Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Jul 2008
Prevalence and impact of pain in neurological inpatients of a German teaching hospital.
The authors sought to determine the prevalence of pain among neurological inpatients and the impact of pain on psychological and social variables depending on severity and chronicity of pain. ⋯ This study documents a high prevalence of pain with high grades of pain severity and chronicity in neurological inpatients. Pain presents a major problem as a secondary comorbid condition among neurological inpatients.
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Clin Neurol Neurosurg · Jul 2008
Potential value of radionuclide cisternography in diagnosis and management planning of spontaneous intracranial hypotension.
Spontaneous intracranial hypotension (SIH) is caused by spontaneous spinal cerebrospinal fluid (CSF) leaks. However, there is debate regarding clinical indication of radionuclide cisternography (RNC) for identification of the actual site of a CSF leak. We therefore investigated the potential value of RNC in SIH. ⋯ RNC is useful for diagnosis and better management planning of SIH.
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The natural history of giant intracranial aneurysms is generally morbid. Mortality and morbidity associated with giant aneurysms is also higher than for smaller aneurysms. This study was carried out to assess the demographic profile, presenting features, complications, and outcome after surgical treatment of giant intracranial aneurysms. ⋯ It is concluded that 14% of all intracranial aneurysms are giant. The most common clinical presentation is SAH followed by features of an intracranial mass lesion. The cavernous ICA is the most common portion of the ICA affected. Direct surgical clipping is a safe and effective method of treatment and should be considered the first line of treatment whenever possible. With proper case selection, optimal radiological evaluation, and appropriate surgical strategy, it is possible to achieve a favorable outcome in almost 90% of the cases.
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Clin Neurol Neurosurg · Jul 2008
Trigemino-cardiac reflex: the trigeminal depressor responses during skull base surgery.
To observe and analyze the occurrence and management of the trigemino-cardiac reflex (TCR) defined as the phenomenon of abrupt drops in heart rate (HR) and blood pressure during skull base surgery. ⋯ (1) Manipulation at or near the trigeminal nerve during the skull base surgery may cause TCR, even if premedication with anticholinergic drug is used; (2) cessation of irritation from surgical manipulation to disrupt the reflex is the most important step to offset TCR; (3) continuous, especially repeated TCR in some rare cases occasionally necessitates the administration of high dose atropine.