochirurgica
-
Acta neurochirurgica · Nov 2009
Review Case ReportsRecovery from paraplegia after the treatment of spinal dural arteriovenous fistula: case report and review of the literature.
Spinal dural arteriovenous fistula (SDAVF) is a rare and enigmatic disease. Functional outcome is particularly uncertain for the small group of patients that are unable to stand at the time of diagnosis (grade 5 gait disturbance on the Aminoff-Logue scale, ALS). The objective of this study is to examine the final functional outcome of patients with SDAVF in grade 5 gait ALS before treatment. ⋯ Interruption of SDAVF in paraplegic patients may improve the final functional gait outcome in some cases. No complete recovery (grade 0 gait ALS) was achieved after treatment. Micturition disturbances had a worse prognosis than motor deficits.
-
Acta neurochirurgica · Nov 2009
First experimental results with a new waterjet dissector: Erbejet 2.
Waterjet dissection represents a useful technique for many surgical procedures. In this experimental study, the technical features and dissection qualities of the new Erbejet 2 with its new pump and nozzle applicator system are evaluated for its neurosurgical use compared to the established Helix Hydro-Jet. ⋯ The new Erbejet 2 is more precise, with almost linear correlation of pressure and dissection depth compared to the Helix Hydro-Jet. Less foaming and the possible application of various separating media are a considerable advantage. All things considered, the new Erbejet 2 offers more options to enlarge the field of neurosurgical indications for waterjet dissection.
-
Acta neurochirurgica · Nov 2009
Clinical TrialFocal cerebral oxygenation and neurological outcome with or without brain tissue oxygen-guided therapy in patients with traumatic brain injury.
In patients with severe traumatic brain injury (TBI), the depth and duration of cerebral hypoxia are independent predictors of outcome. This study aimed to evaluate the efficacy of brain oxygen-guided therapy in improving cerebral oxygenation and neurological outcome in severe TBI patients. ⋯ In TBI patients, brain tissue oxygen-guided therapy is associated with decreased duration of episodes of cerebral hypoxia. Larger studies are indicated to determine the effects of this therapy on neurological outcome.
-
Acta neurochirurgica · Nov 2009
Combination of bone marrow stromal cell transplantation with mobilization by granulocyte-colony stimulating factor promotes functional recovery after spinal cord transection.
Spinal cord injury (SCI) results in severe neurological deficit. However, the functional recovery following SCI is very poor due to the neural lost and limited axonal regeneration. To date, there was no effective treatment. Recent studies have shown that bone marrow stromal cells (BMSCs) transplantated into the central nervous system (CNS) can survive and differentiate into neuronal-like cells. Additionally, granulocyte colony-stimulating factor (G-CSF) can mobilize hematopoietic stem cells and inhibit neural cell apoptosis. Thus, we aimed to evaluate the combined effect of BMSC transplantation and G-CSF administration on rats with traverse spinal cord injury. ⋯ The animals with the combination treatment achieved a better functional and morphologic recovery, although partial. This synergistic effect between BMSCs and G-CSF may be attributed to extrinsic and endogenous neurogenesis in the traverse spinal cord injury.